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Family

The surgeon general wants to permanently change the way we think about addiction.

Jess Keefe didn't know her brother Matt had a drug problem until he was rushed to the hospital in 2011.

His hand was swelling up, he was in pain, and no one knew what it was. After days of tests and close watching, Matt was diagnosed with an infection caused by intravenous drug use. A brain scan revealed the culprit: heroin.

"He was very much in denial," Jess explains. "He didn’t want to acknowledge what was happening and was very resistant to treatment of any kind."


Matt Keefe. Photo courtesy of Jess Keefe.

In the coming weeks, Jess and her family tried as hard as they could to get Matt into a recovery center but to no avail. None of the detox and rehab centers in their area had space for him. Matt was sent home to his parents with a firm verbal prescription: Stop doing drugs.

Tragically, it didn't work. Matt recovered temporarily, but eventually started using again and died of an overdose on Oct. 5, 2015, at the age of 26.

Despite the fact that drug addiction affects tens of millions of Americans every year, treatment for it is remarkably hard to come by.

More than 100 Americans die from drug overdoses every day, making it the number one cause of accidental death in the United States — more than car accidents and gun deaths, according to CDC reports. Overdoses from opiates like heroin and prescription painkillers have quadrupled since 1999.

This neighborhood in Staten Island has a high rate of heroin use. Photo by Spencer Platt/Getty Images.

Despite those high numbers, only about 10% of people with substance abuse disorders receive specialty treatment for their addictions.

Filling the enormous gap between the necessity and availability of treatment requires a massive overhaul of our medical, educational, and criminal justice systems. The first step, though, is the same one that people have to take when they enter addiction recovery: We have to acknowledge that we have a problem.

In a new landmark report, Vivek Murthy became the first U.S. surgeon general to call America's addiction problem what it is: a public health crisis.

The report, released in November 2016, urges a paradigm shift in the way we think of and treat addiction. In it, Murthy calls on the United States to stop thinking of substance abuse as a "moral failing" and approach it instead it as a brain disease that is identifiable, preventable, and treatable.

U.S. Surgeon General Vivek Murthy speaking with President Obama in 2015. Photo by Andrew Harrer-Pool/Getty Images.

"We must help everyone see that addiction is not a character flaw," the report says. "It is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer."

Jess Keefe, who now works as an editor for Shatterproof, an addiction-focused nonprofit, says she is "thrilled" by the report, which was released a little over a year after her brother's overdose. "I can’t emphasize enough how exciting that is to people who are affected by this disease personally, and people who work in the sort of space that I do."

Addiction in America has reached critical mass, and it's taken decades to fully acknowledge it. So what's been holding us back?

People don't die from addiction, Jess says. They die from shame. "That's the thing that really kills people. They feel like they can’t reach out or get resources when they need them because its something that's driven into the dark corners."

Photo by David McNew/Getty Images.

Jess' brother, Matt, for example, hid his addiction from his family until it landed him in the emergency room. Even after, he continued hiding it, holding down a nine-to-five job all the way until the day he died.

Human beings have a long history of stigmatizing diseases we don't fully understand — from leprosy, to cancer, to AIDS in the 1980s. The results of that stigma can be devastating and far-reaching, especially when it persists for generations. Stigma and shame are what keep people with addictions from coming forward to seek help and why doctors and recovery systems can be unprepared to handle those patients when they do.

Until the systems are fixed, until the stigma is addressed, people like Matt will continue to feel discouraged from asking for help, and people will continue to die.

Like any massive problem, solving America's addiction crisis will require a lot of time and dedication, but Murthy has taken a major step forward.

The surgeon general is the highest ranking doctor in the United States, and his acknowledgement of addiction as a public health epidemic will no doubt lead to the medical community having more of the resources and training necessary to fight it

Photo by Jessica McGowan/Getty Images.

The surgeon general's report, however, is just the beginning. The rest of the fight is largely up to us.

Our part in destigmatizing addiction begins with the words we use, says Jess. Instead of calling someone an "addict," for example, which can carry harmful connotations, we can say "person with addiction" or "person with a substance abuse disorder." That small shift in language helps recontextualize addiction as a disease that a person has, rather than their unshakable identity.

When someone stops doing drugs, calling them "clean" carries an implication that the alternative is dirty. "If someone's not using, they’re 'in recovery,'" suggests Jess. "Stuff like that actually has a big impact on how society perceives people with these problems and also how people with these problems perceive themselves."

Photo by Spencer Platt/Getty Images.

The real battle is the one that needs to happen in our minds and in our hearts. Chances are we all know someone, or will know someone, who will face a substance abuse disorder. Thinking of that individual not as someone who's made terrible judgements but as someone with a treatable disease of the brain will help us all provide support and empathy for people in need.

Treating addiction with compassion instead of judgment isn't just the right thing to do; it could be life-saving.

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

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It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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