“I think once I made up my mind that I was allergic to alcohol, and that’s what I learned, it made sense to me. And I think it was kind of pointed out that you know if you were allergic to strawberries, you wouldn’t eat strawberries. And that made sense to me.” — Betty Ford
More than 1,800 commemorative stamps have been issued since the first in 1893. Out of the roughly 50,000 submissions for inclusion in the program, the US Postal Service Citizens Stamp Advisory Committee last year selected 80 subjects to highlight in the stamp program using a stringent selection criterion. No stamp is considered for issuance if one treating the same subject has been issued in the past 50 years. There are now three stamps that have been issued in relation to SUDs by the US Postal Service. The first was the 8 cent Prevent Drug Abuse Stamp in 1971. The 1981, “Alcoholism – You Can Beat It.” stamp, and on April 5th, 2024 Betty Ford Stamp Reveal, commemorating one of America’s best known and most influential recovery advocates, Betty Ford. Each represents the use of a fundamental media source to communicate a message about substance use by presenting images associated with substance use prevention, treatment, or recovery efforts. In my estimation, the Betty Ford stamp is easily the best of the bunch.
The 1971 Stamp focuses on the harms of substance use in ways that in hindsight are recognized as counterproductive. It shows a person crouched on the ground in apparent misery with a blue background. Cold colored and sad. As a young person raised in this era, I can recall that a lot of media efforts focused on the harms of drugs and often depicted pathology, needles, pills and death. The subtext is that weak, dumb or flawed persons are at risk, perhaps most illustrative of this media strategy is the “this is Your Brain on Drugs” prevention video released in the 80s.
The second is the 1981 “Alcoholism – You Can Beat It” I wrote about this last Fall. It was issued at a time when national advocacy groups were relatively strong, and headway was being made in respect to developing services and improving public perceptions about alcohol and other substance dependence. It was a debacle and became known as the least successful commemorative stamp in US History. It shows us we are prone to a profound underestimation of the levels of stigma about alcoholism specifically and addiction in general across our society.
There were 97,535,000 million of the “Alcoholism You Can Beat It” stamps issued. It seemed like a good design with a lot of media fanfare. The New York Times published an article about the stamp, noting it was designed by John Boyd of Anagraphics, Inc., of New York City. The National Council on Alcoholism (NCA), the most active organizations in the space was deeply invested in the campaign. The NCA even had prepared a first-day cover cachet to accompany the new stamp, available for a contribution of $5.
The campaign, intended to support treatment for alcoholism, became the most disastrous stamp issue in the history of the US Postal Service. The campaign was an abject failure. The general public refused to use the stamp. People were afraid that if they put it on an envelope and sent it to someone that the person would think that they were being judged as being alcoholic, or even that someone may think that the sender had a problem with alcohol. Pervasive societal stigma killed a campaign intended to reduce societal stigma. The US Postal Service ended up destroying most of the nine million stamps. Negative perceptions about us run that deep through our society.
This week, we will see our first stamp commemorating a recovery advocate. The reason that the Betty Ford stamp is perfect is that she personified courage to talk about things America had long not spoken of. She was an advocate across multiple issues, most notable women’s rights. First Lady Ford was open about her diagnosis and treatment of breast cancer when such things were simply not done. And then she became an advocate for recovery. On April 21st, 1978, she released a statement to the press “I have found I am not only addicted to the medication I have been taking for my arthritis but also to alcohol” She had decided bravely to show us what recovery looks like. The image above is my favorite one of Betty Ford on the last day that she was First Lady, January 19th, 1977. The photo was her idea. It speaks volumes about who she was and what she accomplished. It is no accident that just under a decade later, on my first day of recovery, I recalled her message of hope and recovery to all Americans.
In this video clip, Susan Ford Bales and others gathered at the White House talking about the former First Lady and her courage in openly facing addiction and her struggles under the bright lights of the press. By doing so, she opened the door for millions of people to dare to hope for a better life. There is an excellent piece by Jeremiah Gardner of the Hazelden Betty Ford Foundation commemorating the recent event at the White House and the official reveal on April 5th that will take place in Rancho Mirage, California. What I appreciate most about the piece is that it provides a history and context of efforts to elevate public awareness about prevention treatment and recovery from substance use disorders.
Betty Ford navigated the perils of being open about substance use conditions and so many of us benefited. Being open about recovery can also have risks. William White, Danielle Tarino and I put together a paper in 2021 considering the risks and related ethics of sharing recovery status, titled Personal privacy and public recovery advocacy to explore issues related to being open about recovery. More recently, Alexandra Plante wrote about similar themes in The Double-Edged Sword: Lived Experience, Tokenism and the Portrayal of Addiction Recovery Stories. For being open about recovery during Operation Understanding in 1976, Mercedes McCambridge stood up and quoted Abraham Lincoln’s Temperance speech to the Washingtonians from 1842 and noted that Lincoln was right. She was blacklisted from Hollywood for it.
As noted by Jeremiah Gardner, the US Postal Service (USPS) reached out prior to the release to ensure it was done properly. They have a Citizens’ Stamp Advisory Committee with criteria they consider before a commemorative stamp is issued. We should require the same for all groups who use people’s recovery stories in order to ensure that it is done to high ethical standards. It would require that no federal dollars be permitted to be used for campaigns to share recovery stories that have not undergone a process like an IRB prior to use. An ethics panel that reviews our stories for use in media to promote the SUD treatment industry in order to protect people from “harm in the name of help.” A Recovery Story Media Review Board (RSMRB) overseen by people in recovery aware of the potential risks who do not stand to gain in any material way by such solicited disclosures.
People like Betty Ford have made great inroads on changing these views, but we have a very long way to go. Stigma against people with substance use disorders remains deeply entrenched in our society. This creates profound risks for people who decide to be open about their struggles. In April 2022, Elveyst and PRO-A released a report highlighting high levels of perceived social stigma against People Who Use Drugs or are In Recovery (PWUD/IR). How Bad Is It, Really? Stigma Against Drug Use and Recovery in the United States. The key takeaway is that perceived societal stigma about people like us remains highly prevalent. We conducted a second survey with an additional report, Opportunities for Change, An analysis of drug use and recovery stigma in the U.S. healthcare system. It is the largest research survey to date assessing endorsed and perceived substance use and recovery stigma expressed by U.S. healthcare workers, as compared to non-healthcare workers. We found pervasive negative perceptions in that survey as well.
Jeremiah Gardner terms these three stamps as “an unofficial trilogy of prevention, treatment, and recovery stamps.” There is a clear progression of messaging here. They shift from a focus on pathology to the power of recovery to transform lives. My own story may illustrate this point on the power of messaging focused on recovery and the role Betty Ford had in my own recovery process. I had been exposed to a constant barrage in my teen years of how dangerous and bad drugs were. It had zero impact on me. On that first day of recovery, as I grappled with the possibility of what it meant to be addicted, I thought about the example of Betty Ford. I don’t think I even knew of another person who was open about recovery in this era. She gave me hope on that day. I wish I could have thanked her.
The stamp series and how the USPS uses an ethics process to consider how our stories are used is important to consider how to message hope of healing most effectively. Positive messaging of hope, consistent with the understanding that communities of recovery are to be included in how and where our stories are used is vital to ensuring we move forward in the direction of recovery for all Americans who experience a severe substance use condition.
To the First Lady of the US Recovery Movement – thank you First Lady Ford for being open about recovery when few were. By instilling hope and living out loud in recovery, you saved thousands of lives, including my own.
Sources
Betty Ford Stamp Reveal. (2024). The White House YouTube Channel. https://www.youtube.com/watch?v=FA6pEN3mSMA
Boom, R. (1983). Sociological Aspects of the Disease Concept of Alcoholism. In: Research Advances in Alcohol and Drug Problems. Research Advances in Alcohol and Drug Problems, vol 7. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3626-6_2
Christensen, M. D. (2007, January 29). Commemorative Postage stamps: History, selection criteria … Congressional Research Service. https://crsreports.congress.gov/product/pdf/RS/RS20221/12
Citizens Stamp Advisory Committee – Who we are – About.usps.com. (n.d.). About.usps.com. https://about.usps.com/who/csac/
Fleming, R. Fogler, S., Stauffer, W., & Sargent, R. H. (April 2022). STIGMA AGAINST DRUG USE AND RECOVERY IN THE UNITED STATES HOW BAD IS IT, REALLY? https://pro-a.org/wp-content/uploads/2022/08/How-Bad-is-it-Really_-Stigma-Against-Drug-Use-And-Recovery-In-The-United-States-2.pdf
Fleming, R. Fogler, S., Stauffer, W., & Sargent, R. H. (February 2023). OPPORTUNITIES FOR CHANGE – An analysis of drug use and recovery stigma in the U.S. healthcare system. https://pro-a.org/wp-content/uploads/2023/02/Opportunities-for-Change-An-analysis-of-drug-use-and-recovery-stigma-in-the-U.S.-healthcare-system-3.pdf
Hazelden Betty Ford Foundation. (2024, March 20). New Betty Ford stamp completes unofficial trilogy of prevention, treatment and recovery stamps. Medium. https://hazeldenbettyford.medium.com/new-betty-ford-stamp-completes-trilogy-of-prevention-treatment-and-recovery-stamps-04bfe073e39b
MacPherson, M., & Radcliffe, D. (1978, April 22). Betty Ford Says That She Is Addicted to Alcohol. Washington Post. https://www.washingtonpost.com/archive/politics/1978/04/22/betty-ford-says-that-she-is-addicted-to-alcohol/bd6734d3-0ea1-4eb2-ab97-7279ca6dcc3d/
Menezes, R. (2022, November 22). The Post Office Regretted Designing This Anti-Drinking Stamp. Cracked.com. https://www.cracked.com/article_36048_the-post-office-regretted-designing-this-anti-drinking-stamp.html
Mercedes McCambridge – 1976 Clip on Vimeo. (1976, May 8). https://player.vimeo.com/video/165727067?byline=0&portrait=0
One of the Most Scandalous Stamps Issued in the US. (2018, December 16). Oldbid.com. Retrieved August 30, 2023, from https://oldbid.com/news/coins-stamps/one-of-the-most-scandalous-stamps-issued-in-the-us/
Plante, A. (2023, May 25). The Double-Edge Sword: Lived Experience, Tokenism and the Portrayal of Addiction Recovery Stories. National Council for Mental Wellbeing. https://www.thenationalcouncil.org/the-double-edged-sword/
Smithsonian Magazine. (2008). Betty Ford’s Tabled Resolution. Smithsonian Magazine. https://www.smithsonianmag.com/history/betty-fords-tabled-resolution-47091868/
Stauffer, W. (2023, September 17). The 1981 “Alcoholism – You Can Beat It!” USPS Stamp Debacle: Lessons Moving Forward. https://recoveryreview.blog/2023/09/17/the-1981-alcoholism-you-can-beat-it-usps-stamp-debacle-lessons-moving-forward/
Tower, S. A. (1981, August 9). STAMPS; NEW ISSUE DESIGNED TO COMBAT ALCHOLISM. The New York Times. https://www.nytimes.com/1981/08/09/arts/stamps-new-issue-designed-to-combat-alcholism.html
White, W., Stauffer, B., & Tarino, D. (2021). Personal privacy and public recovery advocacy. https://www.chestnut.org/resources/0cde861e-468b-459e-bd88-fbfd4fa546f1/Privacy-Paper-Final-1.pdf
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When I worked there she would come to the center and have the Secret Service sit in the front and she would be escorted around the campus by John Schwarzlose, the director. She was sensitive to patient confidentiality and didn’t want the trappings or airs of her position. She gave lectures to the patient community and was very open and humble. I had the privilege of attending some fundraisers with the likes of Sammy Davis, Jr. and Liza Minnelli as the entertainment. Gerald Ford and her were not pretentious people and they both were humble and he deferred to the programs being about the center and her great contributions to it. She was a wonderful lady and a true pioneer in our field. What a class act and I am thrilled with the stamp in her recognition.
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