Voices of Hope: The Lived Experiences of Substance Use Recovery
Researchers at Duke University School of Nursing are empowering those in recovery from substance use disorder to tell their own stories, advocating for change in rural communities.
Faculty at the Duke University School of Nursing are leading a research project that amplifies the voices of people with substance use disorders, bringing attention to treatment and recovery in local, rural communities.
Since 2015, rural areas have experienced a surge in drug overdose rates, surpassing those in urban centers. These communities face unique challenges, including limited access to healthcare providers and treatment facilities, geographic isolation, stigma, and fear of legal repercussions for people seeking emergency help.
Utilizing a research method called photovoice, Assistant Professor Marissa Abram, PhD, PMHNP-BC, CARN-AP, FIAAN, Associate Professor Devon Noonan, PhD, MPH, FNP-BC, CARN, FAAN, and their co-investigators invited study participants to take photographs that represented their lived experiences. In one-on-one interviews and group sessions, participants shared and discussed their photos, combining narrative with visual expression.
“Stigma stems from misunderstanding,” said Dr. Abram. “Addiction is a chronic, treatable medical condition, not a sign of weakness or lack of willpower. When we treat it with compassion and science—not judgment—we open the door to healing and recovery.”
The photovoice project culminated in a public exhibition hosted at Edgecombe Community College, in partnership with the Edgecombe County Community Paramedic Program (ECCPP) and Carolina Family Health Centers, Inc. In addition to local community members and substance use recovery advocates, the event drew healthcare professionals, law enforcement officers, and even government leaders—including North Carolina First Lady Anna Stein, who attended and spoke at the event.
“Seeing the study participants share their voices, stories, and how far they have come with the community they reside in was powerful,” said Courtney Swinkels, the study coordinator. “We are looking forward to continuing our work in this area and future collaborations with our community partners and participants.”
Dr. Noonan, who also serves as Associate Dean of Community Engaged Science at the School of Nursing and as Director of Rural Health Equity at the Center for Nursing Research, emphasized the importance of community partnership and the efficacy of photovoice as a tool of empowerment.
“Partnering with communities to improve health is essential because sustainable and meaningful change begins at the grassroots level,” said Dr. Noonan. “Photovoice empowers communities by sharing their lived experiences through pictures, bringing to light their stories in very meaningful ways.”
In addition to amplifying the voices of individuals in recovery, the team’s goal is to inform improvements in the ECCPP and similar programs, ultimately contributing to the development of more empathetic, accessible, and effective rural health interventions.
“Every person in recovery has a powerful story,” said Dr. Abram. “When individuals share their experiences, it humanizes addiction, fights shame, and inspires others to believe that change is possible. Voices in recovery are voices of hope.”
“Voices in recovery are voices of hope."
- Marissa Abram, Assistant Professor at Duke University School of Nursing