William Stoehr is a prominent artist whose sister died of an overdose. Dr. Nora Volkow is the director of the National Institute on Drug Abuse at the National Institutes of Health.
Together, the artist and the scientist are on a mission to let people know that drug addiction is a disease, not a moral failing.
"Prevention and treatment and recovery can't take place until we get rid of the stigma and people are willing to seek help," Stoehr says.
"If we do not address stigma, we can bring all of the science of the world [and] it will not be utilized," adds Volkow.
It's a team effort.
Volkow, a painter herself, has brought Stoehr to speak about his art with scientists at the NIH.
Stoehr, until COVID-19 arrived, was handing out pamphlets about stigma at his exhibits. And he incorporates what he has learned about brain science into his portraits of people who've been affected by addiction.
The events that brought artist and scientist together began more than a decade ago, when Stoehr saw how the shame associated with addiction was affecting his sister.
"She said once that she was evil," Stoehr says. "Well, she's not evil. She had a disease."
His sister's final relapse came in 2012, after her husband died and she was prescribed opioids to lessen the pain of two unsuccessful back surgeries, Stoehr says.
"There was a bottle next to her, a bottle of vodka, and the opiates," he says. "So it was obvious, and tragic."
Stoehr had once coaxed his sister into rehab by offering to paint her portrait.
After she died, he kept his promise. But he couldn't bring himself to title the work with his sister's real name.
"And so I called it Emma," he says. "And now I continue with the Emma because Emma now has become a stand-in for everyone who is a victim, witness or a survivor."
There are hints of Emma in many of Stoehr's portraits — haunting faces painted with broad strokes on large canvasses.
Eventually, those paintings would lead Stoehr to Volkow, who, as a scientist, was waging her own campaign against stigma.
Substance use disorder has a lot in common with diseases like Alzheimer's, Volkow says. Both alter the brain and both can change a person's behavior.
But society is likely to judge an Alzheimer's patient who asks the same question over and over, she says, "Because you understand that their brain cannot record the memory."
Behaviors sometimes associated with addiction, like lying or stealing, are harder to understand, Volkow says. So it's not enough to merely educate people about the brain circuits that drive these actions.
"I want you to feel the significance of that, to take a stand and say, OK, I now understand why this person is acting this way," she says. "I want you to care for that person, and that's what art does.
Especially William Stoehr's art, which Volkow first encountered in 2020.
"I was struck by the intensity of these images," she says.
When Stoehr and Volkow finally spoke for the first time, the COVID pandemic was raging, and so were overdose deaths.
During that meeting, they found they had a lot in common. Both had a passion for art and brain science. Both saw stigma as a major barrier to treatment of substance use disorder. And both wanted to change society's view of addiction.
"We are coming at this problem from the same place," Stoehr says.
Stoehr wants his portraits to show that addiction affects everyone, and to provoke the sort of conversations that people began having about HIV/AIDS decades ago.
"You had writers and artists, and playwrights and poets and educators and everybody started talking about it," he says. "So they made it OK to talk about this."
Volkow's tool is the growing body of scientific evidence showing that that addiction changes the wiring of a person's brain.
"Having an understanding of how those changes in the brain ultimately affect behavior," she says, "is a key component to get rid of that stigma that a lot of people still have toward addiction."
Stoehr doesn't talk about the brain science of addiction much. But his interactions with brain scientists have influenced his art.
For a decade now, Stoehr has been studying why certain images are more likely to trigger recognition, and emotion, and empathy in the brain.
"Faces with expressive eyes and hands are things that we do have special places in our brain [for] and in many cases we are hard wired to respond to," he says.
So he consciously emphasizes these in his portraits.
Stoehr also harnesses the brain's response to ambiguity. For example, he will paint a slightly different expression on the right side of a face than on the left side.
The effect of that approach was especially dramatic for one woman, who wrote him about her experience.
"She looked at a painting of mine and said that I knew exactly how she felt," he says, "and that she wanted to die. The next day she looked at the very same painting and saw hope in the woman's eyes."
In her note, the woman told Stoehr, "You saved my life."
That sort of emotional response is why Volkow invited Stoehr to share his art and his thoughts on stigma at an NIH awards ceremony a few months ago.
"To the extent that art can make us understand and feel something in a different way, it has succeeded," she says.