Melissa Shackleford has been in addiction recovery for 37 years. She got sober as a college freshman, went on to spend a decade as SVP of Marketing at Hazelden Betty Ford, and built a career at the intersection of healthcare marketing and behavioral health. She is a TEDx speaker, Amazon #1 bestselling author of Harnessing Purpose, and founder of Shackleford Strategies.

In this conversation with Dr. John Hsu and William Pedranti, Melissa breaks down why stigma is not just a cultural problem but a clinical one. She's seen it from both sides: as a person in long-term recovery and as the marketing executive who had to fight to remove stigmatizing language from Hazelden's own outreach materials.

What they cover:

• Why the language we use determines whether someone seeks help or disappears
• The person-first language shift and why it matters beyond addiction
• The Gallup and Shatterproof stigma studies and what the data reveals about how little has changed
• Why doctors call OUD patients "difficult" when no one says that about diabetics who won't follow their diet
• The buprenorphine shame problem inside 12-step recovery communities
• Medicaid's 8-to-9-month wait for OUD treatment and who loses their life in that window
• Why pharmacies refusing to stock MOUD medications is a form of stigma with real body counts
• What Hazelden Betty Ford got right about messaging: lead with hope, not shock
• John's La Joya house: giving six bedrooms to a sober living facility because no neighborhood wants treatment next door
• The one change Melissa asks every doctor, pharmacist, and family member to make

Chapters:
00:00 Introduction and Melissa's background
02:30 Getting sober at 18: what that looked like
05:00 Why person-first language is not political, it's medical
08:00 The parking lot pill count story (and what it says about how we treat patients)
10:00 Stigma inside the recovery community: buprenorphine and 12-step
15:30 MAT stigma and the barriers it creates
17:00 Medicaid pays 80% of OUD treatment, then makes patients wait 9 months
18:40 John's sober living house and the "not in my backyard" problem
20:00 Why OUD patients are labeled "difficult" when no chronic condition patient is
22:00 Long-term MAT: the three schools of thought
24:00 How the drug supply changed: from prescription opioids to fentanyl-laced everything
25:00 Treating the body and the mind: why medication alone is not recovery
26:00 MAT and the work requirement trap: losing Medicaid means losing medication
28:00 Pharmacies that refuse to stock MOUD medications
28:44 These medications reduce overdose-related death by more than 50%
31:00 OUD providers keeping secret lists of pharmacies that will fill prescriptions
32:00 Trust as the currency of healthcare
33:00 Hazelden's messaging strategy: pull out stigmatizing imagery entirely
35:00 People call treatment centers on the worst day of their life
37:00 The one thing to change: use person-first language
40:00 Addiction is not a choice, it's not a moral failing
41:00 Cancer has pink ribbons. Why does addiction still carry shame?
43:00 About Shackleford Strategies and how to connect with Melissa
44:10 Closing

Connect with Melissa Shackleford:
LinkedIn: linkedin.com/in/melissashackleford
Website: https://melissaforsshackelford.com/

About The Saving Dose:
The Saving Dose is a podcast about what it actually takes to close the gap between the medication adherence crisis and the patients who need care. Hosted by Dr. John Hsu, an anesthesiologist and pain management physician with 25 years of experience, and William Pedranti, a healthcare attorney and biotech operator who has taken companies from founding through FDA approval and commercial exit.

New episodes every Tuesday. Subscribe on Spotify, Apple Podcasts, and YouTube.

The Saving Dose is produced by iPill Adherence Tech Services. All content is for educational and informational purposes only and does not constitute medical advice.