Living Proof: centering recovery narratives in public health communication

In the United States, stigma about substance use, addiction, and treatment affects people's awareness of and willingness to seek effective services. Additionally, reducing stigma is vital to decrease overdose deaths and implement compassionate policy and practices. To counter prevailing, judgmental attitudes about substance use, the San Francisco Department of Public Health launched the Living Proof campaign in November 2024. The campaign featured testimonials from San Francisco residents with lived experience, who shared their journeys as evidence that treatment works and that recovery is possible. Through January 2026, the campaign generated an estimated 210 million impressions across billboards, transit shelters, radio, local newspapers, and on social media, exceeding projected impressions. Public polling found high rates of message clarity, with 28% of viewers recalling the campaign unaided, 52% endorsing greater sympathy toward people with a substance use disorder, and 44% reporting that they were likely to take action after seeing the campaign. This community case study offers practice-based lessons for other jurisdictions considering their own campaign and highlights the critical importance of valuing lived experience as expertise.