During a contentious, argumentative debate, one moment stood out for many: During a conversation about his son Hunter Biden's prior drug use, former Vice President and Democratic presidential nominee Joe Biden took a moment to look at the camera and acknowledge his son's struggles in a way that advocates say can reduce the stigma around drug use.
During an attack on Biden's son, Donald J. Trump said that Hunter was "thrown out of the military" and "dishonorably discharged" for "cocaine use." Hunter was discharged from the Navy Reserve in February 2014 after failing a drug test in 2013; however, it was an administrative discharge, not a dishonorable one.
"My son, like a lot of people at home, had a drug problem," Biden said, speaking directly into the camera. "He's overtaking it. He's fixed it. He's worked on it. And I'm proud of him. I'm proud of my son."
Dr. Sarah Wakeman, an addiction medicine specialist at Massachusetts General Hospital in Boston and the medical director for the hospital's substance use disorders initiative, called Biden's commentary a "powerful message."
"I think it was great to see Biden talk about his son with pride and really send the message to everyone who's listening that substance use disorder is not something that families should be ashamed about or that people should be ashamed about, that this is something we can talk about, that this is a health condition," she said. "To hear that declared nationally was a powerful message."
"Reducing stigma, changing the way that we talk about it, changing the perception of people who have a substance use disorder, is the foundation of saving many, many lives," said Gary Mendell, the chief executive officer of Shatterproof, a national nonprofit organization based in Connecticut focusing on reversing the addiction crisis in the U.S.
"Words matter," Mendell said.
On social media, many who are in recovery or whose families have been touched by addiction said they appreciated Biden's response.
"Biden looking directly into the camera to say how proud he is of his son in recovery is the kind of clip that might seem insignificant in the grand scheme of things — but for anyone who loves one of the 20 million Americans with substance use disorders, wow oh wow what a moment," wrote author Amanda Litman.
According to survey data collected by the National Survey on Drug Use and Health, more than 20.3 million Americans dealt with addiction, also known as substance use disorder, in 2018.
Litman's post garnered hundreds of comments, with many sharing their own personal experiences with substance use disorder.
Others highlighted just how many Americans are affected by drug use.
Trump's own family has been touched by addiction. His brother, Fred Trump Jr., passed away in 1981 at 42 and struggled with alcoholism during his life. The president has said his brother had a "tremendous impact" on him, and in 2017, when he declared the opioid crisis a public health emergency, opened up a bit about his brother's struggles.
"He had a very, very, very tough life because of alcohol, believe me, very, very tough life," Trump said in 2017. "He was a strong guy, but it was a tough, tough thing that he was going through."
Doctors and experts also took to social media to talk about how Biden's response could help reduce the stigma that surrounds substance use disorder.
"I didn't want to let it go by unsaid: Substance use disorders should be met with compassion and care, not stigmatizing language and scorn. By anyone," wrote Dr. Esther Choo, an emergency physician.
"Thank you @JoeBiden for helping to fight the deeply entrenched and harmful stigma of addiction last night," wrote Dr. Jason Reed, a psychologist who specializes in addiction.
Wakeman highlighted that stigma can be a major reason why people don't seek treatment, citing a federal report published in 2016 that said only 10% of those with a substance use disorder receive specialized care.
"Stigma and discrimination is probably the biggest barrier when we think about addressing the overdose crisis and fundamentally reimagine our system of care for people who use drugs and people with addiction across the country," Wakeman explained. "...Nine out of 10 people who have a treatable health condition are not even getting treatment and one of the main reasons for that is stigma."