No subject is being changed. The assertion introduced in the root comment is about the effectiveness of public shaming as a means to sustain social order. There are many good replies arguing against that notion.
It is also the peak of naïveté to assume any mechanism of social control will remain restricted to our pet favorite cause. Isn’t that what every discussion here about encryption backdooors ends up concluding?
Actually my writing was bad, I didn’t even mean being ashamed of taking drugs, I meant being ashamed of doing socially harmful things that are often drug-abuse-adjacent in the USA.
Being ashamed of being an addict could lead to avoidance of treatment, so that might be a better example of a negative outcome of shame.