Stigma surrounding addiction remains as strong as ever in the 21st century. The cultural bias against people suffering from this disease contributes to thousands of deaths every year.
Writing for the National Institute on Drug Abuse, Dr. Nora Volkow articulates the problem more clearly. Though gains have been made in reducing the negative perception of many other medical issues such as mental illness, cancer and HIV, “little progress has been made in removing the stigma around substance use disorders. People with addiction continue to be blamed for their disease.” The bottom line is that while the medical profession has long recognized that drug addiction is a disease involving a complex syndrome of brain disorders and dysfunctional behavior, “the public and even many in healthcare and the justice system continue to view (addiction) as a result of moral weakness and flawed character.” It is time to put an end to this societal attitude that increases the suffering of victims struggling with addiction.
A few years ago, Canada’s Centre for Addiction and Mental Health launched its “Stigma of Addiction” project. Its goal was to identify strategies to send anti-stigma messages to the public. Literature reviews, meticulous trials and, most importantly, the voices of people directly affected by stigma guided this project.
In the project, the core question, “What does stigma mean to you?” elicited telling responses. Various participants experienced highly charged emotions surrounding the perceptions of self-hatred, disgrace, embarrassment and shame. Many reported wanting to conceal the problem instead of seeking much needed help after experiencing different treatment and negative judgment from friends, family and caregivers. Society’s judgment was found to be no less kind — victims found great difficulty in seeking public services such as housing, medical care and employment networks (their condition often causing unemployment in the first place). The project also found that negative labels would continue to haunt individuals both personally and socially even after they sought help, further complicating the journey to recovery.
People who were stigmatized the most included those who use illegal drugs, especially crack cocaine and heroin. Women, especially those who are pregnant or have children, people of lower socioeconomic status, the elderly or the young and Native people notably headed those stigmatized groups. Fighting the stigma of addiction therefore becomes a key element in fighting socioeconomic inequality in our societies as a whole.
Socioeconomic complexities temporarily put aside, combating the stigma surrounding addiction includes two main steps. The first is to recognize that addiction is a disease, not a moral failing. DrugAbuse.gov defines addiction as “a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her.” While the decision to take drugs is at first voluntary for most, “repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with the ability to resist intense urges to take drugs.” Further research has proven that addiction causes physical changes in the normal functioning of the brain. Again, its main characteristic is that it creates a compulsive and overwhelming drive to continue using harmful substances. This scientifically notable rewiring of the brain classifies addiction as a genuine disease rather than a mere bad habit. The decision-making abilities found in healthy people are not present in those suffering from addiction.
The second step involves educating the public that addiction is a disease by working to remove the stereotypes that accompany ignorance. The American Psychiatric Association no longer uses the term “addiction” as a diagnosis; instead, the phrase “substance use disorder” describes a continuum of problems related to habitual and compulsive use of addictive substances. That reclassification was an effort to remove the stigma attached to the disease of substance use. To restate, classifying addiction as a disease can have a strong influence on removing the stigma surrounding addiction. Educating people — the general public, students and health care professionals — can help to focus on media inaccuracies and biases; show why addiction causes self-sustaining problems and relapses; and promote empathy by portraying people with substance use problems as human beings who need help. Health care and public officials could devise more personalized substance-use recovery routes for individuals through testimonials of well-known spokespeople, who can raise awareness that substance use problems can affect anyone.
Fortunately, states such as California have begun to devote resources to fighting the scourge of drugs and addiction. According to the Surgeon General’s Report on Alcohol, Drugs and Health, however, still only about 10% of people with a substance use disorder seek or receive any type of treatment. Removing the stigmas and stereotypes surrounding addiction could go a long way in incentivizing people to seek treatment.