People who struggle with addictions are often marginalized, as stigma related to addictions appears to have become very strong over time. Due to the intensity of this stigma other related issues have arisen. Over time, these issues have escalated to a point of becoming a public health issue, as they have been contributing to high rates of death, incarceration, and mental health concerns among dependent populations. This is why changing our perspective on addictions is very important.
Impacts of Addiction Stigma
We live in a society where many people struggle with addictions. However, only a small percentage seeks out treatment. Why?
In a study done by Johns Hopkins Bloomberg School of Public Health, the general public was more likely to have negative attitudes towards those dealing with drug addiction than those who were dealing with mental illness. Additionally, researchers found that people don’t generally support insurance, housing, and employment policies that benefited people who were dependent on drugs (JHU, 2014). It seems that these reasons have a detrimental impact on the decisions of the dependent population to seek out treatment, as well as access to healthcare in general. Perceived stigma in hospitals or doctors’ offices can discourage people from accessing needed healthcare services.
Having a trusted primary care doctor is associated with maintaining well-being and a good quality of life. However, studies have found that some health care providers feel uncomfortable when working with dependent populations. In a study of nurses’ attitudes towards patients, the majority of nurses held negative views about people who used drugs (Howard & Chung, 2000).
Stigma also has a detrimental impact on the self-concept of dependent populations as they often struggle with self-esteem, in addition to a number of other mental health struggles. More specifically, perceived stigma can be internalized. People who use drugs can view themselves as deviants; this can severely impact their self-esteem and self-worth. Historically, a dependence on drugs has been viewed as immoral or the result of a lack of self-control. These views contribute to stigma and present barriers to people accessing necessary treatment. In addition to this, the dependant population often experiences feelings of guilt and shame. These feelings often result in social isolation, which may fuel the addictions and lead to further isolation. This has a tendency to become a vicious cycle that is hard to break out.
Stigma also has a negative impact on harm-reduction effectiveness. This includes harm-reduction strategies such as needle exchanges, substitution therapies, etc. Due to widespread stigma about those who use drugs and who suffer from addiction, however, these interventions are not usually supported by the public and believed by some to facilitate and encourage drug use – despite evidence demonstrating that they actually decrease drug use (Logan & Marlatt, 2010).
Fighting Back Against Stigma
In order to effectively resolve the detrimental impacts of stigma, it is important to fight it actively. This primarily means increasing our knowledge of addictions, which will, in turn, help us to change our perspective on addictions.
Many people do not understand why or how other people become addicted. It is often mistakenly assumed that addicts lack moral principles or willpower and that they could stop abusing substances simply by choosing to change their behavior. In reality, addictions are a complex disease, and quitting takes more than good intentions or a strong will.
In this regard, it is important to know that addiction is 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. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs.
Addiction as a Disease
Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begins abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.
Furthermore, addiction involves changes in the functioning of the brain and body. These changes may be brought on by risky substance use or may pre-exist. The consequences of untreated addiction often include other physical and mental health disorders that require medical attention. If left untreated over time, addiction becomes more severe, disabling and life-threatening.
Changing our perspective on addictions through increasing the knowledge about them is the first step in fighting the addictions stigma. The process of including the knowledge can include factual data about what substance abuse is; warning signs of addiction; information about how alcohol and specific drugs affect the mind and body; the consequences that addiction can have on one’s physical and mental health, family, relationships, and other areas of functioning; and how and why substances are abused. It may also include information on how to deal with a family member or friend who is struggling with a substance use disorder, and how to be supportive during the detoxification and rehabilitation process.
This aforementioned can be done through participation in various psychoeducational programs, as well as therapeutic education – which may help everyone involved in it – from the dependent individual to his family and friends.
Howard, M. O., & Chung, S. S. (2000). Nurses' attitudes toward substance misusers. I. Surveys. Substance use & misuse, 35(3), 347-365.
Johns Hopkins HUB. (October 1, 2014). Drug addiction viewed more negatively than mental illness, Johns Hopkins study shows.
Logan, D. E., & Marlatt, G. A. (2010). Harm reduction therapy: A practice-friendly review of research. Journal of clinical psychology, 66(2), 201.