The Role of Stigma and Addiction and How to Combat It

Stigma is an ancient human mechanism that seeks to enforce the morals of the group by shaming those who seem to be different. It’s a negative social response to the often incorrectly perceived harmful deeds of others.

Particularly in drug and alcohol addiction, stigma not only fails to improve societal conditions but actually makes the addiction crisis much worse. Not only does stigma make it more difficult for addicts to reach out for help, it often results in increased substance abuse.

Addiction Stigma Defined

Stigma is defined simply as a mark of disgrace or condemnation associated with a particular circumstance, characteristic, action, or person. Stigma is an emotional response that one person or a group of people may feel towards the actions or circumstances of another person or group. Stigma is often based on societal norms, laws, cultures, religious beliefs, historical traditions, and other factors.

In the case of addiction, the stigma associated with substance abuse permeates virtually all aspects of human life, including the medical sector, public health policy, the criminal justice system, and the communities that addicts live in. Shaming addicts, holding and expressing negative views of them, condemning them for their addiction, or treating them differently for their drug use all have negative outcomes, often pushing the addict away from potential resources that could help them, often driving them further into patterns of substance abuse.

“As a society, we still keep addiction in the shadows, regarding it as something shameful, reflecting lack of character, weakness of will, or even conscious wrongdoing, not a medical issue.”

Sadly, though the understanding of addiction and how to treat it has evolved considerably in the last century, society as a whole still tends to condemn and harmfully criticize addicts. Quoting NIDA Director Dr. Nora Volkow on the issue of stigma, “As a society, we still keep addiction in the shadows, regarding it as something shameful, reflecting lack of character, weakness of will, or even conscious wrongdoing, not a medical issue.” As long as stigma pervades the societal and cultural response to addiction, addicts will continue to suffer, and the nationwide problem of drug and alcohol abuse will continue unabated.

Why is Stigma Harmful? How Does Stigma Manifest?

Stigma is harmful for many reasons. From Canadian public health research, there are three types of stigma, each of which harms addicts and the communities they live in. The three types of stigma are:

• Self Stigma. This form of stigma occurs when the addict internalizes negative messages about drug addiction, conflating these negative messages and descriptives with themselves. Such can lead to low self-esteem, low self-worth, intense personal criticism, and shame.

• Social Stigma. Social stigma involves other people expressing negative attitudes or behaviors towards people who use drugs and alcohol. These could manifest in the form of critical and harsh messages from loved ones, or they could come from negative messaging in the media. Judgment, discrimination, condemnation, and expulsion from social groups, families, and circles are examples of social stigma.

• Structural Stigma. Structural stigma manifests in public policies, criminal justice laws, and social services that increase stigma rather than reduce it. An example of social stigma would be when healthcare workers do not take addicts seriously or provide them with the proper medical care when they need it. Another example would be when a workplace fires an employee for a recently uncovered drug addiction rather than insisting that the employee get help at a treatment center.

Upon closer inspection, levels and nuances of stigma can be detected in just about every aspect of human life and our regional, societal structures. Unfortunately, stigma has become an ingrained aspect of our communities’ response to addiction. That’s why overcoming stigma and focusing on helping addicts is so crucial.

Other Examples of Stigma Toward Addiction

One of the most common (and harmful) examples of stigma towards addiction manifests in the criminal justice system. Penalizing addicts through incarceration conveys that being addicted to drugs is a criminal inclination, not a serious health crisis. From Dr. Nora Volkow, “When we penalize people who use drugs because of an addiction, we suggest that their use is a character flaw rather than a medical condition. And when we incarcerate addicted individuals, we decrease their access to treatment and exacerbate the personal and societal consequences of their substance use. What’s more, drug laws are disproportionately leveraged against Black people and Black communities, driving societal and health disparities.” Penalizing addicts is wrong, not only because it sends a harmful message that addicts need to keep their addiction a secret or be punished for it, but because the very act of penalizing such individuals does nothing to assist them in overcoming addiction.

“Fear of possible criminal consequences for drug use can shape people’s health decision-making in many
potentially deleterious ways…”

An addiction that goes unnoticed and unaddressed is an addiction that’s more likely to be fatal. Again quoting Dr. Volkow in another article on the subject, “Fear of possible criminal consequences for drug use can shape people’s health decision-making in many potentially deleterious ways. Fear of criminalization can be so serious that addicts would go so far as to conceal it from their doctor, which could have disastrous outcomes. Substance use may be an important fact to consider in a routine medical visit, so its concealment can lead a physician to overlook major factors in a patient’s health.”

Sadly, while addiction can be overcome with the help of quality treatment, addiction, when untreated, is not something an addict has a choice over. If nothing else, the data on skyrocketing overdose deaths should be enough to debunk the harmful stigma that drug addiction is a “choice.”

Addressing Addiction with Compassion is Key

Overcoming addiction involves removing negative judgments levied at addicts and replacing those judgments with compassion. Drug and alcohol addiction is a serious public health crisis affecting millions of Americans. According to the CDC, over 100,000 Americans died from drug overdoses in 2020, the first time in recorded history that the death toll reached six figures. Deaths from alcohol-related health crises are not far behind. Drug and alcohol addiction has become such a lethal crisis that many public health experts attribute substance-related deaths to the recent decline in American life expectancy; the first time life expectancy has fallen since the early-1900s.

Sadly, even though addiction is a life-or-death affliction, Dr. Volkow’s article cited earlier indicates that a very small percentage of addicts ever receive quality addiction treatment. Fewer than 13% of addicts ever avail themselves of treatment, with stigma playing a role in that lack of access to quality care. If an addict is being told he is no good because he is an addict, and if society continues to treat him like a criminal rather than someone who needs help, why would he bother trying to seek help?

Addiction is a physical, mental, emotional, and behavioral crisis that requires specialized, quality treatment. There are many underlying issues intertwined in addiction, with stigma exacerbating an addict’s lived experience. Overcoming all of that takes care, compassion, understanding, and a firm insistence on betterment. If you know someone who is hooked on drugs and alcohol, please do everything you can to reduce, remove, and overcome stigma and make sure they get into a drug and alcohol addiction treatment center as soon as possible.

Sources:

• https://www.drugabuse.gov/about-nida/noras-blog/2021/11/to-end-drug-crisis-bring-addiction-out-shadows
• https://www.canada.ca/en/health-canada/services/opioids/stigma.html
• https://www.statnews.com/2021/08/03/punishing-drug-use-heightens-the-stigma-of-addiction/
• https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm