The most critical key to reducing the stigma around addiction is understanding that addiction is a complicated disease of the brain, not a moral failing. Odds are, many people you know deal directly with addiction. One in seven Americans suffers from a substance use disorder. People with substance use disorder come from all walks of life.
Addiction is often borne out of circumstances beyond one’s control, like genetics, environment, trauma, or another medical condition. Far from a weakness of character, addiction has been defined as a disease by the American Medical Association since 1956. We know that other illnesses do not discriminate by social standing, morality, class, or the size of one’s bank account — addiction is no different. Unfortunately, society is still struggling to catch up with that fact.
This stigma doesn’t only hurt people struggling with addiction by making them feel ostracized; it can also amplify or revive drug use in someone who is trying to recover. Isolation is a significant component of addiction, meaning social rejection can quickly drive someone with a substance use disorder (SUD) back to drug use or prevent them from seeking treatment in the first place.
Stigma isn’t limited to how others treat people with a SUD. Those of us battling addiction also have to fight the internalized, learned stigma that we have against ourselves. Fighting these misconceptions is one of the most important things we can all do in the battle against addiction.
Getting Over Your Own Reservations
If you are a person with a substance use disorder, you likely know how deeply ingrained stigma can be even in the mind of a drug user. It is much easier said than done, but it is important not to allow internalized stigma to prevent you from seeking treatment. Society’s bias can bury itself in our minds about our disease, and that bias often keeps us using. When we are hesitant to seek help for fear of rejection, we lose another battle in the war against our disease.
You may be feeling like you failed your loved ones. This is a hard one for many of us to get over. The reality is that you have failed no one. You may have done things that deserve an apology, and you may even have some trust-building to do, but at the end of the day, you are not your disease. Your disease is to blame, not you.
And on top of that, it is not your fault that you have this disease. You wouldn’t feel like you failed your family if you had diabetes or cancer, would you? Don’t believe this disease is any different.
It’s not unusual when you’re in the thrall of active addiction to feel like you are doomed; like there is no way out. This kind of feeling comes, for many, from internalized stigma. Conversations around recovery with people who don’t understand addiction often don’t inspire much hope. The reality is, that there is hope. Millions of people are walking around this earth, fully clean and sober, living a substantial life in recovery. You are not doomed to continue this cycle. There is a way out, and if it has worked for many of us, it can work for you, too.
Stigma leads to shame, and shame can make us increase our substance use to drown out our feelings or isolate ourselves from others to avoid them finding out. It can lead to anger and lashing out to prevent being rejected or cause us to disguise our condition or its severity. This shame, in short, will always make our disease worse. The key to understanding and overcoming shame is to know that our illness does not define us. We are not our actions, and we do not have to dwell in the past. Joining a recovery program, working with a therapist, meditating, and living in the present can all help overcome shame. It’s easier said than done, but seeking treatment is an excellent way to get started.
What Does Stigma Look Like?
Disparaging terms and misinformed language. Language is powerful. Even if a person means well, their words can be unintentionally harmful. Certain words imply that a person suffering from SUD is at fault or somehow lesser-than. In the recovery community, we try to use language that humanizes the person rather than defining them by their disease. Here are some good places to start:
- Instead of: abuse, try saying: use or misuse.
- Instead of: addict, user, drunk, or junkie, try saying: a person with substance use disorder or person in active use.
- Instead of: former addict, try saying: person in recovery
- Instead of: habit, try saying: substance use disorder or addiction
Reduced quality of healthcare. Being a person in active addiction or recovery can make navigating the healthcare system difficult, to say the least. The stigma can be carried by healthcare workers, no matter how skilled and professional they are. It can lead to being misdiagnosed, improperly medicated, prematurely discharged (or held too long), ignored, or distrusted. This stigma is hard to combat, but you can protect yourself. Advocate for yourself, get second opinions when you can, and find a doctor you trust and respect. It is vital to always be honest and open with doctors about your substance use disorder, so don’t let the potential of facing stigma from them deter you from fully disclosing your history of substance use.
Barriers to success in life. Many of us who have struggled with a SUD experience anxiety when it comes time to do things like looking for a new job or rejoining the dating pool. We fear our history of addiction, past mistakes, or maybe even criminal history will negatively impact how people view us. Ultimately, it is up to you how much you share of your history and with whom you share it. It’s an essential part of who you are, and you don’t owe your deeply personal medical details to anyone. If a criminal history is an unavoidable topic with your potential employer, use it as an opportunity to show how hard you’ve worked to overcome your disease. Similarly, you may worry about the stigma associated with letting an employer know that you’re choosing to enter treatment. Know that being honest about this will afford you some job protections as you seek treatment, but it is your choice if and how much to disclose.
Being treated as an outcast socially due to negative and incorrect impressions society has of addicts. Fighting the stigma starts with ending these misconceptions and freeing people with SUD from the confines of stigma.
- Misconception: People with SUD are weak.
Reality: People with SUD have a disease, just like any other disease, and it is not their fault that they have it. There is no weakness in being ill, and opening up about addiction and seeking treatment is a courageous and strong thing to do. - Misconception: People with SUD are morally bankrupt.
Reality: (say it with us) addiction is not a disease of character. It is a medical condition of the body and mind and means nothing about the moral state of the people who have it. - Misconception: Relapse means you failed.
Reality: Relapse is not a failure — it is a normal part of recovery and nothing to be ashamed of. If you relapse, it means you’re trying, and that is only to be commended. - Misconception: Overdose is a sign of hopelessness.
Reality: Overdose is a terrifying, dangerous thing that can happen to anyone for many reasons. But it does not mean someone is doomed to die from drug use or live the rest of their life in the thrall of addiction. True, lives are claimed far too early by overdose every day. But people come back from overdose every day, too. The advent of Naloxone and other rapid-response treatments is changing the odds in our favor. Overdose can even be a turning point for many people with SUD. It is often the very wake-up call many of us need to seek treatment and start a life of recovery. - Misconception: Certain types of people with addiction are worse than others.
Reality: Using heroin, for instance, does not make someone “worse” than someone suffering from alcoholism. Regardless of the substance used, all people with SUD have the same disease, and we all hope for recovery.
How We Can Fight the Stigma
The most important reason for spreading awareness and fighting stigma is to save lives. It’s important to understand that the fallout from stigma is often responsible for creating the behaviors that are so stigmatized. Here are some ways to fight against it, both within yourself and in society, and some key things to understand about addiction:
- Fight your internalized stigma by treating your SUD and working to understand yourself. Self-reflection, therapy, and getting honest with yourself to understand the things in your life that led you down the path of addiction can all help.
- Talk with others about your experience with addiction. It’s normal to be afraid of telling others. Unfortunately, we know that stigma can create significant social, professional, and other barriers. But if you’re comfortable sharing your story, you make it possible for others to share theirs. Community is vital in recovery, so anything we can do to make others feel less alone helps. AA, NA, Al-Anon, SMART Recovery — these networks make a difference. There is strength in feeling understood.
- Use person-first language. Humanize the disease and, if appropriate, correct others when they use counterproductive terms to de-stigmatize the disease.
- Education saves lives. The more people understand the disease; the better society will be at helping fight it. Broader education means more people will store naloxone, assist others when they’re in trouble, and make it easier for people to reach out for help.
- Share messages of hope and positivity. It is possible to live a full life in recovery, and it is important for everyone to know it.
- Reducing stigma amongst medical professionals improves health outcomes. The better the medical community is at understanding and helping people with SUD, the better treatment we will receive. It is critical to train medical professionals to treat people with SUD with compassion and dignity and understand their unique medical needs.
The takeaway is that we all have a role to play in fixing this problem. Stigma is one of the most significant barriers we face in the battle against addiction. It starts with you if you are one in seven people facing a SUD by fighting the stigma you’ve internalized. Don’t let it stop you from seeking treatment that could save your life. If you are one of the lucky ones who is not personally struggling with addiction, you have a role to play, too. Advocate for those of us who are in active addiction or recovery. Elevate our voices and help us fight for change. The more open we can be about this disease, the better we will be at fighting it. If you or a loved one are considering treatment, give us a call to see how we can help.
Resources:
- (1) https://www.cdc.gov/stopoverdose/stigma/index.html
- (2) https://www.hopkinsmedicine.org/stigma-of-addiction/
From the JourneyPure team where we get to explore a wide variety of substance abuse- and mental health-related topics. With years of experience working alongside those suffering from substance abuse and mental health issues, we bring important messages with unparalleled knowledge of addiction, mental health problems, and the issues they cause.