Shaming the Sick: Stigma and the Damage It Causes

Stigma describes the powerful and negative perceptions usually associated with addiction and substance abuse. It has the power to negatively affect one’s self-esteem, damage relationships with peers, and makes accessing treatment a lot harder for those suffering from addiction. It is by all means a public health issue, as it has a significant contribution to higher death rates, incarceration, and mental health issues among dependent populations.

How Do We Define Stigma?

Stigma is defined as a strong feeling of disapproval that most people in a group or society have about something, like a topic or a group of people. The World Health Organization (WHO) claims that stigma is a major cause of discrimination and it greatly contributes to the abuse of human rights. When someone experiences stigma, they are seen as inferior in one way or another because of their real health status and their perceived health status. It is almost always based on preconceptions and generalizations and therefore its impact can be lessened through education. It causes prejudice, rejection, and discrimination against those who may have socially undesirable traits or may engage in culturally marginalized behaviors, like drug use.

People can have negative feelings towards drug use and they may use derogatory terms such as “junkie” or “crackhead”. These are thoughts, feelings, and labels that can perpetuate stigma.

How Common Is Addiction Stigma?

There are millions of Americans who are addicted to drugs or alcohol and only a small percentage of them receive appropriate treatment. The 2014 National Survey on Drug Use and Health found that over 21 million Americans age 12 and older had suffered a substance use disorder in the previous year and only 2.5 million received the treatment they needed.

Stigma is something that affects us all and at some point in our lives, nearly every one of us has stigmatized others or felt stigmatized. In a study done by Johns Hopkins Bloomberg School of Public Health, people were more likely to have negative attitudes towards those suffering from drug addiction than those who were dealing with mental illness. The study also showed that people are generally unsupportive of insurance, housing, and employment policies meant to benefit people who are dependent on drugs.

Recovery Brands conducted a survey of drug users and participants explained what they wished society understood about addiction. Their answers illustrate the importance of being kind and compassionate:

“Just because I am/was an addict, doesn’t make me a bad person. Deep down inside we are wonderful, loving people.”

“It’s not a matter of willpower or a lack of a moral compass.”

“Addiction is not the entirety of me. I am me; I am not just my addiction. There is a lot of other stuff to love.”

“I wish people saw the time that addicts spent alone. Thinking about everything they’ve done every time they’ve lied and stole.”

Stigma can have a negative impact on harm reduction, willingness to seek treatment, self-esteem, and mental health.

Impact on Harm Reduction

Stigma can have a negative affect on the public’s perception of evidence-based harm reduction strategies such as needle exchanges, substitution therapies, and safe drug consumption rooms.

Because of the widespread stigma surrounding drug users, these strategies are not usually supported by the public and they are believed to actually facilitate and encourage drug use, despite evidence to the contrary.

Impact on Treatment

People who are experiencing stigma about their drug use are less likely to seek treatment and this ultimately results in economic, social, and medical costs. In the United States, for example, the costs associated with untreated addiction (including costs related to healthcare, criminal justice, and lost productivity) amount to over $500 billion.

Stigma in hospitals or doctors’ offices can also have a significantly discouraging effect on people that can keep them from accessing needed healthcare services. Some studies have found that some healthcare providers don’t feel comfortable working with people who are addicted to drugs. In a study conducted on nurses, the majority had negative feelings and views about drug users. When healthcare professionals carry a stigma towards those with drug dependencies, it can negatively impact their willingness to help them, the way they approach them, and it may even prevent drug abusers to seek treatment.

The Social and Mental Impact

Perceived stigma can have a significant harmful effect on people and their social lives as the stress of discrimination can damage their social and mental health. Drug abusers can feel like they are pushed to the outskirts of society and they may lose touch with their communities and their families, experiencing loneliness and isolation.

Someone with no social ties or a person to talk to is less likely to seek treatment, while at the same time being more likely to suffer from depression and hide their drug use from healthcare providers to avoid stigma. The consequences that isolation can have on mental health may lead to even more drug use, and thus to further isolation, creating a vicious cycle that is extremely difficult to break out of.

Perceived stigma can also be internalized, as drug users can see themselves as deviants, which can have a negative effect on their self-esteem. Drug addiction has historically been viewed as immoral or the consequence of a lack of self-control, and these views contribute to stigma and present barriers in the way of accessing treatment.

Fighting Back

Drug abusers report perceived stigma from healthcare providers, friends and family, and the general public. No one likes to feel judged or devaluated and in order to encourage addicts to reach out for help and seek treatment, it is imperative to reduce the stigma surrounding their situations.

Effective ways to help in reducing stigma include:

  • Being compassionate and supportive.
  • Being kind to people in vulnerable situations.
  • Listening without judging.
  • Seeing beyond a person’s drug use.
  • Educating yourself about drug dependency.
  • Treating addicts with dignity and respect.
  • Avoiding the use of hurtful labels.
  • Replacing negative attitudes towards addicts with evidence-based facts.
  • Speaking up when witness to someone being mistreated because of their drug use.