People who struggle with drug or alcohol addiction have another, unnecessary worry; stigma.

Those who project addiction stigma are usually unaware of what addiction really is. Many consider it a choice – if you choose to take a drug, then you choose to become an addict. However, nobody takes a substance intending to become addicted. Rather, addiction and dependence take over the brain and body like a disease. ¹

Throughout this article, we’re going to identify the stigma of drug addiction and how it negatively affects people who struggle with substance abuse.

What is Stigma?

The Oxford dictionary defines a stigma as “a mark of disgrace associated with a person, a personal quality, or a personal circumstance.”

Under this definition, a stigma defies human rights. It discriminates and belittles a person to the point where they are no longer even considered for an association. This is extremely dangerous for groups of people who desperately need help, such as those struggling with substance abuse. ²

Terms like “junkie,” alcoholic,” or “crackhead” can be discriminatory and defy public perception of what this condition is really about. In turn, this can lead a lack of social effort to help these individuals.

If you’re trying to help a loved one beat drug or alcohol addiction, it’s important to drop these prejudices. The more you carry this derogatory perception, the more you’re going to further away you’ll push your loved one.

What Does Stigma Really Do?

When you use stigma against someone who struggles with drug or alcohol addiction, you’re having a negative impact on the following points:

Their Harm to Others or Self

There’s no denying drug abuse can lead to community dangers. It leads to higher rates of violence, crime, and housing problems. Not to mention, it can destroy families and other relationships. ³ To reduce these harms, many communities incorporate:

• Drug consumption rooms designated to reduce common risks involved with drug use
• Needle exchanges
• Other forms of therapy

When stigma is spread throughout a community, harm reduction strategies often become overlooked. This can snowball into higher rates of harm on that community.

Furthermore, people who abuse drugs or alcohol will sometimes harm themselves. Examples of this include using unsafe needles or actual self-harm tactics due to shame. ⁴ When stigma is perpetuated onto those struggling with addiction, this shame will only continue.

Studies suggest addiction is a family (or community) disease as everyone usually is involved (even if only one person is takes drugs or alcohol). In other words, you (or a community) may be fostering an environment where addictive behaviors can continue. ⁵ Addiction can be fostered when an addict:

• Asking for money
• Causing fights
• Guilt-tripping
• Isolating
• Shifting the blame

As such, this may also be a reason some feel stigma against addiction. However, by enforcing this stigma, you are pushing an addict further into their addiction.

Mental Health

People who struggle with addiction most likely already have or have developed other mental illnesses. In fact, many people initially use a substance to self-medicate from conditions like anxiety and depression. ⁶

When stigma is perpetuated onto this person, they may develop shame for themselves. This is usually caused by the social conflictions one has when it comes to their addiction.

With enough stigma, an addict may eventually break social ties. Through this, they are cutting off what could potentially be a support system for recovery. In effect, they are less likely to take the necessary steps towards treatment. ⁷

Self-isolation can then turn into other mental health concerns. For example, a person may become anxious of other people (social anxiety disorder). ⁸ The shame may become so unbearable, they develop strong feelings of guilt and worthlessness (depression). ⁹ These feelings can become so intense, they may start to think of a way out (suicidal ideation). ¹⁰

Sense of Self

When one’s mental health deteriorates, their sense of self naturally follows. Without any self-esteem or self-worth, a person can go down a path even worse than the addiction itself. They may feel they don’t have the courage for treatment. ¹¹

Most people who perpetuate stigma have the sense that people who struggle with addiction lack self-control. As mentioned, in order to beat a substance abuse disorder, one needs a lot of will power. To garner that will power, it’s vital they have people around them who are willing to support and cheer them on.

Will for Treatment and Recovery

The treatment process for substance abuse disorder isn’t easy. In fact, it’s probably one of the most difficult experiences one can have. On top of that, recovery isn’t just a one-time thing. It’s a lifetime pursuit. ¹²

A reputable treatment facility will stray away from stigma. However, that’s not to say everyone in the medical field holds this perception.

Due to social stigmas, there’s a probability your loved one may enter a facility and face stigma from medical professionals. This kind of behavior has gotten to the point where some hospitals and doctor offices will tell people not to seek out proper healthcare services. ¹³

To fight against stigmas, the Affordable Care Act (ACA) was developed to provide better support to people suffering from disabilities (this includes substance use disorders and addiction treatment).

Stigma Statistics

With all of the above information, you might be asking yourself, just how relevant is this stigma?

According to the 2014 National Survey on Drug Use and Health, about 21.5% (more than 1/5th) of Americans age 12 and older have struggled with a substance abuse disorder at one time or another. Yet, only an estimated 2% of those people receive treatment. This may be due to the stigma still circulating within our society.

These problems are furthered when we look into the criminal justice system. The National Center on Addiction and Substance Abuse (CASA) conducted a study of 2.3 million people who had been jailed for drug crimes. It found that 65% of them struggled with a substance use disorder. Yet, only 11% had received treatment.

What Can You Do to Fight Stigma?

Even if you’ve previously participated in stigma, it’s never too late to reach out and support your loved one. You can accomplish this by:

• Avoiding any associations with stigma and negative attitudes.
• Calling out those who try and put your loved one down for their drug use.
• Conducting research, the more knowledge you have about drug or alcohol addiction, the more likely you’ll be able to help.
• Listening to what your loved one has to say and not judging.
• Offering your loved one a support system.
• Sharing your stories with stigma (if possible).
• Showing acts of kindness, especially in vulnerable situations.
• Treating your loved one with a sense of respect and dignity.
• Viewing your loved one for the individual they are, not by the drug(s) they use.

References

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² Yang LH, Wong LY, Grivel MM, Hasin DS. Stigma and substance use disorders: an international phenomenon. Curr Opin Psychiatry. 2017 Sep;30(5):378-388. doi: 10.1097/YCO.0000000000000351. PMID: 28700360; PMCID: PMC5854406.

³ Sartor R. The social impact of drug abuse on community life. Med Law. 1991;10(2):205-8. PMID: 1886469.

⁴ Chai Y, Luo H, Wei Y, Chan SKW, Man KKC, Yip PSF, Wong ICK, Chan EW. Risk of self-harm or suicide associated with specific drug use disorders, 2004-2016: a population-based cohort study. Addiction. 2022 Jul;117(7):1940-1949. doi: 10.1111/add.15820. Epub 2022 Feb 15. PMID: 35112757.

⁵ Mardani M, Alipour F, Rafiey H, Fallahi-Khoshknab M, Arshi M. Challenges in addiction-affected families: a systematic review of qualitative studies. BMC Psychiatry. 2023 Jun 16;23(1):439. doi: 10.1186/s12888-023-04927-1. PMID: 37328763; PMCID: PMC10273571.

⁶ Harris KM, Edlund MJ. Self-medication of mental health problems: new evidence from a national survey. Health Serv Res. 2005 Feb;40(1):117-34. doi: 10.1111/j.1475-6773.2005.00345.x. PMID: 15663705; PMCID: PMC1361129.

⁷ Ingram I, Kelly PJ, Deane FP, Baker AL, Goh MCW, Raftery DK, Dingle GA. Loneliness among people with substance use problems: A narrative systematic review. Drug Alcohol Rev. 2020 Jul;39(5):447-483. doi: 10.1111/dar.13064. Epub 2020 Apr 20. PMID: 32314504.

⁸ Teo AR, Lerrigo R, Rogers MA. The role of social isolation in social anxiety disorder: a systematic review and meta-analysis. J Anxiety Disord. 2013 May;27(4):353-64. doi: 10.1016/j.janxdis.2013.03.010. Epub 2013 Apr 16. PMID: 23746493.

⁹ Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry. 2023 Jul 21;23(1):527. doi: 10.1186/s12888-023-04991-7. PMID: 37479975; PMCID: PMC10362624.

¹⁰ Calati R, Ferrari C, Brittner M, Oasi O, Olié E, Carvalho AF, Courtet P. Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord. 2019 Feb 15;245:653-667. doi: 10.1016/j.jad.2018.11.022. Epub 2018 Nov 7. PMID: 30445391.

¹¹ Yan F, Costello M, Allen J. Self-Perception and Relative Increases in Substance Use Problems in Early Adulthood. J Drug Issues. 2020 Oct;50(4):538-549. doi: 10.1177/0022042620941812. Epub 2020 Jul 16. PMID: 33746248; PMCID: PMC7978475.

¹² Laudet AB, Savage R, Mahmood D. Pathways to long-term recovery: a preliminary investigation. J Psychoactive Drugs. 2002 Jul-Sep;34(3):305-11. doi: 10.1080/02791072.2002.10399968. PMID: 12422942; PMCID: PMC1852519.

¹³ Rao H, Mahadevappa H, Pillay P, Sessay M, Abraham A, Luty J. A study of stigmatized attitudes towards people with mental health problems among health professionals. J Psychiatr Ment Health Nurs. 2009 Apr;16(3):279-84. doi: 10.1111/j.1365-2850.2008.01369.x. PMID: 19291157.