Drug overdose is the #1 cause of accidental death in America, recently surpassing car crashes(1), and nearly 9 out of 10 people who need help never receive treatment.(2) Stigma directly fuels this crisis in three major ways.
Stigma isolates people.
Stigma and shame make addiction a lonely experience. Substance use disorder is the #1 most socially-disapproved-of medical condition that exists.(3) Public perceptions of drug users as bad, reckless, irresponsible people means individuals with substance use disorders are less likely to come forward and seek help. They could lose family, friends, their job, or even go to jail. Instead of talking to loved ones and seeking support, someone with a substance use disorder is more likely to withdraw from family and friends to hide the addiction.
This isolation and loneliness also ripples out to the family and friends of the person with a substance use disorder. The shame and stigma families feel may prevent them from seeking support for themselves, or help for their loved one.
Stigma discourages people from seeking treatment.
When a person with substance use disorder has internalized the negative stigma of the disease, it directly damages that person's chances of recovery.(4)
What's more, talking about evidence-based treatment options, like medications, in stigmatizing ways—claiming that it's just "replacing one drug with another," that it's not "real" recovery—fuels the harmful stigma that keeps people with addiction from getting the help that they need.
Stigma even impacts how health professionals treat patients.
Negative perceptions of people with substance use disorders are all too common among health professionals.(5) And evidence has shown that negative attitudes among medical professionals directly contribute to worse care.
In a 2009 study(6), researchers asked a group of highly trained mental health and addiction specialists to read one of two written passages. One group read a passage that referred to an individual as a "substance abuser." The other group read a second passage that referred to that same person as "having a substance use disorder." The results show that even a seemingly small difference in wording, like this one, does have a tangible impact. The group who read the "substance abuser" passage were more likely to see the person as deserving of punitive action, like a jail sentence. They were more likely to see the person as personally responsible for their condition—which is obviously a huge barrier to providing real medical treatment.
The "War on Drugs" has been ineffective, costly, and damaging.(7),(8) So the fact that even highly trained, well-educated specialists are more likely to suggest ineffective punitive action based on word-choice alone is very alarming.
In order to provide better access to the evidence-based medical treatment that anyone suffering from a disease deserves, we need to change the way we talk about people with substance use disorders.
1. Fox, Maggie. “Drug Overdoses Spur Rise in Accidental Deaths, Says Report.” NBC News, 19 June 2015. 2. CASAColumbia. Addiction medicine: closing the gap between science and practice. 2012. 3. Goffman, E. “Stigma: Notes on the management of a spoiled identity.” Englewood Cliffs: Prentice-Hall, 1963. 4. Broyles LM, et al. “Confronting Inadvertent Stigma and Pejorative Language in Addiction Scholarship: A Recognition and Response.” Substance Abuse Journal, 2014. 5. van Boekel LC, Brouwers EP, van Weeghel J, Garretsen HF. “Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review.” Drug and alcohol dependence, July 2013 6. Kelly JF, Westerhoff CM. Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. International Journal of Drug Policy, 2009. 7. Drug war statistics. Drug Policy Alliance. 8. Werb D, Kerr T, Nosyk B, etal. The temporal relationship between drug supply indicators: an audit of international government surveillance systems. BMJ Open 2013; 3:e003077.doi:10.1136/bmjopen-2013-003077
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