Fresh Outlook Foundation

Countering Substance-Use Stigma with Compassion

Fresh Outlook Foundation

Chances are you know people affected by substance-use issues. And, odds are even greater that they have experienced the “stigma” caused by society’s uninformed beliefs about them, and negative attitudes directed toward them and their families.

Take Andrea (not a real person, but based on real experiences)… she’s a 35-year-old Vancouverite who has lived with substance-use issues off and on since she was sexually assaulted at age 14. She started smoking marijuana, but quickly escalated to cocaine and then heroine. She says stigma from so-called friends, who frequently call her a “junkie,” has diminished her prospects for recovery. They say she’s “weak” and that her drug use is simply a matter of choice… that she could stop if she really wanted.

Their prejudice and associated hurtful language impact her self-esteem, making it difficult for her to talk about her abuse and addiction, build and maintain positive relationships, and hold a job. She worries that, without help, she’ll end up broke and homeless with no hope of healing.

The upside of Andrea’s story, however, is that her experiences moving forward can be more positive if the people around her, including mental health care professionals, learn more about substance use and show compassion by using respectful language.


Embracing Education, Language and Open-Mindedness

Because stigma is rarely based on facts – but rather on assumptions, preconceptions, and generalizations – its negative consequences can be prevented or lessened through education, appropriate language, and open-mindedness. Here’s how you can help: 

EDUCATION: Learn about drug dependence as a disease deserving of care and treatment like any other medical condition. Drug dependency disrupts regions of the brain responsible for reward, motivation, learning, judgment, and memory. People with dependencies compulsively use one or more substances despite serious health, social, and financial consequences. More broadly, dependency negatively impacts families, workplaces, neighbourhoods, and communities.

For more information click here.  

LANGUAGE: Use neutral, medically accurate terminology when describing substance use and respectful “people-first” language focusing on the individual(s), not the action.

Instead of saying people are “addicts,” “junkies,” “crackheads,” or “users,” say they are “people who use drugs,” or “people with substance-use disorders.” Instead of saying “former drug addicts,” say “people with lived experience,” or “people in recovery.” And, instead of “substance/drug abuse” use “substance/drug use,” “substance-use disorder,” or “drug dependence.” 

OPEN-MINDEDNESS: Don’t judge people who use drugs (e.g., don’t let your biases colour the way you see them). They are not morally inferior. They are not weak and do not lack character. They are sick and need medical help. You don’t know their life stories and have no way of knowing how you would respond in similar situations.


Digging Deeper into Stigma

People with substance-use issues are commonly stigmatized by society’s negative beliefs about them. According to the World Health Organization, stigma is a major cause of discrimination and exclusion, and contributes to the abuse of human rights. Its destructive judging, labelling, and stereotyping behaviours leave people who use drugs with debilitating emotions such as anger, blame, shame, rejection, hopelessness, grief, distress, and isolation. If left unchecked, these feelings can lead to tragic outcomes such as poverty, unemployment, homelessness, and suicide.

People who use drugs most commonly face social stigma, structural stigma, and self-stigma. Experiencing one or more of these often prevents people from getting the important health and social services they need. 

SOCIAL STIGMA is reflected in the negative attitudes directed toward people who use drugs and their families and friends. It includes the use of negative labels in everyday conversation and the media, and the use of negative images of people who use drugs and/or their families and friends. This type of stigma discounts real challenges and opportunities for recovery, and results in people being ignored.

STRUCTURAL STIGMA is social stigma exhibited by public service providers such as first responders, health care professionals, and government representatives. It leads to people with substance-use issues being ignored or not connected to the proper health or social services that most of us take for granted.  It is enabled by health care structures and services that enhance stigma, such as withholding treatment until substance use is better managed. Structural stigma can also affect a person’s ability to find housing and jobs, which in turn affects their overall health and quality of life.

SELF-STIGMA occurs when people with drug dependences internalize social and structural stigmas. They “become” the attitudes and beliefs society has about them, which makes recovery especially difficult.

For more information about stigma and substance use click here.

Joanne de Vries is a communications professional who provides public education and consultation services to businesses, non-profits, and different levels of government. She is one of the principals of Alliance Communications, and the Founder and CEO of the Fresh Outlook Foundation.

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