This is eighth post in this particular Series, which comes from my book Our Recovery Stories: Journeys from Drug and Alcohol Addiction. It ties in nicely with a previous blog, Nothing to mourn; just a drug addict, by Dr David McCartney.
Stigma can be defined as social disapproval of personal characteristics, actions or beliefs that go against the cultural norm. It can occur at a variety of levels in society, i.e. individuals, groups, organisations and systems. A person can be labelled by their problem (e.g. addiction to drugs and/or alcohol) and they are no longer seen as an individual, but as part of a stereotyped group, e.g. a junkie, alkie, etc. Negative attitudes and beliefs toward this group create prejudice which leads to negative actions and discrimination.
For example, people addicted to heroin are often considered to be carriers of hepatitis C and other blood-borne viruses, thieves who rob old ladies of their handbags, and dirty, weak-willed junkies who will never get over their problems. ‘Once a junkie, always a junkie’ is a saying I’ve even heard in discussions amongst drug treatment agency workers. Our Wired In research has not only shown the strong prejudice that exists towards heroin users, but also towards recovering heroin addicts.
Stigma can impact on a person with a substance use problem, or someone on a recovery journey, in various ways. It can create feelings of shame, blame, self-disgust, self-hatred and hopelessness, and impact badly on self-esteem and self-efficacy. The person may isolate themselves, or remain in the drug-using community for fear of being judged and treated badly by other so-called ‘normal’ people. They may decide to avoid looking for help for the same reasons. External stigma has become internal stigma—both forms of stigma are barriers to recovery.
Family members are also affected by stigma, in the sense that they are fearful of being blamed or held responsible for their family member’s addiction, or they are upset by the way that their family member is treated by other members of society.
‘The worst thing for me was the attitudes of some of my work colleagues. It’s very strange because I work in a caring profession in the health service, but some of the attitudes of workers were truly awful. Over the time that Kevin was an inpatient, I heard that the staff had been gossiping about him, not only on their ward but on other wards. They discussed Kevin and our whole family in a very derogatory manner. Much of what they said was unfounded or damn right untrue. I find it incredible that they can break confidentiality with other members of staff.
I was angry and hurt and felt dreadfully bad for Kevin. He was desperately ill and they were discussing him in such a malevolent way. Gossiping, saying, ‘Why hasn’t his father visited?’, or ‘His sister has cut him off?’, which was quite untrue at that time….
… People are really unaware of the deeper issues surrounding addiction. I would have thought the people I was close to at work would have understood. Yet all they could say was, ‘She should cut him out of her life.’ I actually had someone say that to me, not in a nasty way, but thinking that she was being helpful. I took it as well-intentioned, because she wasn’t malicious, but I said, ‘There’s no way I could do that, he’s my son.’ Kerry
Society needs to change in order to help more people recover from addiction. People who have recovered, or are recovering from serious substance use problems, can become advocates and contribute by helping communities transform into environments that are more accepting of people who have developed substance use problems, and ensure that treatment and other support services eradicate stigma and discrimination towards people who are trying to recover from their problems. Such advocacy can facilitate personal recovery, as well as indirectly facilitate recovery in others.
‘I believe that if there wasn’t such a massive stigma attached to addiction, then more people would be inclined to seek help. As it is, a lot of addicts wait until they hit a rock bottom or two, before they finally get so desperate that they have no choice but to ask for assistance.
As a society, we need to foster an environment of sympathy and support, rather than judgement and blame, in order that people are able to ask for help sooner. We should encourage people rather than sanction them for admitting they have a problem. Addicts should not have to wait until they have lost everything, including any self-esteem they once had, and are so desperately mired in shame that death or recovery are the only options.
We also need more role models who are prepared to stand up publicly and show that they are not ashamed of being recovering addicts, because there is nothing to be ashamed about. I only understand as much as I do about addiction because others were prepared to share their knowledge with me. I only knew that recovery was possible, and desirable, because of examples of other alcoholics who had found recovery. But we need to bring that message out of the dimly-lit church halls and into the open for everyone to see. It shouldn’t be hidden away, obscure and hard to access. The message should be loud and clear, so that it is accessible to everyone.’ Beth
In saying this, it must be recognised that some recovering people prefer less visible, direct, or explicit ways of dealing with stigma, such as ‘passing for normal’, only confessing current or past problems to people they trust. Some of these people may avoid professional treatment because they have experienced prejudice, or feel they have been judged negatively, in such services, and turn to peer support groups. Recovering addicts are far less likely to be judgemental and prejudiced.
Ultimately, each individual will find what suits them best during their recovery journey. What is important is that the person feels good about themselves and proud of what they have achieved. They must find places in the community that allow them to feel in this way. They must have role models. They must learn ways to overcome the negative attitudes of others. They must know when they deserve better and stand up for themselves when they are being mistreated.
I leave this section with the words of Gabor Maté from his book In the Realm of Hungry Ghosts [1]:
‘Addicts are locked into addiction not only by their painful past and distressing present but equally by their bleak view of the future as well. They cannot envision the real possibility of sobriety, of a life governed by values rather than by immediate survival needs and by desperation to escape physical and mental suffering. They are unable to develop compassion towards themselves and their bodies while they are regarded as outcasts, hunted as enemies, and treated like human refuse.’
[1] Gabor Maté MD, In the Realm of Hungry Ghosts: Close Encounters with Addiction, North Atlantic Books, USA, 2008.
The photograph used in this blog post was by Andrew Wolff and has come from Unsplash, a great resource of free high resolution photographs.
