stigma of rehab

What is the Stigma with Addiction? 

The stigma associated is a public health issue. It contributes to the high rates of death, incarceration, and mental health issues among the dependent populations.

In spite of anti-stigma efforts that attempt to educate the public on the fact that addiction is a biologically-based illness like heart disease and diabetes, a study published in the American Journal of Psychiatry shows that the stigma has not decreased. National surveys show that many Americans believe that people with alcohol or drug addiction or schizophrenia are likely to be violent.

What is a stereotype? 

A stereotype is a widely held but fixed and oversimplified image or idea about a particular person or thing. You probably know an addict. Maybe you were one. Maybe you are one. When people hear the word addict, many images come to mind. Depending on whether we’re talking about alcohol or drugs, the description may vary.

Shame Condition

A feeling of shame commonly accompanies substance addictions. This comes from the public stigmatization of addicts, which the addict may come to accept as truth in his mind. The name-calling and stigma place a sense of shame for drug users because of a disease that takes control of them psychologically and physically. 

It is a fact that when people meet, they judge one another and evaluate each other’s behavior and then try to find ways to group each other into ready-made categories. This takes place until more information is given to fill out the actual identity. This process becomes contaminated when the categories become negative stereotypes.

Risks of Addiction Stereotypes

Addiction stereotypes are dangerous for several reasons because:

  • Most addicts don’t fit the stereotype, so they fool themselves into believing that they don’t have a problem.
  • Since they don’t fit the stereotype, family and friends don’t put pressure on them to quit.
  • The addict will be ashamed to admit he is an addict because of the negative stereotype.
  • Family and friends may also be worried about the stigma and feel like they need to hide the addiction.
  • The public, in general, feels less sympathy toward their suffering and may view addicts as bad people and entirely responsible for their situation. 
  • People who experience stigma regarding their drug use are less likely to seek treatment.
  • Perceived stigma in doctors’ offices and hospitals can discourage treatment seeking.

In a study done by Johns Hopkins Bloomberg School of Public Health, the general public was more likely to have negative feelings towards those dealing with drug addiction than those dealing with mental illness. 

SUDs are often treated as a moral and criminal issue instead of a health concern. This is especially true of illegal substances. Using a substance like heroin has not only been deemed deserving of social and moral disapproval, but society has also defined it as a crime.

It is no wonder people with substance use disorders (SUDs) are not admitting it or coming forward for treatment. The 2014 National Survey on Drug Use and Health found that 21.5 million Americans age 12 and older had a substance use disorder in the previous year. However, only 2.5 million received the treatment they needed.

Make Recovery Visible

A study in the journal Social Science & Medicine showed that public portrayals of successfully treated schizophrenia, prescription painkiller addiction, and heroin addiction led to greater belief in the effectiveness of treatment and less willingness to discriminate. 

The movement to make recovery visible will help to destigmatize problem alcohol and drug users and create hope and an avenue for others to follow. The advocacy groups, Faces and Voices of Recovery and Anonymous People/Many Faces1Voice encourage people to come out with their stories of recovery proudly.

In her book Sober for Good, Anne Fletcher’s goal was to boost the addict’s belief that he has what it takes to overcome the problem of addiction and accomplish the goal of sobriety. When she asked Stanford University’s Albert Bandura, Ph.D. how to increase a person’s sense of having the ability to achieve sobriety, he said, “Show them successful role models, others who have struggled to master situations that you fear or see as difficult.”

Peer Support

For this reason, peer support specialists are essential for a person in recovery. Peer support specialists are people with significant life-changing experiences, also referred to as “lived experience.” They support people with struggles related to psychological trauma, mental health or substance use.

Because of their lived experience, peer specialists have the expertise that professional training can’t duplicate. Peer support specialists model effective coping and self-help strategies based on their own recovery experience and support the patient in advocating for himself. 

Words Matter

Commonly used terms like “drug abuse” and “drug abuser” have an association with physical, sexual or emotional abuse. This gives people the idea that people with an addiction “are willfully engaging in substance misuse when in reality they have lost the choice of use.” Says David Eddie, PhD., clinical psychologist at Massachusetts General Hospital’s Recovery Research Institute.

The words we use express what’s normal and frame how health professionals and society in general look at a problem. Clinical psychologists and physicians who, when they heard a patient described as a substance abuser, were more likely to say that punishment was required. If the patient was described as having a substance use disorder, their recommendation was treatment.

According to John Kelly PhD., founder and director of the Recovery Research Institute, “To fight these stigmas, we first need to normalize the process of recovery, providing positive examples of what recovery looks like. When people see that up close, their stereotypes begin to break down.”

Common Public Perceived Stereotypes

Alcoholic Stereotypes

  • Drinks cheap liquor- usually from a brown bag. 
  • Drinks every day and is never sober.
  • He needs to drink as soon as he wakes up.
  • Moves from job to job.
  • Engages in domestic violence.
  • Becomes verbally or physically aggressive in public when intoxicated.
  • Prefer to drink alone.
  • Likely to be estranged from the family.
  • Frequent blackouts.
  • Wears cheap clothing and has poor hygiene.
  • Usually homeless.
  • Is a terrible parent.
  • Over forty years old.

Drug Addict Stereotypes

  • Criminal history and frequent contact with the police.
  • Steal money and belongings from family and friends.
  • Unable to hold a job.
  • Under forty years old.
  • Unable to sustain a relationship
  • No ambition in life.
  • Probably live in a rundown building with other addicts.
  • Spend a lot of time on the “wrong” side of town.
  • Poor hygiene.

Some Facts About Substance Users

  • There are factors such as age, gender, social, and economic status which influence the type of substance a person might use, addiction can happen to almost anyone, for almost any reason, and at any point in their life. Research has shown that the type and number of adverse childhood experiences can harm development later in life. Individuals who struggle with depression and anxiety have a higher risk of having substance use issues.
  • The inability to stop using a substance that causes negative outcomes is better explained by immediate and long-term changes in the brain caused by the substance rather than a defect in character or lack of willpower. Mood altering substances such as alcohol, marijuana, cocaine, and opioids all affect the levels of the chemical dopamine in the brain. Reward pathways in the brain are stimulated more and for longer periods than with normally pleasurable activities like sex. These effects make the user want to use it again in spite of possible consequences.
  • Overcoming addiction isn’t as simple as stopping substance use. Many people think that all the problems created by an SUD will go away once the use stops. But this is actually the time when cravings will be more intense. People who use should never be encouraged to “go cold turkey” without medical supervision.
  • Recovery is an ongoing process. There are many types of recovery programs. Short and long-term residential, intensive outpatient, outpatient, 12-step meetings and more. It is important to realize that relapse may be a part of the long-term process of recovery. 
  • Addiction is not the same for everyone. Cognitive, behavioral, and physiological symptoms and the impact of addiction will be different for different people. Some people can function at a high level and might not even suspect they have an addiction. For others, the impact can be devastating and result in breakdowns in relationships, loss of employment, and financial instability.

Five Reasons Not to Call Someone an Addict

  1. It causes stigma and shame. Labels that are stigmatizing stop people from reaching out for help. The “shame condition” mentioned earlier. But research has shown that the type and number of adverse childhood experiences can have a negative impact on people later in life.
  2. Shame leads to a negative self-image. When a person with an addiction is shamed with labels, they feel terrible about themselves and are not likely to try to achieve their goals.
  3. People see themselves as the problem. When someone is labeled an alcoholic or drug addict, the person is seen as the problem, not an individual struggling with a problem.
  4. It creates helplessness. It can cause negative “self-talk.” “If I’m an addict, then I’ll always be an addict.” Helplessness keeps people turning to alcohol or substances. On the other hand, if that person sees himself as “someone with an addiction,” he may be able also to see himself as “someone without an addiction.”
  5. It ignores all circumstances. We see our own actions as being driven by circumstances. We see others’ behavior as being driven by their personality. By labeling someone as an addict, you ignore their circumstances and blame their actions completely on their personality.

If you know someone who has an addiction, don’t use the “addict” label. Try to see them using the person-first language. If you have and addiction, you should try to see yourself as a person first, with a substance use disorder. Seek out a treatment approach that is shame-free and judgment-free.

Stigma by Association

Sometimes forgotten are the families of people with SUDs. Families experience high levels of guilt and self-blame, particularly parents who start to believe that the upbringing they provided is responsible for substance misuse. Thus, some families stigmatize themselves through feelings of guilt and low self-worth.

Families struggle to express themselves about a family member’s substance use because of the fear of stigma and worry that they won’t be properly understood. Families also experience stigma on a daily basis. When someone in the family uses drugs or alcohol, people can feel anger, betrayal, guilt, fear, isolation, and loss of control. They may be abandoned by friends and other relatives. Sometimes because of their support for the drug user they find themselves isolated from the support they need themselves.  

Obviously, drug use doesn’t just affect the individuals; families are also on the frontline of addiction. They experience stigma about whether or not their family member is in recovery. It is vital that drug and alcohol treatment should include therapy for the family of the substance user who needs support too. 

Evidence shows that treatment is more likely to be effective and recovery sustained when families, partners, and carers are closely involved. Supportive relationships are a key part of successful recovery from drug or alcohol dependence.

Continuing the Misconception

Holding on to the misconceptions about addiction and the people who have substance use disorders allows many people to feel better about themselves and their own sense of inadequacy for whatever reason. Instead of feeling compassion, they feel disgusted.

This stigma has far-reaching negative implications for the object of their disdain, causing increased shame and guilt that makes it even more difficult to reach out for help. Family members continue to struggle with their shame and anger because their loved one won’t “just quit.”

Substance issues are so common today that you probably know someone who is struggling to deal with one. Maybe you are the person with a SUD. You may have experienced the problems substance use can cause to family, work, and personal relationships.

Break Out of the Stereotype

There is a place you can go to overcome the guilt and shame you may feel because of your substance use. Maybe you have a family member or loved one that needs to start the journey to getting sober and living a full life free of addiction.

Coastal Detox is a drug and alcohol detox and treatment center located on Florida’s Treasure Coast. Call us anytime at (866) 924-3350. We offer Medical detox (if necessary), Residential Treatment, an Executive Program, Treatment programs for First Responders, Working Professionals Program, and a comprehensive Recovery Management Program

Our peer specialists will help you on your road to recovery and show you it can be done successfully. Don’t let the stereotypes and stigma stop you from living a full life.

References:

www.alcoholrehab.com

www.ncbi.nlm.nih.gov/articles

www.rehabs.con/pro-talk-articles

www.wikipedia.org

www.apa.org/monitor/2019

www.drugabuse.com/addiction/stigma

www.adfam.org.uk/files/docs

www.psychologytoday.com

www.goodtherapy.org

Content Reviewed by Jacklyn Steward

Jacklyn StewardJacklyn is a Licensed Mental Health Counselor (LMHC) and an EMDR trained trauma therapy specialist with over 6 years of experience in the field of addiction. She has a Masters Degree in Mental Health and Substance Abuse Counseling from Nova Southeastern University.