Thousands of lives are lost each year due to overdose and other medical complications stemming from untreated substance use disorders. For generations, substance use disorders have been shrouded in misconceptions that have kept countless people from seeking help. A strong stigma remains associated with substance abuse, resulting in feelings of personal shame for the afflicted individual and widespread cynicism among the public regarding recovery outcomes.

While some progress has been made in addressing the stigma associated with substance use disorders, those struggling with substance use are still often blamed for their disease, despite the consensus among medical and behavioral health professionals that addiction is a complex brain disorder, not a moral failing. Anticipated and internalized stigma is one of the largest barriers to recovery and must be overcome to combat one of the United States largest public health crises.

What is the Stigma Associated with Substance Use Disorders?

The stigma surrounding substance use disorders occurs at the individual, family, community, and professional levels. Stigma can be defined as a characteristic, behavior, or circumstance that is socially discrediting. [1] Substance use disorders remain one of the most highly stigmatized conditions throughout the world. The stigma surrounding SUD is heavily influenced by the beliefs that addiction is caused by the individual and that the individual should be able to control it. [1]

The stigma associated with substance abuse disorders also stems from the behavioral symptoms associated with the disease. Impairment, erratic behavior, and other common behavioral signs of substance use reinforce public misconceptions about the character of the using individual. These misconceptions often result in discriminatory behavior, maltreatment, and rejection of the person struggling with a substance use issue. [2]

Studies have shown that the stigma associated with SUD results in the following negative outcomes:

  • Reluctance to seek treatment for those dealing with a substance use disorder. [3,4]
  • Reinforced stereotypes of individuals with SUD leading to societal labeling and discriminatory behavior. [4,5]
  • Negatively impacted care for SUD due to provider bias. [2]

Overcoming the Stigma Associated with Substance Use Disorders

Large scale stigma reduction is necessary to ensure access to quality care for those suffering from a substance use disorder. Effective ways to reduce the stigma surrounding substance use disorders include:

  1. Use Person-Centered Language

    The language used to discuss substance use disorders, and those diagnosed with them, should be person-centered and used consistently. [5] Utilizing person-first language works to distinguish the individual from the diagnosis and carries neutral connotations rather than negative labels. [7]

    The list below outlines some de-stigmatizing terminology regarding SUD: [6,7]

    • Person with a substance use disorder
    • Person in active use
    • Person in Recovery
    • Tested positive (on a drug test)/Tested negative (on a drug test)
    • Abstinent from drugs and/or alcohol
    • Substance use disorder

  2. Focus on Education

    Studies have shown that providing educational anti-stigma interventions can reduce stigma surrounding substance use disorders at the structural and personal levels. [9] Educational interventions can be provided to the general public, but have been shown to be most effective in professional settings or as a form of prevention. [8]

    For example, including dedicated course work on substance use disorders was shown to reduce the internal stigma held by the participating medical students.[9] The same principals have held true in studies exploring stigma among healthcare workers and police officers. [9] Reducing stigma in professional settings is vital, as it helps maximize access to quality care for those affected by SUD, which ultimately reduces the tragic consequences of untreated substance use disorders.

  3. Recognize that Recovery is Possible
    Many people who suffered a substance use disorder go on to live beautiful, meaningful lives. However, the narrative surrounding SUD is often focused on the behaviors associated with active use and stereotypes individuals with an active SUD as unreliable, untrustworthy, and all around “bad”. Studies have shown that personalizing recovery is an effective way to combat public stigma. [9]

    Showing the faces of recovery highlights that SUD can affect anyone, anywhere, at any time. This increase in visibility also identifies those with substance use disorders as more than their disease and places value on their experiences.

A Final Word

Overcoming the stigma associated with substance use disorders requires a long-term commitment to eradicating the discrimination and prejudice experienced by individuals struggling with a SUD. Anyone can join the effort to eliminate stigma and encourage those suffering from the disease to step forward and receive help. The stigma surrounding substance use disorders can only be changed through action.

If you or someone you live is struggling with a substance use disorder, help is available. Contact Greenbriar Treatment Center today to learn how we can help.

Resources

  1. Kelly, J.F., Saitz, R., Wakeman, S. (2016). Language, substance use disorders, and policy: the need to reach consensus on an “addiction-ary”. Alcoholism treatment quarterly, 34(1), 116-123. DOI:10.1080/07347324.2016.1113103
  2. Robert D. Ashford, Austin M. Brown, Jessica McDaniel & Brenda Curtis (2019) Biased labels: An experimental study of language and stigma among individuals in recovery and health professionals, Substance Use & Misuse, 54:8, 1376-1384, DOI: 10.1080/10826084.2019.1581221
  3. Hadland, S. E., Park, T. W., & Bagley, S. M. (2018). Stigma associated with medication treatment for young adults with opioid use disorder: a case series. Addiction science & clinical practice, 13(1), 15. https://doi.org/10.1186/s13722-018-0116-2
  4. Yang, L. H., Wong, L. Y., Grivel, M. M., & Hasin, D. S. (2017). Stigma and substance use disorders: an international phenomenon. Current opinion in psychiatry, 30(5), 378–388.
  5. https://apastyle.apa.org/6th-edition-resources/nonhandicapping-language
  6. https://www.drugabuse.gov/drug-topics/addiction-science/words-matter-preferred-language- talking-about-addiction
  7. https://obamawhitehouse.archives.gov/sites/whitehouse.gov/files/images/Memo%20- %20Changing%20Federal%20Terminology%20Regrading%20Substance%20Use%20and%20Substance%20Use%20Disorders.pdf
  8. Committee on the Science of Changing Behavioral Health Social Norms; Board on Behavioral, Cognitive, and Sensory Sciences; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington (DC): National Academies Press (US); 2016 Aug 3. 4, Approaches to Reducing Stigma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK384914
  9. Livingston, J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction (Abingdon, England), 107(1), 39–50. https://doi.org/10.1111/j.1360-0443.2011.03601.x