Even though it is 2020, the concerns and fears around stigma related to addiction remain alive and well throughout the United States. The concept of stigma describes the powerful negative thoughts that affect how an individual is viewed when they struggle with a substance abuse disorder or addiction. Stigma has the potential to adversely affect one’s self-esteem and damage relationships with loved ones and friends. But most concerning among the effects of stigma is the detrimental impact it has on preventing those who need treatment from seeking and accessing addiction treatment services.
Though society as a whole has come a long way regarding viewpoints related to substance abuse, shame, and guilt remain associated with addiction and addiction treatment. Stigma remains a public health issue as it contributes to increased death rates, incarceration, and mental health concerns among substance-dependent populations.
What is Addiction Stigma
Stigma is defined as a set of negative beliefs that a group or society as a whole holds about a topic or group of people. The stigma of addiction stems from behavioral symptoms and other aspects of a substance use disorder. According to information provided by The World Health Organization (WHO), stigma remains a significant cause of discrimination and exclusion, and it contributes to the abuse of human rights. When someone experiences stigma, they are seen as less than others around them because of their real or perceived health or social status.
Stigma is rarely based on facts. It is commonly centered on assumptions, preconceptions, and generalizations, and therefore its negative impact can be prevented (or at the very least lessened) through education. Family, friends, and the general public often carry negative feelings about drug use or behavior. They may even use derogatory terms such as “junkie,” “alcoholic,” or “crack head.” These labels, thoughts, and feelings also serve to perpetuate stigma.
How Prevalent is Addiction Stigma?
The unfortunate truth is we live in a society where millions of Americans are dependent on drugs or alcohol. Of the more than twenty-two million Americans who struggle with addiction each day, a mere ten percent of those will receive treatment in a drug and alcohol treatment facility like The Hills Treatment Center in Los Angeles. For many generations, the combination of personal shame and public stigma has produced significant, sometimes insurmountable obstacles to addressing the problem of alcoholism and drug addiction in the United States. At the local levels, the same challenges pertaining to addiction stigma keep drug and alcohol addiction underdiagnosed, underfunded, undertreated, and vastly misunderstood by many.
Stigma affects everybody. It is likely safe to say that nearly everyone has felt stigmatized or has stigmatized another at some point in their lives. Drug and alcohol addiction are far too often seen as a moral failing or a criminal matter rather than the public health problem that they are. In a study done by Johns Hopkins Bloomberg School of Public Health, the general public indicated they were more likely to have negative attitudes towards those dealing with drug addiction than those dealing with a mental or physical illness. Also, researchers on the same study found that people don’t generally support insurance, employment policies, or housing programs that benefit people dependent on drugs.
How Stigma Hurts
Addiction stigma can negatively impact several areas, including self-esteem, mental health, and harm reduction. While these impacts can have detrimental effects on physical and emotional health, the most significant difficulties associated with stigma pertain to treatment. Ongoing stigma has been shown to reduce an individual’s willingness to seek addiction treatment or access needed healthcare.
Impact on Treatment
Unfortunately, individuals who experience stigma regarding their drug or alcohol use are significantly less likely to seek treatment. Eventually, this results in economic, social, and increased medical costs. In the United States alone, economic impacts associated with untreated addiction (including those pertaining to health care, lost productivity, and the legal system) cost society billions of dollars each year. Currently, the estimated cost of drug abuse in the United States exceeds $740 billion annually, which continues to grow.
Stigma is more than just a societal problem. Perceived stigma in hospitals, doctors’ offices, or other treatment facilities can discourage people from accessing much-needed healthcare services. Studies have found that some healthcare providers feel uncomfortable when working with people dependent on drugs or alcohol. This is unfortunate, as having access to a trusted, qualified primary care provider is directly associated with maintaining physical and emotional well-being and good quality of life. When healthcare providers carry a stigma towards people with drug or alcohol dependencies, it can affect their willingness to assess or treat the patient for substance abuse or other medical conditions. It can also affect how they approach them, which may prevent addicted individuals from seeking health care services altogether.
The Affordable Care Act
To better support people with substance use disorders, the Affordable Care Act includes benefits for addiction treatment. Before the passing of this legislation, many insurance companies could choose whether or not to provide addiction treatment benefits as part of their health policy coverage. Now, people who have Medicaid or purchase plans through the health exchange are eligible to receive treatment services, including psychotherapy and counseling at a qualified addiction treatment center such as The Hills in Los Angeles. Plans vary, and some have limitations associated with their coverage. For example, some may place limits on the number of days or visits covered, how much the deductible and copayment will be, and whether or not prior medical authorization is needed for treatment. Despite these limits, however, more Americans than ever before have access to addiction treatment care. Whether they choose to seek or can gain access to treatment remains a significant public health issue.
Impact on Harm Reduction
Stigma can also affect the public’s perception of evidence-based and essential harm reduction strategies. The term harm reduction refers to public health interventions such as needle exchanges, substitution therapies, safe consumption rooms, and similar. Due to the often-widespread stigma about those who use drugs and who suffer from addiction, these interventions are usually not supported by the public. Some also believe these intervention measures facilitate or even encourage new or ongoing drug use.
Social and Mental Impact
Perceived and overt stigma can cause significant harm to people in their social lives. The chronic and ongoing stress of discrimination is likely to affect the mental and social health individuals who struggle with drug or alcohol addictions. Those with substance abuse disorders can feel ostracized or pushed to the outskirts of social circles. Also, they may lose touch with their community and family. These unfortunate circumstances can result in profound loneliness and isolation, which often serve to increase the frequency or amount of substance use.
When individuals lack social ties or a person to confide in, they are less likely to reach out for health care or much needed mental health and addiction treatment. They are also at an increased risk of depression and may hide their substance abuse disorders from healthcare professionals to avoid stigma or drug shaming. Isolation can result in significant mental health challenges, fueling increased drug use, leading to further isolation. This is a vicious circle that is often difficult to break without the ability to seek or receive much-needed addiction treatment at an addiction treatment center like The Hills.
Many people internalize perceived stigma. Those who use drugs and alcohol view sometimes view themselves as deviant or “bad people,” which can severely impact self-worth and self-esteem. Historically, addiction disorders, whether to alcohol or drugs, were viewed as moral failings or voluntary habits. Although addiction is now classified and commonly considered a disease, these views remain, and themselves contribute to stigma and present significant barriers to treatment.
In today’s society, people share stories about being victims of perceived or overt stigma from health care providers, loved ones, and the general public. To further encourage people to reach out for help and get on the path to recovery, it is essential to find ways to reduce the stigma surrounding drug and alcohol addiction and addiction treatment.
While education proves to be one of the most effective ways to help reduce stigma, there are other methods as well, some of which require only a small shift in attitude. For example, offer compassionate support or encouragement to someone you know to be struggling with an addiction disorder. Please encourage them to seek medical assistance or treatment at an addiction treatment center. Displaying kindness and listening with empathy and compassion instead of judgment or hostility to people in vulnerable situations is likely to encourage treatment-seeking behaviors.
It is also essential to see the person for who they are and not the drug they use over the alcohol they drink. Remember, addiction is a disease, not a desire or a choice. Avoid using hurtful labels to describe one’s current situation, as labels only serve to promote stigma.
If you or a loved one struggles with addiction but fear seeking treatment due to concerns surrounding stigma, know that you are not alone. At The Hills in Los Angeles, CA, our evidence-based treatment programs can provide you with the detox and addiction treatment that you need in an environment safe from judgment or stigmatizing experiences. We understand that the decision to seek treatment is difficult. For many, addiction treatment takes them away from their family and loved ones for an extended time. In some cases, treatment will also take you away from your employment, your social circles, and the environments with which you are familiar. While this separation from potentially triggering settings may benefit your treatment and recovery, it is still emotionally challenging. Seeking treatment is the first step on the road to a substance-free, healthy life. If you are ready to seek treatment for your addiction, contact the Hills in Los Angeles today.