Blog 2- The Stigma Around Addiction

 What is stigma?

    Stigma is the negative beliefs, attitudes, or perceptions that can lead to discrimination and separate one group or person from the rest of society (Judd et al., 2021).  Unfortunately, opioid use addiction is the most stigmatized health condition in the world (Cheetham et al., 2022).  Society often views opioid addiction as a personal choice rather than a disease (Cheetham et al., 2022).  The public views those with opioid use addiction as dangerous, manipulative, and undeserving of health care benefits, housing, and resources for food (Cheetham et al., 2022).

 (Substance Use Services Blog Series, 2020).

Why Does Stigma Exist?

Stigma exists because of the lack of knowledge the public has on the disease of addiction (Cheetham et al., 2022).  The public often hears the negative aspects of addiction through the media, such as the news (Cheetham et al., 2022).  The news is known for portraying the negative side of stories for a more dramatic reaction from the public.  How often do we hear the positive aspects of improvement in opioid treatment facilities on the news? Never. Usually the news talks about the number of overdoses and deaths that follow addiction. 

          Stigma can also exist because of the policies and regulations around treatment (Cheetham et al., 2022).  Methadone and suboxone clinics have strict rules for treatment, including drug testing, amounts of doses that can be filled at once, where the medication can be picked up, and who is allowed to prescribe the medication (Cheetham et al., 2022). The public forms a negative stigma around treatment because of all the rules that exist.   

What Are The Effects of Stigma?

    Stigma makes it difficult for those with opioid addiction to find quality health care.  Many providers refuse to care for patients who suffer from addiction because of the monitoring, regulations, and rules around treatment plans (Cheetham et al., 2022). Providers have a fear that their reputations will be ruined (Cheetham et al., 2022). Providers also feel that these patients are difficult to manage because they have a difficult time achieving pain control and are often looked at as "drug seeking" (Cheetham, et al., 2022).  I am ashamed to admit this, but I hear the "drug-seeking" comment at least once a shift from providers and healthcare workers caring for those with opioid use addiction.  I can understand the frustration providers feel when their patients state their pain is a 10/10 while they are relaxing on their phones, texting, and smiling.  Believe me, I get it.  It is not our job to treat these patients with any lack of respect, judgment, or slang language including "drug-seeker".  It is never acceptable. 

Confronting the Stigma of Opioid Addiction in Nassau County FL. (n.d.)

  Stigma can also cause a patient to lose social support and go into isolation (Christie, 2021).  The shame from the stigma of opioid use addiction can lead to weaker relationships among friends and families (Christie, 2021). This isolation also leads to a lower desire to seek treatment opportunities which ultimately can lead to overdoses and mortality (Christie, 2021).   

How Can We Avoid Stigma?

    To avoid stigma, it is important to educate the public on addiction (Cheetham et al., 2022).  The public needs to see that addiction is a disease and not a choice and that it can be treated successfully (Cheetham et al., 2022).  The public needs to see videos such as Andrew Allen's interview from Husson University ( linked below). 

 

https://husson.instructure.com/courses/2029948/files/164206902?module_item_id=39648104

In this interview, Andrew does an amazing job explaining how his addiction started, how it impacted his life, and how he never lost hope in finding treatment.  Stories like Andrew's will speak to the public in a positive light.

    Stigma can also be avoided by using destigmatizing language when discussing cases of patients with opioid use disorder (Cheetham et al., 2022). The words we choose to use are influential on the attitudes and beliefs of those around us (Cheetham et al., 2022).  For example, using the term "druggie" should be replaced with "a person who suffers from opioid use addiction" (Cheetham, et al., 2022). The healthcare community as a whole needs to educate all staff about destigmatizing language in hopes of decreasing the stigma around addiction.

References

Cheetham, A., Picco, L., Barnett, A., Lubman, D. I., & Nielsen, S. (2022). The impact of stigma on people with opioid use disorder, opioid treatment, and policy. Substance Abuse and Rehabilitation, 13(13), 1–12. https://doi.org/10.2147/SAR.S304566

Christie, N. (2021). The role of social isolation in opioid addiction. Social Cognitive and Affective Neuroscience, 16(7), 645–656. https://doi.org/10.1093/scan/nsab029

Confronting the Stigma of Opioid Addiction in Nassau County FL. (n.d.). https://www.nassaufldrugprevention.org/what-is-stigma

Judd, H., Meier, C. L., Yaugher, A. C., Campbell, E., & Atismé-Bevins, K. (2021). Opioid use disorder stigma reduction through story telling narrative and sharing: A qualitative review and lessons learned. International Journal of Mental Health and Addiction, 21(1). https://doi.org/10.1007/s11469-021-00606-y

Substance Use Services Blog Series: Different Kinds of Stigma, Shame, and Self-Compassion. (2020, June 18). Deltassist Family and Community Services Society. https://deltassist.com/substance-use-services-blog-series-different-kinds-of-stigma-shame-and-self-compassion