Addiction is a disease that is recognized as a major public health concern but is generally regarded by society as the result of an individual’s personal choice or a moral failure. In the time of the COVID-19 pandemic, the number of drug overdoses has significantly increased (Mendell). Having responded to the crisis by changing prescribing practices and increasing funding for treatment, the government has overlooked the most important cause of the problem — the stigma (Mendell). To provide a long-term solution for the crisis, public perceptions of addiction need to be changed for it to be regarded as a disease that requires medical and psychological treatment.
Problem overview
Drug addiction is perceived as a complex sociological threat, whose social, behavioral, and biological aspects present an ongoing public health challenge and affect the lives of communities, families, and individuals. According to the World Health Organization, drug use is “the habitual use of psychoactive substances in dangerous amounts of even methods that may bring harm to the user” (6). Addiction is a disease that is treatable with appropriate medical interventions that include medication, behavioral therapy, fitness regimens, vitamin treatment, and support groups (“Stigma of Addiction”). However, people suffering from addiction are often confronted with a negative attitude of society, which perceives addiction not as a disease but a character flaw or a weakness.
Society tends to stigmatize behaviors that are seen as different from the acceptable norm. The most common stereotypes related to substance use include the assumptions about the lifestyle associated with drugs and alcohol. Drug users are perceived as deviants who are alienated from society, are often unemployed, and engage in risky and criminal behavior (“Stigma of Addiction”). They are believed to be dangerous and unpredictable, unable to make decisions about treatment and finances, and are to be blamed for their own condition (Yang at el. 384). Stereotyping leads to discrimination and negative attitudes, reduces the willingness to deal with substance abuse issues on all levels of society, and discourages individuals with addiction problems from seeking treatment.
Overcoming the stigma
The main issue regarding the stigma of addiction is that it is perceived in society as a moral failing, character flaw, personal choice, or a lack of willpower. However, contrary to common perceptions, it is a disease, recognized by most medical associations. Substance use disorders (SUDs) are defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition as the presence of pathological behaviors associated with the use of substances (Carapanzano 2). These behaviors include impaired control over use, impaired social behavior, and risky use practices (Carapanzano 2). Pharmacological effects such as tolerance and withdrawal are also criteria of diagnosis. Addiction is a complex disease of the brain and body caused by a combination of behavioral, psychological, environmental, and biological factors, including genetics (“Is Addiction a Disease?”). While the initial and early decisions to use substances are based in large part on a person’s conscious choice, one the brain has been affected, that choice becomes impaired (“Is Addiction a Disease?”). Addicts lose control over substance use and are no longer able to regain it despite severe consequences. In order to stop using, addicts need professional help and medical treatment, which they cannot get unless addiction is recognized and treated as a disease.
Stigmatization of addicts leads to severe behavioral, medical, and social consequences. Unlike mental illnesses, which are also stigmatized but perceived as diseases that people cannot control, stigma against people with addiction is more complicated. A person’s addiction is often used as an insult against them, and addicts tend to hide their problems for fear of being discriminated (“Stigma of Addiction”). Addicts are often blamed for their condition, which leads to the loss of self-respect and self-esteem (Crapanzano 3). Qualitative studies confirm that stigma experiences negatively impact feelings and beliefs about treatment, affecting the likelihood that a person will seek treatment, complete it, or achieve recovery (Crapanzano 2). A person often chooses to struggle with their problem on their own, without getting help, because they perceive the consequences of coming out as too severe. Overcoming stigma is required for addicts not to feel guilty about their disease and become willing to seek professional help that they need.
Stigmatization occurs at all levels of society through policies and practices, preventing addicts from getting equal medical treatment and social support. It is rooted in the historical separation of addiction treatment from mainstream healthcare and is amplified by the current barriers to accessing medications for substance use disorders (Atkins et al.). Health care policies do not address addiction as a chronic disease and set restrictive requirements limiting access, coverage, and reimbursement for addiction treatment (Atkins et al.). Individual-level stigma held by healthcare providers results in negative attitudes, fear, lack of awareness of the health condition, and uncertainty as to how to treat it (Atkins et al.). Consequently, addicts who seek professional help often find themselves unable to have access to quality care. Addressing the issue of stigmatization on the healthcare level is required for addicts to be able to receive equal and adequate treatment.
Treating addiction as a disease and providing proper medical care also means acknowledging that addicts require support just like other people with long-term illnesses. Studies show that the likelihood of relapse goes down when individuals have access to psychotherapy and peer group support, and get help from their families (“Is Addiction a Disease?”). If families treat a person recovering from addiction with love and respect, it helps them to stay clean and sober and return into society. Overcoming stigma means not blaming an addict for their condition, maintaining a sober living home, and encouraging them to continue seeking treatment and attend support groups.
In the time of the COVID-19 pandemic, dealing with the stigma around addiction is especially important. The pandemic has a dramatic impact on people who have substance abuse problems. Overdose deaths have spiked, illegal drugs have become toxic and unpredictable, and the unintended consequences of some COVID-19 safety products have led to a tragic increase in deaths (“Using Compassion to Tackle the Stigma of Addiction”). In order to deal with the crisis, the stress experienced by people struggling with addiction needs to be reduced by collaborative efforts. Dr Nel Wieman, a representative of the First Nations Healthy Authority, claims that “the key to responding to the current overdose crisis is a sense of compassion towards people who are experiencing addiction” (“Using Compassion to Tackle the Stigma of Addiction”). Understanding that every life matters is essential for overcoming the stigma and reducing the harms of substance use.
Despite its negative consequences, stigma is sometimes regarded as a protective and motivating factor that prevents people from trying drugs and stimulates the process of recovery in addicts. Some studies suggest that the feeling of shame associated with excessive drug use motivates the healing process, leading to treatment-seeking and even recovery (Matthews et al. 280). Being a protective factor, it also deters non-users from experimenting with substance use (Carpanzano 5). However, multiple studies prove that, paradoxically, it promotes continued use once an individual has entered the drug culture and may prevent access to treatment services (Crapanzano 5). The positive effects of treatment motivated by shame have not been proven to outweigh the negative effects of public stigma (Matthews et al. 280). According to Matthews et al. (280), “public stigmatization is long-lasting, pervasive, and often inescapable; it interferes with a person’s life goals and quality of life.” The feeling of shame only increases the desire to escape from reality and undermines the motivation needed to start treatment.
Conclusion
The stigma of addiction needs to be addressed on all levels of society to deal with the current addiction epidemic and provide adequate support and treatment for addicts and their families. It needs to be acknowledged that addiction is not a personal choice but a mental disease that can be treated. Currently, many addicts do not seek treatment because they fear discrimination, and those who do may not be able to have access to quality care. People suffering from addiction need support both from the community and their families in order to seek and maintain their recovery. Addiction can happen to anyone, and nobody is safe, it does not make one a bad person, only a good person with a bad disease.
Works Cited
Crapanzano, Kathleen, et al. “The Association Between Perceived Stigma and Substance Use Disorder Treatment Outcomes: A Review.” Substance Abuse and Rehabilitation, vol. 10, 2019, pp. 1–12.
“Is Addiction a Disease?” Partnership to End Addiction, n.d., 2020. Web.
Matthews, Steve, et al. “Stigma and Self-Stigma in Addiction.” Journal of Bioethical Inquiry, vol. 24, no. 2, 2017, pp. 275–286.
Mendell, Gary. “COVID-19 Has Led to Surge in Opioid Overdoses. Here’s How We Can Confront the Stigma.” USA Today Opinion, 2020, Web.
“Stigma of Addiction.” American Addiction Centers, 2020, Web.
“Using Compassion to Tackle the Stigma of Addiction.” FNHA, 2020, Web.
Yang, Lawrence, et al. “Stigma and Substance Use Disorders: An International Phenomenon.” Current Opinion in Psychiatry, vol. 30, no. 5, 2017, pp. 378–388.
World Health Organization. International standards for drug use prevention. 2016, Web.