Health Take-Away: Reduce stigma of substance use disorders

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The isolation and fear all of us are experiencing these days is all too familiar to the millions of people struggling with a substance use disorder. The difference is that while we readily empathize with each other about the impact of the current viral pandemic, we tend to stigmatize and isolate sufferers of substance use disorders blaming them for their disease.

Addiction is a chronic, relapsing brain disease characterized by compulsive drug-seeking and use, despite the harmful consequences. Addiction changes the structure and functionality of the brain. While it's true that many of those with substance use disorder may have made the initial decision to experiment with drugs or alcohol, it is still a disease and should be treated as such. No one is born wanting a life of turmoil.

The stigma that we as a society attach to alcohol and other drug addictions can severely isolate individuals and families. It actually encourages people to deny a fatal illness and ignore its symptoms. It keeps desperately ill people from seeking help.

In other words, this stigma keeps the sick — sick. It has us believe that people with addictions are somehow inherently bad. It focuses only on the mistakes people may have made, dismissing them as selfish, dishonest, manipulative and weak-willed. It ignores the strengths and resiliencies that live in even the most troubled human being. This kind of negative focus only feeds those harmful behaviors and destroys their ability to believe they will ever get well.

Stopping the stigma of substance use disorder begins with how we talk about it. Even those of us in the field of treating this disease realized we needed to change our clinical language. We now use and encourage everyone else to use what is called person-first language, which emphasizes the person instead of the disease. Every patient is "a person with a substance use disorder," and not an "addict" or an "alcoholic" or a "drug abuser." In the everyday world, those latter terms often are further and terribly translated into demeaning words like "junkie" or "drunk."

When a person is labeled by their illness they are seen as part of a stereotyped group and not as an individual. This stigma becomes a mark of shame or disgrace that sets a person apart. By giving a human face to this disease, rather than cruel caricatures, we begin to recognize the courage it takes to make the transition into recovery. Patients in recovery are "normal", everyday people who live, love, work, play pay taxes and vote, sharing the same hopes and dreams as everyone else.

The lesson here is that we need to view substance use disorder addiction as we would any other disease. We must look for and care for the human within - the child, the sibling, the parent, the friend. It's about treating people in a way that rescues them from needless isolation and fear. We all know that feeling these days, and we should take it to heart as the world eventually emerges from this current challenge.

Shannon McCarthy, MSW, LADC I, LCSW is the department director of Behavioral Science and Substance Use Disorders at Berkshire Medical Center.



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