The sting of stigma can be intensely painful to those affected by it. It influences individuals who may be every bit as creative, intelligent, talented and humanly flawed as the next person. People who suffer from substance dependence, are heavily stigmatized in the eyes of the society. They are often not acknowledged as complex individuals, but are rather defined by their substance reliance.

To put things into perspective, i would like to evoke a quick time lapse to the ancient Greece. In ancient Greece, “stigma” referred to a skin mark they left on the bodies of criminals, slaves, and traitors to identify them as immoral. These people were ritually polluted, looked down on and avoided.

The origin of stigma´s definition truly makes you raise an eyebrow, considering that this is more or less, what occurs in our modern, “civilized” society. Stigmatized people today might not be given a skin mark, but they are given discriminative labels. Labels which portray them as indecent and outlawed. Collective discrimination is still very much awoken in our society. This prevailing, due to generational prejudices and harmful stereotypes.

What does stigma look like?

Stigma manifests itself in many forms. Stigma is founding your perception on prejudices. Stigma is when you are on the train in the morning and the person next to you smells like alcohol and you think to yourself : ” I can’t imagine why they don’t do something about their
lives. It’s disgusting how they choose to live.”

Stigma can also be a movie scene whereas a person who uses substances, is vaguely portrayed as an outcast, a thug. It is stigma that turns a complex individual, to a stereotype.

This is why stigma stands for a multilayered issue. Manifested in a personal and sociocultural level, both promptly interconnected with each other. To “bring home the message”, stigma can take the form of:

• Biases
• Distrust, anger, or fear
• Stereotyping
• Labeling
• Avoiding
• Discriminating
• Shaming (AHS, 2019)

Stigma is not just about hurting someone’s feelings. Stigma is about prejudice, discrimination and violating a person’s human rights.

Margaret Kittel Canale, MEd, and Ellie Munn, MSW

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“Relax, it`s just a word”

I strongly advocate that being an inclusive person takes more than claiming to be one. It sure comes in quite easy for anyone to make such a statement. However, encouraging inclusion is a life-time commitment involving continuous research and listening to marginalized, stigmatized crowds unconditionally. Encouraging inclusion is defined by your actions, your willingness to convey dogmas, the way you use your words.

Stigmatized perspectives towards substance abuse provoke extensive discriminative language apropos of substance dependent individuals. Now, i would like to illuminate that i myself, may have used discriminative language in the past, exclusively due to lack of education and awareness. That is why i am here to establish that even if the intention behind an expression might not be malicious, it does not prevent the action of being hurtful itself.

Nonetheless, a word stands for much more than a series of letters. A word can breathe prejudices, hatred and bigotry generations of value. Thus, every time you use a discriminative word, you recall all of it; the prejudices, hatred, the bigotry. You recall all the pain that they may have caused to a stigmatized person.

What i suggest by that, keep in mind that whenever you speak as an outsider of a stigmatized group, you simply do not get to decide which expressions are harmful or not, nor use them in any context. Hence, remember to actively listen and consider those affected by stigma. Think before you speak and fuel your language with compassion.

“Clean” vs “Dirty”

Discriminative language does not always cite to slurs or idioms. It can also inhabit the interpretation of substance abuse in a way that promotes toxic stereotypes or generalizations.

This for instance, entails portraying addiction as a moral or personality failure rather than a medical issue. It can also involve using language that indicate phraseology of “clean” versus “dirty”, pinpointing judgement upon drug dependency. (AHS, 2019)

Considering that rewiring your language might hold a more deep rooted process, here is a simplified, quick guide on how to use more inclusive language when it comes to substance abuse:

Instead of:	Rather use:	Rationale:
Addict, Junkie, Druggie (or other slangs and slurs)	Person who uses substances/with substance use disorder	The person is not defined by their substance use
“Clean” when sober, “Dirty” when using	Person in recovery/positive drug screen, negative drug screen	Literal and neutral terms, refers to medical nature of substance use, avoids slangs
Relapse	Return to use	Doesn´t imply judgment

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Impact comes from action

Whilst generational prejudices and misconceptions might not be easy to diminish, there are initiatives that can be considered in regard of reducing stigma and thus, boost inclusion.

In Mandela´s famous words, education is the most powerful weapon which you can use to change the world. By increasing knowledge on issues surrounding substance abuse, attitudes can be shifted and like so, aid inclusivity. First and foremost, it is vital to comprehend what factors push people to develop problems with substance abuse in the first place. Keep in mind, that for instance trauma, involves a common spawn for substance dependence.

Forty to 60 per cent of people
with a mental health problem
will also have a substance use
problem sometime in their life.

Health Canada (2001).

Whilst educative programs should be spread more widely in schools and professional spaces, you can play your own part on advancing education. Living in the “Era of Knowledge”, you are one search away of doing your own research on the matter. Having this privilege allocates us liable of staying aware on relevant societal issues.

Stigma is rarely based on facts but rather on assumptions, preconceptions, and generalizations; therefore, its negative impact can be prevented or lessened through education.

(Link, 2001)

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There`s a story behind a label

What if the “druggie” of your neighborhood, had a name and a story? Well obviously they do, but what if you actually considered this the next time you come across with them? Even so, what if you actually heard the story behind this person, what drove them to this circumstance? Would it not affect your overall attitude towards them?

This is where the role of personalizing substance abuse comes to play as an anti-catalyst for stigma. According to Visions Journal issue “Stigma & Discrimination”, using this tactic can increase empathy and modify behaviors towards substance dependent people. So what does this mean in practice?

• Having people who have experienced substance use problems and the related prejudice and discrimination speak about it
• Using well-known spokespeople to raise awareness that substance use problems can affect anyone
• Showing that people with substance use problems come from a variety of backgrounds
• Demystifying and humanize recovery, treatment, relapse

Telling positive stories;

• Showing the positive face of people with substance use problems rather than the negative (e.g., ways in which individuals contribute to society) ( “Stigma & Discrimination” issue of Visions Journal, 2005 )

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Tolerance is ignorance

Reinforcing inclusion goes beyond your own attitude and morals. It`s one thing to not actively pursue into discriminatory behaviors yourself, it´s another to tolerate discriminatory behaviors around you. Every time you overhear a prejudiced comment and remain silent, unaffected, you are welcoming and aiding stigma and injustice. You become a part of the problem.

I wish to spark you into seeking to criticize and abolish bigoted behaviors. Whoever it is that encourages prejudice, do not hesitate to address the harm; confront them and educate them on the topic. Call out your friend who is making an “innocent joke” about a stigmatized person. Call out the news media post that does little to foster empathy for people who use drugs. Call out the school substance education, the public health campaigns that  mobilize stigma by positioning drug users as dirty, diseased and dangerous.

To think how empowering it is that you can make an impact upon dwindling stigma! You can be the reason for someone to feel heard and understood, or to receive help. By playing your part, you aid disposing worn-out labels and most importantly, you underline inclusion.

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Sources:

https://www.heretohelp.bc.ca/visions-stigma-and-discrimination-vol2/stigma-addiction-project

https://www.albertahealthservices.ca/assets/info/hrs/if-hrs-reducing-stigma.pdf

https://www.drugrehab.com/addiction/stigma/

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