Stigma is defined in the dictionary as “a mark of disgrace or infamy.” The stigma of addiction—the mark of disgrace or infamy associated with the disease—stems from behavioral symptoms and aspects of substance use disorder. For example, symptoms of alcohol and other drug addiction, such as impaired judgment or erratic behavior, can result in negative consequences including legal, occupational and relationship problems. Understandably, these kinds of consequences cause embarrassment and shame among those afflicted and affected. They also create stigmatized attitudes and perceptions about addiction among the wider public, a response that perpetuates and exacerbates the private shame associated with drug addiction.
For generations, this combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and other drug addiction in America. Today, the stigma of addiction is seen as a primary barrier to effective addiction prevention, treatment and recovery efforts at the individual, family, community and societal levels. Addiction stigma prevents too many people from getting the help they need.
The ultimate irony here? Many of the negative, stigmatizing behavioral symptoms associated with the disease of addiction tend to diminish and abate when appropriately addressed and managed in recovery.
At the individual and family levels, alcohol and drug addiction is traditionally considered a private matter, something only whispered about. Even when the symptoms of the disease are obvious to all around, individuals and families too often avoid seeking help for fear of even acknowledging the problem. This is one reason only one in 10 Americans with a substance use disorder receives professional care for addiction.
At the community and societal levels, the same undercurrent of addiction stigma keeps drug and alcohol addiction under-diagnosed, under-treated, under-funded and misunderstood by many, especially as compared to other chronic health conditions such as heart disease, asthma and diabetes.
While addiction is one of our nation’s biggest public health problems, insufficient public resources are dedicated to confronting the problem. Drug and alcohol addiction is too often seen as a moral issue or a criminal matter rather than a health problem. Many public policies and practices related to housing, education, jobs, voting rights and insurance discriminate against individuals who have addiction, even after they’ve established long-term recovery. And despite advances in understanding addiction as a disease, substance use disorder remains largely marginalized by the mainstream medical field, starting with a lack of robust education on the topic in medical school. As evidenced by the devastating opioid crisis in our midst, our country is paying the price for years of neglecting the fiscal and educational investments required to confront the highly stigmatized disease of addiction.
At the Hazelden Betty Ford Foundation, we are committed to challenging the stigma, stereotypes and pessimism long associated with drug and alcohol addiction. Our fundamental addiction stigma-smashing strategy is to shine a light on people who are in recovery and, in doing so, expose the long-hidden reality that people actually do recover from drug and alcohol addiction; that it’s a chronic disease that can be successfully managed for life; and that it affects individuals who are every bit as moral, productive, intelligent, talented—and humanly flawed—as the next person.
We create venues for advocating pro-recovery messages, policies and programs. And we promote community spaces where recovery can flourish and serve as a beacon of hope to others.
We educate other health care professionals, and we contribute in every way we can to the vision of one day having all doctors and nurses equipped with the basic knowledge and experience to recognize and address substance use disorders in a non-stigmatized way, based on an informed appreciation for the complexity of the disease and the recovery process.
Finally, recognizing that public perceptions are swayed by the popular words and images used to describe people and communities, we are committed to de-stigmatizing the language associated with alcohol and drug addiction, and the portrayal of drug addiction in news and entertainment media, as well as within our institutions. For example, we strongly support renaming federal agencies such as the National Institutes of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to remove the morally charged and inaccurate word “abuse.” This recommendation is not about political correctness. It’s about making a conscious effort to correct stereotypes and misperceptions that negatively impact the way substance use disorders are experienced and addressed in the world.
As professionals responsible for helping our patients reframe and overcome their private shame, which is fed and reinforced by public stigma, we make it our responsibility to smash the stigma of addiction everywhere we see it. Not only do these efforts benefit patients in our drug treatment programs, clinically speaking, they also encourage more people in the throes of active addiction to reach out for help. And on a larger, societal scale, we can ultimately and more accurately shape public perceptions and public policy discussions about the problem of addiction and the promise of recovery.