The dictionary defines stigma as a mark of disgrace associated with a particular circumstance, quality, or person. Social stigma goes even further, it is the disapproval of, or discrimination against, a person based on perceivable social characteristics that serve to distinguish them from other members of society. Such as race, culture and health.
Stigma is different from disapproval of particular behaviours because it is not necessarily linked to the actions of an individual, but rather to what is assumed about ‘someone like that’. It also goes beyond stereotyping, as the stereotypical perception of who or what the person is becomes their defining feature, obscuring other aspects of their individuality and becoming fixed and hard to change. Such stigma then often leads to prejudice and active discrimination. (UKDPC)
Stigma experienced by dependent substance misusers and their families often delays people seeking help. They fear that once they do, they will be stuck with the label ‘hopeless addict/alcoholic’ for life. Families often experience changes to their day-to-day lives, through reduced social invitations, children targeted by bullies etc.
Substance misusers will and often do internalise stigma, which can have an impact on the person’s mental health and self-esteem and can lead to greater potential in severity of substance misuse dependency.
Professional attitudes all too often reinforce stigma and lower expectations of recovery. Stigma puts barriers in the way of recovery and reintegration, for example by making it difficult to find a job.
What can be done to reduce stigma toward people with a history of Substance misuse problems? We could improve the knowledge of the general public, consider the language and labels that are used towards people, train the workforce in various settings, promote self-help and mutual aid groups and support the recovery community.
But how do you go about doing this?
Major campaigns have been realised around mental health, such as ‘SEE ME’ and ‘it is okay not to be okay’, have helped to improve public attitudes and promoted more positive images of people with mental health problems. We need to also provide a balance to media reporting, expose negative attitudes and behaviours as shameful and by doing more to promote positive role models in the media.
Staff who work in the drug and alcohol field, both statutory and 3rd sector may hold or develop stigmatising attitudes, often unwittingly. The conflict normally occurs around reductions in scrips and clients goals, but staff are following evidence based guidance and may be concerned by relapse.
There are great examples out there of good practice that should be shared with staff. Leadership within services will have an important role to play in raising staff ambitions for their clients, making sure staff receive the correct training and to consider the use of language and champion recovery.
Mutual aid and self-help groups are hugely important in helping to shift the negative views against those rebuilding their lives such as AA, NA and CA. Another group which supports recovery group and has been rising in membership are SMART recovery.
The Scottish Recovery Consortium (SRC) has taking a lead in making recovery visible, through the organisation of the Recovery Walk.
As long as stigma persists, the goal of sustained recovery will remain out of reach for many substance users and their families.
“Do not let your potential be threatened by stigma”
The UK Drug Policy Commission has created a detailed handout about dealing with Stigma, click on the link below to read this.
National charity Adfam has also created a detailed handout about dealing with Stigma, click on the link below to read this.
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