It is not uncommon to come across derogatory terminologies such as mlevi (drunkard), crackhead, junkie and stoner among others, being used to describe persons suffering from substance use dependence. These words are meant to be dismissive and disrespectful and they are also leftovers from the time when the understanding of dependence was inadequate, hence stigmatising.
According to the World Health Organization, stigma is a major cause of discrimination and exclusion, and it contributes to the abuse of human rights. When a person experiences stigma, they are seen as ‘less than’ because of their real or perceived health status. Rarely is it based on facts, but rather on assumptions, preconceptions and generalisations; and as such, its negative impact can be prevented or lessened through education.
Such individuals continue to be blamed for their disease, even though medicine long ago reached a consensus that dependence is a complex brain disorder with behavioural components. Unfortunately to date, the public and even many in healthcare and the justice system continue to look at it from the lenses of ethical flaw and blemished character.
The global health body further observes that stigma results in prejudice, avoidance, rejection and discrimination against people who have a socially undesirable trait or engage in culturally marginalised behaviours, such as drug use.
Truth is that society today tends to stigmatise behaviours that are viewed as different and unsuitable from what is usually considered the acceptable norm. The stigma associated with addiction and mental health problems creates obstacles to accessing care and support for people and their families.
Rehabilitation services for persons in dependence are viewed so differently that there was a world-leading song about it. The song Rehab was written and performed by Amy Winehouse, who struggled with addiction throughout her life and lost the battle when she was just 27.
Unfortunately, that hit song helped to contribute to the stigma of rehabilitation services, particularly among teenagers. Rehab is commonly seen in a negative light across the board. Individuals with substance use disorders are sometimes seen as selfish, untrustworthy people with no self-control. That misunderstanding helps drive the stigmatisation of drug treatment hence undermining efforts by persons who would openly seek the services.
Perceived stigma can also be internalised and contribute to people who use substances viewing themselves as deviants; this can severely impact their self-esteem and self-worth. Traditionally, dependence on drugs has been viewed as immoral or the result of a lack of self-control. These views contribute to stigma and present barriers to people accessing necessary treatment.
Additionally, stigma can have a negative impact on the family members of people with substance use disorders by encouraging them to stay silent instead of seeking out the support they need to process their own feelings surrounding their loved one’s addiction.
With this in mind, how then can this stigma be overcome? While societal beliefs cannot be transformed instantly, progress can be made on different fronts to address stigma and help create an environment that promotes recovery for those in need.
Persons with substance use dependence should be encouraged to report perceived stigma from healthcare providers, loved ones and the public. No matter the situation, no one likes to feel judged or devalued. Educational programmes and modelling of non-stigmatising behaviour can as well help people provide nonjudgmental, empathic support.
Personalisation of substance use problems is another strategy that can be adopted to deal with stigma. This can be achieved by having people who have experienced substance use problems speak about the prejudice and discrimination through using well-known spokespeople to raise awareness that the disorders can affect anyone. In line with this, it is also important to show that people with substance use problems come from a variety of backgrounds.
According to an article published in July 2020, 'Stigma: How it affects the substance use disorder patient', words matter and thus language helps in understanding and interpreting the world around us. They convey meaning, whether the effect is good or bad.
Words can be used to help decrease stigma and a good example is the use of first-person language, which recognises that people are, first of all, people. They may have a substance use disorder, so the language becomes a person with a substance use disorder.
Mwangi is Manager Corporate Communications-Nacada [email protected]
Twala is Manager Counselling and Rehabilitation-Nacada [email protected]
