It has been incredible to see a diverse group of people and organizations pool their skills and resources to mount Anti-Stigma Week, with activities that all have one goal – enhancing individual and community health and well-being by transforming stigma around drug use.
This year’s Anti-Stigma Week theme is Drug Use, Dignity and Human Rights. Drug use, and especially illicit drug use, is associated with high degrees of stigma that hurt individuals’ health and access to health care and reduce community cohesion.
Stigma is a societal process that marks people as outsiders. Those who are different – because of their behaviours or identities – are subject to disapproval and marginalization.
They aren’t seen as people, as someone’s daughter or father, neighbours with their own stories and failings and hopes. This prejudice makes it easier for active discrimination to take hold, or to leave individuals fearing that others think them less worthy. The way systems are organized and accepted societal attitudes reinforce these tendencies.
The effects of stigmas on the health and well-being of individuals and communities are devastating. It robs people of dignity and can contribute to physical and psychological health problems. In some cases, this adds to past trauma and abuses that have added to situations such as addiction and homelessness.
Poor people are more likely to be stigmatized, with gender, age and culture all playing a role in how people are perceived. Stigma is a barrier to housing, employment and educational opportunities that are central to improving health and well-being and self-sufficiency.
When people are excluded from services or marginalized by policies, the result is also decreased productivity and increased financial costs to society.
Stigma is often not easily recognized. We tend to think and act in commonly accepted stereotypical ways and only on reflection recognize the way in which our attitudes and responses to others can be stigmatizing.
For example, the language we use can reinforce stereotypes about certain groups that do not reflect their reality. Working in the field of substance use and addictions, we frequently hear terms like “drug user,” “addict” and “junkie.”
Labels like these tend to contain moral judgments about the worth of vulnerable individuals and contribute to stigma. They make it easy to forget these are also people -employees, parents, children. This has been brought home to us many times in our work and we have become sensitive to the use of these terms.
It is a powerful moment when we question the use of such language and provide alternative language such as “people who use drugs.” Inclusive and respectful language is an excellent start for transforming stigma and removing barriers between people and communities.
If children are repeatedly told that they are worthless, pretty soon they will start saying that they are worthless. Stigma often becomes internalized and people come to see themselves in the ways they are perceived -“I am just a throwaway or I am worthless.”
When society repeatedly treats people who use drugs as less worthy or a drain on resources, pretty soon people come to believe and act in ways that reinforce these beliefs.
Stigma adds to the shame and can prevent people from accessing resources even when they are seemingly available.
This cycle can be broken through respect and inclusion. Listening is a good place to start breaking down barriers. Beginning with “tell me about yourself. What is important to you? What is your opinion?”
There is a slogan: “Nothing about us without us.” It suggests that people with the experiential knowledge related to the issue at hand -those who have lived it -must be supported in being actively involved and leading in developing inclusive policies, practices and decision-making structures that directly impact their well-being.
Anti-Stigma Week provides an excellent time to think about the use of language and unintentional ways that stigma is communicated and to begin the process of transformation that will contribute to health and well-being of every citizen in our community.
Bernie Pauly and Cecilia Benoit are scientists in the Centre for Addictions Research at the University of Victoria
Originally published in the Times Colonist, February 13, 2011