End Addiction Stigma, Please!

by Marianne Wylie, MSW, RSW

Addict. Alcoholic. Druggie. Drug user/abuser…. The list of shaming, blaming labels placed on people who have problems because of their substance use or abuse or other addictions keeps people in a perpetual cycle of regret, worthlessness, self-hatred and depression, ever worsening the patterns of addiction. 

​Putting someone down with insults and dehumanizing labels because of the negative behaviours that often accompany addiction actually works to feed the addiction. It increases the person’s risk of relapse and danger. The stigma of addiction becomes internalized by the person struggling with it. If they start to believe that it is who they are, they will struggle to know who they are and what life is possible outside of the addiction. This feeds the problem because when they do examine it the question that comes up is “Who am I then when it’s gone? A nobody?”.
 
Too often a person comes in to see me for counselling to address their struggles with mental health, traumas, grief, and addiction, expressing fear that I too will shame them or view them negatively when they have problems associated with their addictions.
 
So I’d like to say, respectfully, that this cycle of blame and shame must stop if we want to support people to get better. Substance use, after all, is a symptom of the real underlying issues.

When a person has internalized the labels people have placed on them, they often experience deep shame and depression which greatly interferes with their ability to deal with the underlying issues in counselling. This can be a huge block in the therapeutic process.
 
As a therapist, I feel that exploring a client’s substance use is relevant and reasonable even when there is no concern about addiction or misuse. Not to judge or view the person negatively or to assume their use is a problem. But because it helps me to learn more about the person: how they view themselves, their trauma history, their safety and risk for danger, the impact in relation to their mental wellness, and their coping patterns.
 
Some of the questions I might ask include:
What kind of substances (drugs, alcohol, caffeine) do you use?
How often?
How much at any one time?
Who do you use it with or around?
Do you experience withdrawal symptoms?
If so, how often and how intensely?
How intensely do you experience urges or cravings to use the substances?
 
Why do I get so personal? I ask so that I can get a good understanding of the person’s habits, and to discover strengths such as how many times they have tried to reduce or stop (however minor one might think), what was done to reduce/stop - what worked and what didn’t, how one reduces the risk of danger (e.g., drinking water between drinks or not reusing or sharing needles).
 
Ultimately, I want to know because I want to know that they are okay. This information helps me to ensure the person’s safety and to know what strategies and approaches will likely help with the issues that they came to counselling for. Sounds reasonable, right?
 
But this can’t happen when people have experienced such internalized shame that they are fearful of opening up about it.
 
We NEED to change how we see people who struggle with addiction and change the language we use. To those who have been hurt by a loved one’s addiction… you are hurt and have been hurt by the consequences of your loved one’s addiction. You deserve to have this acknowledged and validated. And society’s view of giving a “tough love” approach to your loved one doesn’t work. They need support, empathy and boundaries. This does not mean that you have to agree with their actions or compromise your mental wellness. What is equally needed is for you to use assertive (not aggressive or passive) strategies and set boundaries. We don’t want to reject the person. We want to reject the behaviours and the impact of the behaviours on others.
 
People who struggle with any kind of addiction or abuse of substances are PEOPLE first and foremost. Take out the label. See the person for who they are aside from their addiction. Instead of addict, alcoholic, drug user, etc… replace the language to “a person with a substance use disorder”, “a person experiencing the negative affects of use” or “a person in recovery”.
 
Let’s all help our loved ones and ourselves and shift how we talk about addiction.