Addiction is an extremely enigmatic, complicated disease. As we have continued researching and trying to learn more about addiction, our understanding of the disease has evolved. Presently, the American Society of Addiction Medicine defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry.”1 When a person abuses mind-altering substances consistently for an extended period, these circuits in the brain become dysfunctional, resulting in a number of biological, psychological, social and even spiritual symptoms. Upon reaching the point of active addiction, the individual pathologically seeks the rewarding, pleasurable effects of intoxication while also using those substances to cope with stress and intense emotions.
Despite how ubiquitous this disease model of addiction has become, much of the population continues to hold addicts in an overtly negative regard. It used to be that individuals who suffered from a mental illness were seen in the most negative light, but due to the stigmatization of addiction, addicts are now often viewed even more negatively than those with a mental illness. This is extremely problematic for a number of reasons,2 but the most damaging of these reasons is that the stigma attached to addiction discourages people with substance abuse problems from seeking help since they don’t want to identify themselves as addicts.
But why, exactly, has addiction become so stigmatized? What is the source of this demonization? And, perhaps most importantly, is there a way for us to overcome the addiction stigma in the current sociopolitical climate?
A Tradition of Judgement
The first reason for the addiction stigma is really quite simple. The stigma exists today because it has always existed and has (seemingly) become inextricably linked to our zeitgeist. Ever since substance abuse became a societal, cultural dilemma, substance abuse problems have been looked upon with very harsh judgement. Initially, this was due to addiction being very poorly understood. Since substance abuse is quite simply a behavior, having a substance abuse problem was seen as a behavioral and, in particular, moral problem, which is why people came to see addicts merely as bad people.
Unfortunately, attitudes toward addiction haven’t evolved in the same way as our scientific understanding of addiction. The accumulation of information about addiction has had very little effect on mass popular opinion, which remains negative largely out of tradition or habit. As we’ve seen with women’s suffrage and racial equality, as well as the more recent marriage equality movement, popular opinion can be quite enduring. Society will hold steadfast to preconceived notions and attitudes, even when they’re as unfounded as they are with addiction. This is surely one of the most difficult factors to overcome.
Discrimination Exists Even in the Medical Industry
Historically, anyone needing treatment for substance abuse or addiction had to go see a physician or specialist who specifically offered addiction treatment. The vast majority of general practitioners and primary care providers haven’t been able to offer addiction treatment or even prescribe medications like methadone and Suboxone as part of addiction treatment. Instead, most encounters that these general physicians have had with addicts involved addicted individuals trying to con doctors into writing them prescriptions for addictive substances.
This became a major problem after the 1990s when OxyContin abuse skyrocketed, resulting in many physicians viewing addicts as liars and a major nuisances to their practices.3 And if physicians start looking upon addicts as “junkies,” the average person is likely to follow suit. Although a better understanding of addiction has resulted in most physicians having more sympathy for these individuals, there is still a major problem with discrimination against addicts in the medical and healthcare industries. However, the Obama Administration has been encouraging physicians to become certified to prescribe Suboxone to substance abuse patients4 while other forms of addiction medicine are slowly making their way into general practice.5
Associations Between Substance Abuse and Criminal Behavior
Prior to the onset of addiction, a substance user attempts to continue his or her substance abuse without having to sacrifice relationships, financial stability and career. However, a substance abuse habit is unsustainable and inevitably results in financial destitution. In fact, it’s for this reason that some addicts eventually become so desperate to obtain drugs or money to buy more drugs that they’ll resort to crime. Meanwhile, criminal activity is the most common focus in media portrayals of addicts. As a result, the public has come to see all addicts as untrustworthy, perhaps even dangerous, and deserving of punishment rather than being worthy of help.
To make matters worse, statistics show that many inmates have been incarcerated for drug-related crimes. Current estimates are that nearly half of the entire prison population is serving time for drug-related convictions.6 As well, studies show that alcohol or drugs are involved in 78 percent of violent crimes, 83 percent of property crimes and 77 percent of crimes related to public order, immigration, weapons offenses, and parole and probation violations. Further, at least 65 percent of inmates meet the diagnostic criteria for substance abuse disorders. These numbers would seem to validate the association between substance abuse and criminal behavior, but they don’t represent the population of addicts as a whole.
There are far more addicts who don’t get incarcerated than there are addicts who do. Unfortunately, statistics about the percent of drug-related crimes and the prevalence of substance abuse problems in prison seem to indicate a major correlation between crime and addiction when the reality is that, while addiction makes people desperate and somewhat more likely to commit crimes, there are more addicts who don’t.
Considering the widespread views about association with crime, discrimination by medical professionals and outdated moral judgement, it’s clear why a person suffering from addiction might be hesitant to seek help. Addicts encounter roadblocks resulting from the addiction stigma every single day. This stigma can make it difficult to get funding for treatment and adequate mental health treatment, and it often means many lost opportunities, which is why a number of recovering addicts keep their recovery secret.
The answer to the issue of addiction stigmatization is, though not easy, quite simple: education. At present, the negative views of addiction are largely the result of inaccurate media portrayals and an enduring, destructive tradition. We need to understand that addiction isn’t indicative of immorality, and the best way to do this is to learn more about addiction as a disease. In the face of the current addiction epidemic, our only hope to begin the healing process at large is by encouraging an enlightened understanding of the psychological, physiological and behavioral implications of a substance abuse disorder.
Written by Dane O’Leary