What is stigma?
Stigma is “...a set of negative and often unfair beliefs that a society or group of people hold about something.” Stigma is rooted in myths, misunderstandings, and negative attitudes.”
Stigma is commonly directed negatively towards individuals who use, or have used, alcohol and other drugs (AOD). Illegal drug dependence is ranked as the most stigmatised health condition worldwide, with alcohol dependence following as the fourth most.
The stigma of drug use and drug dependency
When a person is labelled by their drug use, they are no longer seen as the person they are, but as part of a stereotyped group.
A significant percentage of people will try drugs in their lifetime, but few people will develop a dependency or substance use disorder. There are many reasons why an individual may be more susceptible to substance use disorders, including genetic, social and environmental factors that, according to scientific studies, are often beyond their control.
The latest National Drug Strategy Household Survey reports an estimated 10.2 million (47%) people aged 14 and over have used an illicit drug at some point in their lifetime, and an estimated 3.9million (18%) of the population have used an illicit drug in the last 12 months.
Despite the relatively high number of people who have tried illicit drugs, according to the Australian Bureau of Statistics 3.3% of Australians (647,900 people) aged 16–85 years had symptoms of a substance use disorder. A substance use disorder (SUD) is a treatable mental disorder that affects a person’s brain and behaviour, leading to their inability to control their use of substances, such as legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form.
When we acknowledge that drug use disorders are fairly rare and drug dependency is often beyond an individual's control, we begin to understand why the stigmatisation of drug use is unfair and unhelpful.
Challenging the Stigma
Challenging the stigma surrounding drug use requires collective action and a commitment to empathy, equity, non-stigmatising language, and evidence-based approaches.
Empathy: Empathy comes from a better understanding, and this can be achieved by listening to and amplifying the voices of individuals with lived experience. By centring their narratives and advocating for their rights, we can empower individuals affected by substance use disorders and promote a culture of inclusivity and support.
Equity: Equity in AOD healthcare means fair access to services is available to all people in the community, and unfair and avoidable barriers to treatment are removed (Department of Health 2021). Inequities in health systematically put groups of people who are already socially disadvantaged at a further disadvantage with respect to their health. Population groups at greater risk of poor health include Aboriginal and Torres Strait Islander people, people who are socio-economically disadvantaged, people living with a physical or intellectual disability, people affected by discrimination, social exclusion, incarceration, and people from culturally or linguistically diverse backgrounds.
It is important to note that equity and equality are not the same. Although both promote fairness, equality achieves this through treating everyone the same regardless of need, while equity achieves this through treating people differently depending on need. This means ensuring there are specialist drug and alcohol services available for marginalised groups that cater for their specific needs.
Non-stigmatising language: Language is powerful - especially when discussing alcohol and other drugs and the people who use them. Stigmatising language reinforces negative stereotypes. “Person-centered” language focuses on the person, not their substance use. An example of person-centered language would be using phrases such as “substance use” or “person with a dependence on...” rather than “addict” “drugie” or “suffering from addiction.” You can learn more about the Power of Words here.
Evidence-based practice: (EBP) is an approach to care that integrates the best available research evidence with clinical expertise and patient values, that together provide quantifiable results which can further shape how we care for people. Evidence-based practices include psychological interventions such as cognitive-behavioural therapy, contingency management, and Motivational Interviewing. Other examples could include practices such as medical-assisted treatment such as OTP (Opioid Treatment Program).
Why is addressing the stigma of drug use important?
Stigma is frequently cited as a barrier to help-seeking for many with substance-related conditions. Stigma can lead to an increase in drug use alongside a decrease in help-seeking, which can in turn lead to a negative cycle of further shame and stigma.
A report by the Queensland Mental Health Commission concluded that experiences of stigma and discrimination negatively impact people’s access to services including health care, fair treatment in the justice system, employment opportunities, relationships with family and friends and feelings of social inclusion. These experiences are distressing and can result in people feeling shame, anger, rejection and a sense of worthlessness and hopelessness. This in turn can trigger further alcohol and other drug use.
Stigma intersects with other social determinants of health, exacerbating disparities among vulnerable populations. Aboriginal and Torres Strait Islander people experience multiple stigmas, which further compounds access to treatment and quality of life. One study, published in the International Journal of Drug Policy found Aboriginal and Torres Strait Islander participants experienced multiple psychosocial stressors linked to stigma at significantly higher rates than non-Indigenous participants. These stressors include diminished access to health care (33%), experiences of racism (34%), grief and sorrow (39%), worry for family (46%), and child welfare experiences (46%). The qualitative findings highlight the cumulative impact of historical, political, and social stressors on an already stigmatised population.
Finally, it is important to note that stigma and discrimination may not always be obvious, discrimination can be built into behaviour or language as the ‘norm’ without being consciously noticed. It is everybody’s business to consistently reflect on their own assumptions, beliefs, and behaviours to make sure that people who use alcohol and other drugs are always treated with respect.
Getting help
If you think you might benefit from help with drugs or alcohol it may be time to discuss with your doctor / GP, counsellor, or a support service.
For free and confidential advice call the Alcohol and Drug Information Service (ADIS) on 1800 250 015. You can call ADIS 24 hours a day, 7 days a week. Or start a Web Chat with an ADIS counsellor online Monday to Friday, 8.30am – 5pm.
Family Drug Support provides 24 hours a day, 7 days a week telephone support to families and carers in crisis due to alcohol and other drug use issues. FDS (Family Drug Support) is staffed by volunteers who have experience with family members with alcohol and other drug use. FDS also provides face-to-face support meetings and resources for family members. You can contact them on 1300 368 186
The Your Room website houses all the latest drug and alcohol news, trends, and information. Visit the A-Z of drugs to learn more and start a conversation with Yas the chatbot who can help you find answers about alcohol and other drugs or tell you about available services.
A comprehensive list of resources and support information can be found here
