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1/9/2008
SPOTLIGHT ON...
Stigma
by Ames S.

The argument over addiction as a matter of chemistry or choice continues among professionals searching for answers to one of society’s oldest and most pressing problems. For those in the middle – those with addictions, either active or in remission – watching the question swing back and forth can be like watching a tennis match. Addiction is a disease, so nobody is to blame. Addiction is entirely volitional – nobody forces those people to drink or take drugs. They can’t help it. It’s their own damned fault. Disease. Choice. Brain chemistry. No willpower. And so it goes.

Whether alcoholism is a disease or a function of personal choice, the way people perceive alcoholics and addicts has not changed considerably over time. On one hand, people seem to recognize that alcoholism is more than a moral issue, and yet, at the same time, believe that alcoholics ultimately do it to themselves.

You’d think that recovery would be a ticket out of this mess, but the stigma surrounding addiction doesn’t just stop when people put down the alcohol and drugs. According to a  national survey conducted in 2004 by Peter D. Hart Research Associates and Robert M. Teeter's Coldwater Corporation, people in long-term recovery from addiction to alcohol or other drugs face widespread stigma and discrimination.

According to the poll, two thirds of the public believes that a stigma exists toward people in recovery from addiction to alcohol or other drugs. A significant minority (27 percent) admits they would be less likely to hire someone who was in long-term recovery from addiction, and strong majorities say that discrimination in the workplace (80 percent) and the availability of health insurance for people seeking recovery (75 percent) is a problem in the United States today.

“Stigma is one of the meanest and most difficult aspects of addiction because it makes it harder for individuals and families to deal with their problems and get the help they need,” says David L. Rosenbloom, Ph.D., the Director of Join Together, a program of the Boston University School of Public Health, which helps communities fight substance abuse and gun violence. “Society imposes stigma - and its damage - on addicts and their families because many of us still believe that addiction is a character flaw or weakness that probably can't be cured.

“The stigma against people with addictions is so deeply rooted that it continues even in the face of the scientific evidence that addiction is a treatable disease and even when we know people in our families and communities living wonderful lives in long-term recovery.

“Stigma is the reason there is so much social and legal discrimination against people with addictions. It explains why addicts and their families hide the disease.”

According to the Center for Substance Abuse Treatment (CSAT) in “Substance Use Disorders: A Guide to the Use of Language,” one way to combat stigma is to stop perpetuating negative connotations people may have about addiction by using words like addict, alcoholic, user and abuser, which reinforce the stigma, says CSAT. These terms label a person by his or her illness and, because they make no distinction between the person and the disease, deny the dignity and humanity of the individual.

The U.S. Department of Health and Human Services' (HHS) Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) published a report entitled Changing the Conversation: The National Treatment Plan Initiative to Improve Substance Abuse Treatment in November 2000. The intent of this report was to "change the conversation" about substance abuse and treatment to stress that addiction is a treatable disease.

Clearly, it will take more than a change in language to alter society's perceptions, attitudes, and policies toward addiction. Says Dr. Nora Volkow, Director of the National Institute on Drug Abuse, "At one point, we had the stigma of leprosy. Nobody spoke about leprosy. We had a stigma of cancer at one point. There's still a significant stigma with some of the mental diseases, but much less so than there used to be. But the one that's lagging behind is addiction."

Millions of Americans are in long-term recovery from addiction to alcohol and other drugs and are leading productive lives. “It is now time for this to be affirmed in all areas of society,” says Pat Taylor of Faces and Voices of Recovery, a national recovery advocacy organization. "Breaking the cycle of addiction is critical to a healthy society," continues Taylor. “Our nation's policies and programs should support -- not set up roadblocks for -- the 23 million Americans who still need help."