Addiction is a severe problem that affects millions, and is growing rapidly. While drugs and alcohol significantly damage the body, mind, and spirit, one of the most significant issues with addiction is the stigma or the belief that addiction is a choice or a moral failing. Stigma is one of the biggest reasons people don’t seek help and support for their substance use disorder (SUD), and this is killing people.
Addiction is a chronic biological, psychological, and social disease that affects only a portion of the general population. Most people who try drugs or alcohol will not become addicted. Taking a drink or using a substance does not flip a switch, creatingan instant addiction. A complex set of biological, genetic, and environmental factors go into someone developing a drug or alcohol dependence. This idea of drug addiction as a moral failing is only increased by its criminalization and social ostracization, which further pushes those with addictions to the margins of society.
Many people who aren’t addicted to drugs or alcohol often can’t comprehend the chemical and physiological wiring that goes into an addiction. Just because one person can stop using a substance doesn’t mean someone else can, no matter how much they want to, which is why addiction is characterized as the inability to stop using a substance. The drug or alcohol use will continue regardless of the intense damage that substance is doing to the mind, body, and spirit of the individual.
Ask anyone who has had their life torn apart by their addiction, and they’d tell you they wished it was as simple as “just saying no.” As much as many people with substance use disorders would prefer addiction to not be a chronic, lifelong condition, many studies have shown that it is, in fact, a disease. And unfortunately, like many diseases, it is progressive and often fatal. But, like most diseases, addiction is treatable, and there are many options for those seeking help.
When we handle addiction like a moral failing, we treat people with substance use disorders like “bad” people and people who don’t have substance use disorders like “good” people. Moralizing addiction stops people from seeking out of fear or shame. Why would anyone want to self-identify as a “bad” person?
So instead, the addicted person attempts to handle their recovery alone by using willpower to overcome achemical imbalance. Unfortunately, using willpower or trying to “white knuckle” abstinence is rarely enough to overcome the powerful disease of addiction.
Stigma isn’t only seen in family and friends, either. The concept of stigmatizing addiction is baked into the laws of the country that penalize people for reaching out or throwing them in jail for admitting their need for help. Like the stigma around mental health disorders, those with substance abuse disorders fear losing jobs, friends, family, and support simply for being transparent about their struggles. Stigma is everywhere and can have devastating effects.
The inverse is also true. When we treat addiction like what it is, a disease with treatments and medication and the possibility of recovery, it allows people to start the process of healing the illness. Recovery rates are higher when people have support, empathetic communities, stable housing, meaningful activities, and people in their life who don’t write them off as simply being beyond help.
The Substance Abuse and Mental Health Administration (SAMHSA) defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.” Expecting or demanding perfection from someone in recovery ignores the chronic and debilitating nature of addiction and infuses that same sense of morality into the process of achieving sobriety.
Progress is not always linear; relapses and remissions happen with diseases, including addiction. This does not mean that the person is not in recovery, nor does it mean they are not working hard towards building a fulfilling and meaningful life for themselves. In the same way that addiction can be stigmatized, the rocky and difficult road to recovery can be equally stigmatized. When we look at someone who relapses as a failure or moralize their mistakes, we make it that much harder for them to come back to abstinence.
The deadly practice of stigmatizing substance abuse must end. It does incredible damage and harm to those who want to recover and keeps them trapped in a cycle of isolation and shame.When we make a conscious effort to treat addiction as a disease and not project our moralized view of what we think we know and what we assume about addiction, it can make us better allies.
If you are looking to find support and resources for yourself or someone else, call the 24/7 SAMHSA National Helpline at 1-800-622-4357.
About the Author
Scott H. Silverman is one of the nation’s leading experts on addiction and recovery. He’s made countless public speaking engagements and appearances on television to raise the alarm about the opioid epidemic. He is the founder and CEO of Confidential Recovery, an outpatient drug rehab program in San Diego that specializes in helping Veterans, first-responders, and executives achieve long-term recovery.
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