The escalation of overdose deaths in the UK highlights a vast, often ignored, public health crisis. In 2022, there were 4,907 deaths linked to drug overdose, and this rate has seen a consistent annual increase since 2012. Men are more affected, with a death rate of 114.3 per million, compared to 55.8 per million among women. Additionally, those from Generation X are most likely to suffer from substance-related deaths, particularly people aged 40 to 49.[1]
Addressing the stigma associated with addiction is vital, as this acts as a barrier to seeking help and can dramatically affect the recovery outcomes and quality of treatment available. In a survey of 14 countries assessing the stigma attached to 18 different health conditions, substance use disorder (SUD) emerged as the highest or second most stigmatised condition in 12 countries. Similarly, alcohol use disorder (AUD) was ranked between the second and seventh most stigmatised condition in 13 of these countries.[2]
Through dismantling the misconceptions surrounding addiction and overdose, we can advocate for a change in narrative that promotes a more compassionate and beneficial approach to addiction treatment and recovery.
Defining Stigma and Its Layers
The stigma associated with SUD and AUD encompasses various behaviours and attitudes that negatively impact individuals struggling with addiction. It manifests through labelling, stereotyping, and discriminating, creating substantial barriers to effective treatment and social acceptance.
Public Stigma
Public stigma arises from societal views that blame individuals for their addiction, often perceiving them as weak or morally flawed. This societal judgement can lead to exclusion from community and family circles, reduced opportunities for employment, and significant mental health challenges.[3]
Structural Stigma
Structural stigma refers to the policies and institutional practices that limit the resources available to those with these disorders. This can include limited funding for addiction services, restrictive access to treatment programmes, and policies that favour punitive rather than rehabilitative measures.[4]
Internalised Stigma
When people absorb and accept negative societal attitudes toward their condition, they develop internalised stigma. This can lead to feelings of shame, low self-esteem, and a belief that they are undeserving of help, which severely hampers recovery efforts.[5]
Anticipated Stigma
Anticipated stigma involves the expectation of discrimination, leading people to avoid seeking treatment or help for fear of judgement or mistreatment. This anticipation can often be as crippling as actual experiences of stigma, perpetuating a cycle of silence and suffering.[6]
These stigmas create a hostile environment that discourages people from seeking help and receiving the support necessary for successful recovery. It is, therefore, crucial to address this to change public perception and improve the health outcomes of those affected.
Impact of Stigma on Addiction and Overdose
Stigma not only harms the social standing of people struggling with addiction but also undermines their recovery journey. The pervasive impact of stigma can be seen in how it influences the accessibility and the quality of healthcare people receive, along with their willingness to seek help.
Stigma often prevents people from seeking treatment due to fear of judgement or discrimination, and this is compounded by structural stigma within healthcare systems that may not prioritise addiction services or offer equitable care.
Additionally, healthcare professionals’ biases and misconceptions around addiction can lead to substandard care, with patients potentially receiving cursory attention or even encountering overt discrimination within treatment settings, which can discourage them from continuing treatment or accessing further help, and this can massively impact overdose intervention as people may be less likely to access harm reduction services and may worry about the legal ramifications of calling an ambulance.
Stigma also erodes social support by increasing isolation. Friends, family, and the wider community may distance themselves or express negative attitudes towards those struggling with addiction, exacerbating feelings of loneliness and rejection, which can result in people using alone or in secret, which can be linked with a higher risk of overdose.[7]
Perhaps most destructively, stigma can be internalised by people, leading them to believe they are unworthy of recovery or incapable of change. This self-stigmatisation lowers self-esteem and can trigger or worsen mental health issues such as depression and anxiety, making it harder for people to commit to recovery and maintain their sobriety.
Research consistently shows that stigma leads to poorer health outcomes, and people struggling with addiction who experience high levels of stigma are more likely to have higher rates of relapse, lower rates of treatment adherence, and, ultimately, a higher risk of overdose.[8]
Addressing stigma is not just about changing perceptions; it’s also about creating a supportive environment that enhances recovery. It requires concerted efforts across societal, policy, and individual levels to ensure everyone can start their recovery journey without prejudice or discrimination.
Strategies to Combat Stigma
To effectively change the narrative surrounding addiction, it’s important to implement communication strategies that help promote understanding and empathy. Several approaches that can contribute to this goal include:
- Educational Initiatives: Increasing public awareness about the nature of addiction as a medical condition rather than a moral failing can help change perceptions.
- Language Reform: The way we speak about substance use has a significant impact on stigma. Promoting the use of non-stigmatising language, such as saying someone with a substance use disorder instead of derogatory terms like drug addict or junkie, can make a big difference.
- Media Representation: Media plays a powerful role in shaping societal attitudes. Encouraging media outlets to portray addiction realistically and compassionately can aid in normalising the conversation.
- Peer-Led Programmes: Initiatives led by people who have experienced addiction firsthand can be particularly impactful. These programmes provide relatable insights and real-life success stories, which can inspire others and encourage a supportive community environment.[9]
- Policy Advocacy: Advocating for policy changes that facilitate access to treatment without discrimination is essential. This includes pushing for healthcare policies that treat addiction on par with other medical conditions, ensuring that people receive appropriate care without judgement.
- Inclusive Healthcare Practices: Training healthcare providers to treat individuals with SUD and AUD with the same respect and dignity afforded to all patients is vital. This includes ongoing education on the latest research and best practices in addiction treatment.[10]
The overall goal is to create a society where individuals feel empowered to seek help and support without fearing stigma or discrimination.
Empowering Recovery and Enhancing Care
It’s essential for those struggling with addiction and their loved ones to recognise that they are not alone and that help is available. At Assured Healthcare and Wellness, we offer expert nursing care tailored to each person’s unique needs. Our experience in the field of addiction and mental health allows us to navigate the complexities of these conditions and help individuals reclaim their lives.
We encourage anyone affected by addiction and overdose, whether directly or indirectly, to reach out for support. Engaging with professional help can be a transformative step toward recovery. Let us help you or your loved one start on the path to recovery today.
Sources:
- https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2022registrations
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311321/
- https://pubmed.ncbi.nlm.nih.gov/28499109/
- https://mentalhealthcommission.ca/wp-content/uploads/2021/09/Combating-Mental-Illness-and-Substance-Use-Related-Structural-Stigma-in-Health-Care.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527047/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9948814
- https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-00933-y
- 378862991_Relapse_in_Substance_Use_Disorder_and_Its_Relation_to_Stigma_An_Outpatient_Based_Cross_Sectional_Study
- https://www.gov.wales/sites/default/files/statistics-and-research/2019-07/141127-review-two-peer-led-recovery-interventions-en.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656222/
