Substance Use Services Blog Series: Myths Behind Stigma
June 10, 2020
The first series of posts in our Substance Use Services blog discussed the types of resources available to Delta residents looking to abstain from or reduce their substance use. Over the next weeks, we will be examining stigma and its consequences. Stigma is one of the most significant barriers people face when they reach out for support. When people who use substances and their loved ones face stigma they are discouraged from talking openly about any difficulties. This can prevent them from coming to terms with substance use problems which can lead to increased suffering and potentially tragic consequences. If you would like to speak to someone non-judgmental about yours or a family member’s drug or alcohol use, please call the Deltassist Substance Use Services line at (604) 594-3455 ext. 108. Other resources available to Delta residents are listed in the preceding blog posts.
What is Stigma?
The Canadian government defines stigma as, “negative attitudes and beliefs about a group of people due to their circumstances in life. It includes discrimination, prejudice, judging, labelling, isolating and stereotyping.”[1]
What are the negative attitudes and beliefs that stigmatize people who use substances?
Stigma is often fuelled by incorrect beliefs about substance use that have been proven wrong by scientific and statistical research. Here are some common myths that fuel stigma contrasted with the realities behind them:
Myth: You can identify a person who uses substances just by looking at them.
Reality: There is no way to tell if someone uses substances just by looking at them. Substance use is something that affects people across the lifespan regardless of their income or to what people groups they belong.
Additionally, many behaviours that people associate with drug and alcohol intoxication can be caused by other medical situations. For example, slurred speech, shaking, and psychosis can all be caused by other neurological conditions. Do not assume that a stranger’s behaviour is caused by alcohol and drug use.
Myth: People who use drugs cannot hold down jobs. 
If someone has a job, they do not have a substance use problem.
Reality: Many people who use substances continue to work their jobs. In fact, substance use can affect people in any career, including doctors, judges, and members of government.
Additionally, many people who cannot work do not have substance use problems. Despite this fact, many people who receive income assistance and/or experience poverty and homelessness experience stigma related to substance use regardless of whether or not they have ever used substances.
Myth: Only people who use illegal drugs heavily are in danger of overdose.
Reality: Many kinds of legal substances, such as prescriptions drugs and alcohol, can cause overdose when used heavily or when combined in certain ways. Please inform your subscribing doctor and pharmacists of all the drugs you are taking and follow their instructions about using them carefully.
Additionally, people who use small amounts of drugs can be in danger of overdose if the drugs are laced (mixed with other drugs without the user’s knowledge) and drugs such as the opioid fentanyl can cause overdose when used in small amounts. You do not need to have a history of substance use problems to be in danger of overdosing.
Myth: Because some people can quit drugs “cold turkey” (i.e. suddenly by choice), anybody can.
Reality: The relationships between quitting, the human body, and substances are complex and unique to each individual. People’s choices around substance use will be influenced by the specifics of their bodies’ chemistry (such as their genetic makeup), the context in which a choice is being made, and the person’s life experience.
Additionally, the presence of some substances in the human body can cause a physical dependence on the substance that makes quitting cold turkey dangerous and even potentially lethal. People who may have developed physical dependence on a drug or alcohol are encouraged to call their local withdrawal management service to see if they require medical assistance. For Delta residents that is Creekside Withdrawal Management Detox Services at (604) 587-3755 option 2.
Myth: People who use substances need to be punished so they will not use substances again.
Reality: Punishment tactics rarely work for those who wish to quit or reduce their substance use. In fact, punishment and stigma increase the likelihood that people who use substances will become isolated from the resources and communities that can support them reach these goals.
Why is stigma about drug use a public health issue in Canada?
Stigma is a public health issue because when people who use substances experience stigma from someone working at a formal resource (such as an emergency services worker, or a substance use counsellor) or a community member, they are less likely to reach out when they want and/or need help.
What can I do about stigma?
Examine your own beliefs and attitudes. Do you believe any of the myths discussed above that have been proven wrong? If so, ask yourself why you hold onto these beliefs. What is your evidence?
Adjust your language about drug use and people who use drugs. Some words around drug use have clear negative connotations (like junkie), while other words have come to have negative connotations because of the way they has been used in the past. If you use language with negative associations you may be promoting stereotypes and negative judgements, even if that is not your intention.
The Canadian government recommends the following two principles be used to determine language choice around substance use:
- Use “neutral, medically accurate terminology when describing substance use
- Use “‘people-first’ language, that focuses first on the individual or individuals, not the action (e.g. ‘people who use drugs’)”
For specific examples, visit the government of Canada webpage .
Acknowledge that you still have implicit biases that may be stigmatizing. Implicit bias are associations our brains make between ideas automatically, without our thinking about or even realizing we are making them. It’s a function of our brains to make these associations so that we can remember things easily. These biases can persist even when the logical, aware part of our brains do not believe there is a connection between the ideas. Because these biases are often outside our awareness and persist even against our reasoning, it is important to be open to feedback from other people around how your behaviour or language may be stigmatizing.
You can find out about your implicit bias around various subjects by taking an online test created by researchers at Harvard. Unfortunately, they do not have a substance use specific test but they do have test around issues such as mental health, weight bias, and racism here.
Click here for the second post on the topic of stigma and here for the third post.
Update Sep 21, 2020: A fourth post on stigma now looks at how we can be stigmatized for multiple parts of our life circumstances at the same time, such as in the case of racial or gender stigma. Access this post here.
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[1] https://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/stigma.html
