Substance Use Services Blog Series: The Impacts of Stigma on Self and Family
July 4, 2020
This week we are finishing our three-part series on stigma (find the first post on myths and realities here, and the second post on different kinds of stigma, shame, and self-compassion here). In the previous posts, we mentioned that stigma deters people who use drugs from seeking help, but we didn’t elaborate on how. This post will explore:
A) How stigma becomes a barrier to accessing help
B) How stigma affects the families of people who use substances
A) How stigma impacts getting support
Stigma can bring up hopelessness and other painful emotions
Hearing negative beliefs about oneself from others can bring up painful emotions that people typically try to avoid in their daily lives, such as, shame, fear, and anger. One aspect of stigma that can be painful is the way it generalizes unique human experiences. Making generalizations about who someone is, or how they have lived, can lead to frustrating misunderstandings and feelings of loneliness or invisibility for the person being misconstrued.
But the problems with stigma go further than generalizations because they perpetuate a specifically negative picture of those who are stigmatized. Stigma about substance use often focuses on the choice to use substances as morally wrong (or as taking a personal risk) and the person who used substances as deserving any negative outcomes resulting from their use. This belief greatly reduces the complex set of circumstances around using to a simple black and white dilemma. Reducing the complexity can generate feelings of moral failure, powerlessness, and hopelessness for people who want to quit or reduce their use but find themselves continuing to use. Getting help with substance use requires hope and some sense of empowerment. When people feel powerless and hopeless, they are unlikely to believe that change is possible. In fact, some people who use substances have reported that stigma increases their use, because substances at least temporarily allow them to escape the painful emotions caused by stigma[1].
Stigma can blind us to problems with our own substance use
While you may have alrea
dy heard discussions about stigma similar to the one above, a less talked about issue is how stigma can blind people to the fact they are having a problem. When a person believes that people with an ‘addiction’ or ‘substance use problem’ look or act a certain way (e.g., not showing up for work or buying illegal drugs), they may not recognize when their own use is affecting their life negatively. In this way stigma can cause people who use substances to suffer for longer than if they had had a more neutral view of who may be having a problem. It can also lead people who use substances to take less precautions around overdose prevention, if the stigma they believe suggests overdose is something that only happens to people who are using drugs more frequently or to those who are having specific kinds of socio-economic problems (such as experiencing homelessness). In other words, not only does stigma create a barrier for those who want to get help, it blinds people from recognizing that help could be useful.
B) Stigma’s effect on the Family
There are also many ways in which stigma can affect the family members of people who use substances. While the following sections look at how families may be affected, keep in mind that no family is the same and different family members may be affected differently at different times.
Family members may also be hurt by the various kinds of stigma
When the public or service providers promote stigma about substance use, family members of people who use substances may also experience the range of uncomfortable emotions described in the section above (fear, anger, hopelessness, invisibility, etc.). Stigma can thus become a barrier to family members accessing help for themselves or supporting the person who is using substances to access helpful services.
Loved ones of people who use substances may also experience self-stigma and shame, imagining they have somehow caused the substance use or are at fault for not being able to prevent it. Because current research often focuses on the correlation between substance use problems and adverse childhood experiences and/or trauma, parents and especially mothers, may blame themselves for their child’s substance use, or fear that others will blame them. This can lead to prolonged denial that their child has a problem or a delay in getting help for themselves or their loved ones.
Recognizing and researching this correlation is very important, however, it is equally as important to keep in mind that not everyone who survives trauma or adverse childhood experiences comes to have a substance use problem and not everyone who has a substance use problem had a traumatic or adverse childhood experience. The reasons that people come to have problems with substance use is always complex. To avoid stigmatizing people who use substances and their families, assume nothing about their pasts or about their family dynamics.
Loved ones may also be in denial that there is a problem.
Same as in the discussion above about stigma blinding individuals to problems they may be having with substances, stigmatizing beliefs about how ‘addiction’ or ‘problematic substance use’ appears can also obscure problems with substance use from family members, slowing down the process of getting help.
Family members may also stigmatize the person who uses substances.
A 2010 Toronto study, involving interviews of 60 people who were currently using substances, found that according to the interviewees, the most significant stigma with the most negative impact on their well being came from their own family members[2] . According to the study report, participants described incidents of stigma such as, “being cut off from family connections, a lack of support, and negative judgements not only about their behaviour but also about their character”.
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At Deltassist, we acknowledge that when a family member is suffering from problems related to substance use, other members of the family may also be suffering. It can be very difficult to balance supporting the person who uses substances in helpful ways, while maintaining healthy family boundaries. An upcoming post will be completely devoted to issues and resources for the families and loved ones of people who use substances. For immediate suggestions on how to talk to friends and family members in an non-stigmatizing way check out this resource we posted in a previous blog, “When Words Matter,” by Fraser Health.
Please also remember that:
- Delta residents who would like to discuss their own or someone they love’s substance use can access counselling through the Deltassist Substance Use Services intake line:
604-594-3455 ext. 108 - Other services that are available to Delta residents looking to reduce or quit their substance use are listed here .
- If you are elsewhere in British Columbia or cannot find a service you are looking for, please call the BC Alcohol and Drug Information and Referral Service at 1-800-663-1441 or
604-660-9382
And keep hope in mind. Despite the stigma in the world, everyday people continue to stop and reduce their substance use. Here is a 5 minute video from PBS in which a handful of people share how they triumphed over stigma and their substance use problems.
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.toronto.ca/wp-content/uploads/2018/01/93e2-stigmadiscrim_rep_2010_aoda.pdf
[2] https://www.toronto.ca/wp-content/uploads/2018/01/93e2-stigmadiscrim_rep_2010_aoda.pdf
