What is the nature and extent of the stigma associated with problem drug users?

Written by: Timokleia Panagopoulou.

The nature and extent of stigma is associated with problem drug users and that creates implications for policy and practice.  More specifically, stigma is “a mark of disgrace associated with a particular circumstance, quality, or person” (Oxford Dictionaries, 2013). Stigma for problem drug users has been created because people believe stereotypes such as drug users  are ‘junkies’, burglars inferiors (Lloyd, 2010) and burdens (Singleton,2011; UK Drug Policy Commission [UKDPC], 2010). As a result people don’t want to live next door to a drug user and many of them are opposed to a relationship with a drug dependent. All these beliefs create discrimination for that group of people, as they may be isolated from social events as well as from all of society and as a result their drug use may have increased (Buchanan & Young, 2000).

The nature and extent of stigma on problem drug users

The stigma facing problem drug users is multi-levelled, as it has a lot of consequences. The three most serious are the personal problems they face, as well as mental and psychical problems. Also, their families face stigma.  Health professionals, as well as the media, are responsible for introducing negative stereotypes.  Finally, the whole society is responsible for the current state of stigma in society.

User’s problems

Drug users often report social exclusion from other members of society.  They accept that other people stigmatise them, and they henceforth don’t react to people in a manner typical of the rest of society.  Non-drug users view users as a lower social class of society and more than 50% in Scotland believe that they are a burden on society (Singleton, 2011).  Sometimes they feel that other people are talking about them negatively when they are not present.  It seems that they are unable to create true friendships and relationships with others for a long period because of the isolation created by stigma (Buchanan & Young, 2000). As a result of all these stereotypes, discrimination is increased and (Young, Stuber, Ahern & Galea, 2005) drug user’s self-esteem is substantially decreased (Simmonds & Coomber, 2009).

Mental and physical problems

Because of stigma, problem-drug users not only face rejection, but they also anticipate others’ rejection of them.  The result of this is chronic stress. A research, which took place in three New York city neighbourhoods between 2000 and 2001, shows that drug users are more stressed at work or at home than non-drug users, on account of such stigma (Young, Stuber, Ahern & Galea, 2005). Sometimes, this chronic stress effects parts of the brain (Ahern, Stuber & Galea, 2007), which in turn can lead to chronic health problems, in general (Young, Stuber, Ahern & Galea, 2005). This kind of problems drive drug users cannot cope without self-medication and as a result they continue to use drugs.

Family

Family members of problem-drug users, also face stigma in their daily life.  More specifically, stereotypes and people’s reactions stigmatise also them. 29% of people in Scotland believe that heroin users suffer family difficulties (Corrigan, Miller & Watson, 2006). Family members feel shame for drug use and because of that they avoid personal relationships with people who know about the family member’s drug dependence because they believe that people will judge them in a negative way (Singleton, 2011). The consequence of that is, to remain isolated and not make new relationships.

Health Professionals

Some of health professionals also have stigmatized reactions to drug users. More specifically, the attitudes of some doctors, nurses are negative, and these individuals accept that their behaviour toward them is different than that to their other patients (Lloyd, 2010). Research from the U.S.A. points primary-care doctors and physicians, who work at hospitals viewing problem-drug users in a negative light (Lloyd, 2013). It seems that, they agree with the stereotype that problem-drug users have a poor social prognosis. Social services refer to them as junkies (Simmonds & Coomber, 2009).  These negative attitudes have an impact on treatment, as those with such attitudes are inappropriate for helping a drug user to gain the goal of recovery.

Media

Media has a real power to create imagery that can have widespread influence. Sometimes it is pivotal in the stigmatisation of problem-drug users. However, they do not report the full extent of the issues facing problem-drug users as they represent criminality as one and the same.  Taylor (2008) suggests that the media turns these individuals into ‘outsiders’ of their society. A lot of people in a given society may not know a drug dependent, personally, but all of them have their own opinion about the dangers of use, as well as the lifestyle of users.  This is the public opinion that the media has created (Australian Injecting and Illicit Drug Users League, 2011. This is happening because people love watching this kind of programmes and as a result media may earn more money.  If someone has been identified as a drug-user, by the media, they then have great difficulty in shedding this label (Count the costs, 2011). Consequently, the level of drug use grows at 70%, because of the stigma created by media (Lloyd, 2010).

Society

The majority of people believe that drug addicts are dangerous and unable to be reasoned with (Lloyd, 2010). In general, when people speak of drug users, they describe them as dirty, homeless and jobless. However, this is often an untrue assessment (Australian Injecting and Illicit Drug Users League, 2011). A case of society stigmatising drug users can be seen in pharmacy interactions. Some heroin users pick up their prescribed methadone from their pharmacy, where they cannot avoid the stigmatisation of both staff and other customers (Lloyd, 2010). Drug users face exclusion from the society even when they manage to overcome their addiction (Taylor, 2008). Moreover, drug addiction is one of the most serious causes for social disapproval (Room, 2005). Simmonds and Coomber (2009) support the notion that society stigmatises poor drug users more so than more affluent users. Also, especially in smaller towns, friend groups are often segregated between groups who use and groups who do not, with very little mixing (Simmonds & Coomber, 2009).

Measures to reduce the problem of stigma

Drug users don’t have any support from governments or from whole of society and as a result their treatment blocked as their access is made difficult. In order to reduce the problem of stigmatisation, governments must take measures to ensure the successful reintegration of prior drug-users into society. This will only happen when a better general knowledge of drug use, amongst national populations, reduces national fears (Singleton, 2011).

To conclude, it is true to say that stereotypes, for drug users, create a lot of difficulties in their daily lives, such as psychological problems, chronic stress and isolation for themselves as well as for their families. These stereotypes have been increased because of health professionals, media and society and as a result they implicate policy and practise. More specifically, people face them as criminals and ‘junkies’. Consequently, they suffer from discrimination as often they cannot work and they cannot vote as members of society. Moreover, drug users are responded to differently than other patients within the health care system and some of them are abused. What is more, their families have problems with their accommodation. Finally, some of them who are younger lose their rights to ask for studentships and continue their studies.

The main and the most important consequence of stigma on problem drug users is that the discrimination and the stereotypes which create more drug use.  It is for this reason that health professionals and all members of every society should understand the powerlessness of problem-drug users, and it is thus necessary that these other members assist them in establishing normalcy within their lives (Weil, 2013).

References:

  • Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88, 188-196.
  • Australian Injecting and Illicit Drug Users League (2011). Why wouldn’t Discriminate against all of them? A Report on Stigma and Discrimination towards the Injecting Drug User Community. Canberra, Australia.
  • Buchanan, J., & Young, L. (2000). The war on drugs- a war on drugs users?. Drugs: education, prevention and policy, 7(4), 409-422.
  • Corrigan, P.W., Miller, F.E., & Watson, A.C. (2006). Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members.  Journal of Family Psychology, 20(2), 239-246.
  •  Count the costs, (2011). The War on Drugs: Promoting stigma and discrimination. www.countthecosts.org
  • Lloyd, C. (2010). Sinning and sinned against: the stigmatisation of problem drug users.  Kings Place. London: UK Drug Policy Commission.
  • Oxford Dictionaries, (2013). http://www.oxforddictionaries.com/ 
  • Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review,24, 143 -155.
  • Simmonds, L., & Coomber, R. (2009). Injecting drug users: A stigmatised and stigmatising population. International Journal of Drug Policy, 20, 121–130.
  • Singleton, N. (2011). Getting serious about stigma in Scotland: The problem with stigmatising drug users. London: UK Drug Policy Commission.
  • Taylor, S. (2008). Outside the outsiders: Media representations of drug use. Probation Journal 55(4), 369-387.
  • Weil, L. (2013). Drug-related evictions in public housing: congress’ addiction to a quick fix. Yale Law & Policy Review, 9(1), 161-189.
  • Young, M., Stuber, J., Ahern, J., & Galea, S. (2005). Interpersonal discrimination and the health of illicit drug users. The American Journal of Drug and Alcohol Abuse, 31, 371–391.

One thought on “What is the nature and extent of the stigma associated with problem drug users?

  1. Thanks, Timokleia

    A very well-researched and thorough post.

    Have you done any research into why groups stigmatise difference? It is the norm in the animal world and we seem to be no different to any other social creature.

    Anecdotally (which I know is not evidence) my observation is that difference that does not constitute a threat (ie small numbers or small differences) is tolerated – and sometimes treated with sympathy. Where is the boundary?

    Could this be something to work with as a hypothesis? If we perceive that the person has created the difference by choice we are less forgiving than if it has occurred by force of circumstance.

    You will note that Free Will v Determinism is a theme of this blog, so your response will be of interest.

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