Stigma /ˈstɪɡ·mə/ – a strong lack of respect for a person or a group of people or a bad opinion of them because they have done something society does not approve of. (Cambridge Dictionary)
Stig·ma /ˈstiɡmə/ – noun – a mark of disgrace associated with a particular circumstance, quality, or person (Oxford Pocket English Dictionary)
Stig·ma / stig-m / noun-
a: a mark of shame : STAIN
b: an identifying mark or characteristic; especially a specific sign that indicates the presence of a disease (Merriam-Webster Dictionary)
Scientific consensus and public perception
Addiction is a confounding, frustrating disease with a history that puts it in a class of its own. Throughout most of humanity’s time on earth, addiction has been defined as some level of character or moral defect. It is only in our very near past that the medical community has come to consensus on the fact that addiction is a true, definable brain disease. But, here’s the rub: If any of us were to act as a street reporter and go out into the general population to ask, “Is addiction a disease or a choice,” we’d come back with a variety of answers. My guess would be that the majority would say, “It’s a disease… but…”
And, the “but” is where the problem lies when it comes to the stigma associated with addiction. The vast majority of people believe that there is a choice involved in acquiring the disease of addiction; that there is some level of personal culpability in becoming an addict. With that sentiment comes the belief that all of the bad behavior associated with addiction is a moral choice and not a choice born of a diseased brain.
It’s the brain not the character, a disease not a choice
There is no other chronic, progressive and potentially fatal disease that we identify by an associated behavior.”
As an aside, allow me a moment to explain why I use the word “addiction” rather than the current diagnostic terms of “Substance Use Disorder” or “Behavioral Health Disorder.” Both of those terms describe a disease in terms of its symptom, not in terms of its biology. Excessive uses of a substance and/or addiction related behaviors are symptoms of addiction. They are not the cause of addiction. There is no other chronic, progressive and potentially fatal disease that we identify by an associated behavior. We do not call diabetes the “carbohydrate abuse disease,” or lung cancer the “smoking disease,” or high cholesterol the “saturated fat overconsumption disease.” That would be ridiculous because medical science understands that these conditions are far more complex than a single behavior or cause. So, unless we begin labeling all diseases by their associated behaviors rather than their biology, I’ll just stick with the term “addiction.”
That’s my on little war on addiction-related stigma, to be truthful. One of the reasons that addiction stigma exists in our culture is that the average person continues to hear the professionals define addiction in terms of behavior. Granted, some of the most outstanding features of addiction are astoundingly poor judgement, terrible decision making, and a frightening lack of self-preservation. However, those visible and often disastrous symptoms have their roots in a diseased brain; not in a flawed character or lack of basic morality.
Societal roots of addiction stigma
As I began this narrative with a mention the history of addiction, I will say stigma has its own history. People with the disease of addiction have gone through some very dark times in the not-too-distant past. Initial treatment for people with “hopeless” alcohol addiction was to send them places called inebriate asylums against their will. Shameful parts of our history marked people with addiction as “defectives,” which allowed them to be forcefully sterilized so as not to procreate. These drastic attempts to treat the addicted person are baked into our society’s judgement about addiction and are symbols of just how hard it is to treat and manage the disease.
Breaking stigma one story at a time
Fortunately, addiction can be treated. It can be managed. There is hope that we can overcome stigma of addiction as the evidence about the true biological origin of the disease comes out in credible ways. People can come to understand that recovery from addiction is not only possible, it can be amazingly positive. It is why I say with regularity in my role as public speaker that I am a woman in long term recovery. I break stigma because people do not see me; a white, blond, 50-something woman with a PhD as their stereotype of addiction. No, I’m not the stereotype of addiction, but I am certainly not a rare example of life in recovery either. I’m happy to say that I am not alone!
Shame, disrespect and disgrace have no place in the prevention, treatment and recovery from a disease. My great hope is that understanding of addiction will grow to the point where those who suffer with the disease along with their friends and family will be afforded the same measure of respect and grace that we offer anyone with a chronic disease. It is simply the human thing to do. It is simply the right thing to do.
