There are many reasons why people addicted to substances resist admitting they have a problem. Denial is one of the symptoms of addiction and people fear the effects of withdrawals. Unfortunately, the stigma surrounding addiction makes the journey so much harder. Although there is countless evidence to the contrary, a fair amount of people still view it as a moral failing.
This stigma is rooted in misconceptions, prejudices, and even political campaigns. Demographic factors also play a role, in terms of both internal and external perceptions.
The addiction recovery community has spent decades trying to break the stigma, but there is still plenty of work to be done. If you are still struggling to see why addiction is not a moral failing, or have loved ones who are resistant to seeing it as a disease, here are some of the facts that need to be more widely understood.
Why is Addiction Stigmatized?
There are multiple factors at the root of the addiction stigma, some less innocent than others.
To begin with, addiction does make people act in ways that are harmful to themselves and others. When you are one of the people being harmed, or are part of a community with major addiction issues, your gut reaction may well be one of anger. It’s tough to experience manipulation from someone you trusted and still feel compassion for them.
This is why understanding the disease model of addiction is so crucial. To engender empathy for the person, it is necessary to know that these harmful behaviors are symptoms of an illness and not due to personal misgivings. You wouldn’t judge a person with a physical illness for their symptoms, after all.
However, there are other factors perpetuating the stigma surrounding addiction.
The Problem with ‘Just Say No’
In the 1980s, first lady Nancy Reagan led the much-publicized ‘Just Say No’ campaign in order to fight addiction. Her approach may have been well-intentioned, but not only did it not work, but it has had negative consequences that continue to this day.
The idea behind ‘Just Say No’ is that preventing addiction is all about individual choices. The theory is that, with a little bit of willpower, a person can resist the siren song of substances.
If only this were true! People with substance use disorders often express that they would love to just say no, but there are physical and psychological factors that cause them to start and continue using.
Sadly, many awareness campaigns still take this approach, warning people of the dangers of substances instead of combatting the underlying causes of the illness. Evidence shows that, rather than reducing addiction, it shames and shuns those struggling, making it harder to ask for help and reducing the resources set aside for it.
Racial Prejudices
In looking at the response from some sectors of society, we can see stark differences in how addiction has been seen according to demographic factors. The most poignant example of this is how different the approach to the opioid epidemic has been to the crack and meth epidemic.
The opioid epidemic has mostly been treated, both in discourse and government interventions, as a public health crisis. Even in many communities that hold stigma towards addiction, there has been an outpouring of sympathy and a push to provide resources to help those who are struggling.
In contrast, the response to crack or meth addiction has largely focused on legal enforcement. Addiction to these substances is viewed as a crime rather than an illness – a perspective that has led to mass incarceration. The underlying causes of these epidemics, including poverty, systemic prejudice, and generational trauma, were largely ignored.
Experts have pointed out the demographic differences in who is affected by these substances, indicating that prejudice is a likely factor in how they are treated. The opioid epidemic has had a disproportionate impact on white suburban and rural communities. The crack and meth epidemics had a disproportionate impact on black urban communities.
Combatting Stigma: Addiction as a Disease
In this context, it is important to discuss how we can combat addiction stigma. The core concept that needs to be more widely understood is why addiction is not a choice or moral failing, but rather a disease.
The disease model of addiction shifts attention to the physical and mental health factors that cause substance use disorders.
Substances like drugs and alcohol have a particular impact on the body that is more complex than simply helping a person ‘feel good’. Addictive substances actually take over some of the functions that regulate mood. Over time, the body becomes dependent on them to carry out these functions effectively. When the person stops using the substances, they experience withdrawals, as the body struggles to adapt to their absence.
From a psychological perspective, there are often mental health struggles – such as depression, anxiety, unresolved trauma, and a lack of healthy coping mechanisms – that draw a person to substance use. They feel that there is something missing in their life, or are battling to get through each day, and substances provide temporary relief.
Ultimately, the person is using substances because they are suffering, not because they are morally bankrupt or lack willpower. Without addressing the underlying issues, it is impossible to tackle or treat addiction.
This is true from a societal perspective as well. People who live in communities with systemic issues like poverty and crime are at higher risk of becoming addicted to substances. Considering this context, initiatives which target these macro problems are necessary to help prevent substance use.
Conclusion
The disease model of addiction is not new. It has been around since the 1960s. Unfortunately, it is still widely misunderstood, which is why the idea that addiction is a moral failing has been perpetuated.
Too many people still wonder, ‘Is addiction a choice or a disease?’ The understanding that addiction is an illness is crucial to ensuring people get the help they need. Someone who feels shame about their struggle is less likely to ask for help. People who judge those already struggling are also less likely to intervene with kindness.
It is time we break the stigma of addiction, increasing compassion and access to treatment.
