Drug Rehab Center

By Geoff Thompson – MA, CCC 
Program Director

Lots of addiction experts believe that one of the greatest barriers to recovery is that clients have internalized the stigma of addiction. Basically, this means that clients think of themselves as ‘failures’ or ‘diseased’ or ‘irresponsible’ or having ‘defective character traits’ or a ‘defective personality’, and so on.

It’s not surprising that they think of themselves like this. Watch any real-life cop show, and you will see most of those arrested are addicts. And pretty stupid ones at that. The impression is that all addicts are criminals. Watch Oprah or the afternoon talk shows, and you will hear the ‘experts’ condemning the addict as incapable of making decisions, an immoral person, and so on. Watch just about any movie, and you will hear that addicts are either the cause of human suffering or that those in recovery are only one drink away from catastrophe.

Governments sponsor prevention programs that tell young people to “just say no,” as if the addiction were no more than a simple choice. The typical message is that a “poor choice” to use drugs leads inevitably to disaster. Almost all treatment programs claim that drugs leave users incapable of reasonable thinking, which is why they tell clients what to think and what to do. A counsellor on the Intervention television show said that he felt his work with a client was successful because the client “learned that he couldn’t trust himself.” Documentaries regularly show addicts as irresponsible mothers, fathers, and partners. In several BC communities, local politicians routinely blame addicts as the main cause of suffering in their communities.

As if all this weren’t enough, popular opinion has raised the power of drugs to almost magical levels. Newspapers and television tell us that just using a drug a couple of times will plunge the user into the abyss.

Experts have noticed that this sort of exaggeration is a real detriment to recovery because those struggling to get off the drugs often believe what they hear. Two of the more famous experts are Stanton Peele and Steven Hayes. Peele tells us that these messages actually increase the drug problem because they are “one-sided propaganda” and do not match what we know from research, which is that most people in our society use drugs and yet go on to live good lives. Hayes developed a treatment program specifically to help addicts overcome the stigma of their addiction, which he considers one of the greatest barriers to recovery.

What do Peele and Hayes know? Here are some interesting studies. Researchers studied those convicted with a DUI, who were ordered to attend the Victim Impact Panel (VIP), sponsored by Mothers Against Drunk Driving (MADD). It turns out that attending VIP actually increased the chances that the person would later be charged with another DUI. The reason was that VIP increased the stigma felt by participants, which led them to drink more. The most popular drug prevention program, Drug Awareness Resistance Education (DARE), is based on the stigma. Research has shown that not only does DARE not work, but that with some kids it actually increases drug use. And studies comparing recovering addicts with those recovering from cancer and other illnesses have shown that the stigma of addiction significantly decreases successful outcomes for the addicts. In BC, we know that at least two-thirds of those with mental health or addiction symptoms do not seek help because of the stigma attached to addiction: they fear losing their kids, being denied health insurance, losing jobs, losing their driver’s licence, etc.

So what can be done about all this? In this blog article, we’ll try to figure out how people with addictions can self-assess whether they have internalized the stigma (bought into the popular opinion) and, if so, what can be done to get rid of it.

Internalizing the stigma of addiction? Part I

Steven Hayes begins his therapy for addicts by asking them to complete an inventory to see how addiction has affected their lives. He then talks with them about what they were thinking and feeling as they completed the questionnaire.

Inevitably, his clients say that they felt badly about all the money they had spent, the relationships that were destroyed, the jobs lost, and so on. They have made sense of their addiction by assuming what the popular media and politicians say is true: they are failures, losers, and defectives. Hayes argues that these beliefs inhibit their recovery. Even though they may pay lip-service to the idea that addiction is a health issue, the more powerful thought is ‘…but I must be a defective person because I became an addict’.

At Sunshine Coast Health Center when we listen to the stories of clients, we hear a catalogue of embarrassment and shame. This is particularly evident in the week before Family Program—it’s almost a guarantee that there will be more chaos during this week than other weeks, which is the a common sign that clients feel stressed. Clients keep secret their worries: What will my family tell the counsellors? Will I get caught in a lie? Do I have to plan to keep certain family members away? What’s going to happen to me when I sit in with my family Sunday afternoon?

And the big one—Will the counsellor explain to the family that the things I did in active addiction were not really me?

These feelings and thoughts are typical of those who have internalized the stigma of addiction. For them, it’s very tough to break away from the popular idea that addicts are defective.

Internalizing the stigma of addiction? Part II

Here are five public statements that describe addiction: 

• Canadian Human Rights Act, Part I, Section 25: “disability means any previous or existing mental or physical disability and includes disfigurement and any previous or existing dependence on alcohol or a drug” (1985)

• Canadian Society of Addiction Medicine (CSAM): “Addiction…[is] a primary, chronic disease…. Like other chronic diseases, it can be progressive, relapsing and fatal” (1999)

• Nora Volkow, head of the National Institute of Drug Abuse (NIDA): “…addiction is a chronic brain disease” (2007)

• Bill W: Alcoholism is a “spiritual” condition (1939)

• Psychologist Paul Wong: “Addiction is a response to living a life that lacks personal meaning” (2005)

So, we have descriptions from very reputable sources, who tell us that addiction is a health problem or a response to a meaningless, monotonous, and boring life. When we think about someone suffering a medical condition or having a need to find meaning, we generally don’t jump to the conclusion that the person is weak or has a flawed personality or is making some conscious choice about having or not having the condition. Would you consider Terry Fox as having a flawed personality because he suffered from a medical disability? Would you condemn Anne Rice or KD Lang as being irresponsible because they searched for a meaningful life?

Tips for overcoming the stigma of addiction

Almost everyone has an addiction has, consciously or unconsciously, internalized the stigma. And overcoming this is tough.

The late US senator, Harold Hughes, lamented that addicts face the same stigma that those with mental health issues used to have to put up with. Today, the public understands that depression or bipolar disorder, etc, are not choices—that there is a neurobiological vulnerability to mental health struggles. But this is not yet true for addiction: so many people still tar the addict as irresponsible and immoral.

Here are three tips to overcome the stigma.

Tip One: Remember that science has confirmed that not everyone can become an addict. It seems that addicts have a neurobiological vulnerability to addiction. Neuroscientist James Kalat put it this way: “Addiction isn’t in the drug, it’s in the person.” The famous addict-writer William S. Burroughs stated the obvious: “No one ever wants to be an addict.”

Tip Two: When you think you need to defend yourself against others, stop. Addiction neuroscientist Carlton Erickson recounts the story of a person who wrote on a reply card to an invitation to hear Betty Ford talk at a fundraiser for alcohol research: “I’ll never give a penny to help those d**n drunks.” There’s not much anyone can say to such a person. And your job in recovery is not to change these people.

Tip Three: Be conscious of the language you use to describe yourself. You have probably used descriptions of yourself that are based on the stigma: I’m a drug fiend, a drunk, etc. In fact, one of the reasons why 12-step programs are offensive to some is because they believe that saying, “Hi, my name is Harry, and I’m an addict” reduces them to a label. (This is not the intention of AA/NA, by the way.) We would never expect a patient at a hospital to introduce himself as “Hi, my name is Sue, and I’m cardiomyopathy.”

Overcoming the stigma of addiction: Self-determination

At Sunshine Coast clients often hear the statement, “You are the author of your life.”

A good example of this concept is the actress Drew Barrymore. At 13, Barrymore was called, quite publicly, “the youngest drug addict in America.” ‘Experts’ pointed out that she grew up with a family of addicts and thus was at the mercy of the addict’s genetics. They pointed out that she was doomed unless she started to listen to experts. Imagine what the young teen must have thought of herself, having all these ‘experts’ declare publicly that she was defective, powerless over addiction, and at the mercy of her genetics (Actually, we know; she wrote an autobiography, Little Girl Lost.)

As Drew grew into adulthood, she gave up the drugs. Experts, such as Stanton Peele, point out that the young woman refused to reduce her life to the label ‘addict’. She refused to believe the experts when they equated her life with addiction. She refused to identify herself with the stigma.

What if Drew actually bought into the pronouncements from Dr. Phil and the others? It is very likely that she would have never achieved the success she has today. It’s difficult to imagine a successful person who believes they are defective, cannot make good decisions, cannot trust themselves, etc.

Addiction neuroscientist Carleton Erickson also reminds us that many people “have a desire to hold drug users accountable for their actions. Individuals who may have been emotionally, physically, or financially affected by other people’s drinking and drugging may be loath to ‘let them off’ by saying they couldn’t help it.”

At Sunshine Coast, we remind clients that their job is not to change negative people; that’s their job because they are the authors of their lives.

Tags: addiction, addiction stigma, D.A.R.E., Drew Barrymore, Harold Hughes, James Kalat, just say no, MADD, Stanton Peele, Steven Hayes, William S. Burroughs

This entry was posted on Wednesday, August 5th, 2009 at 2:13 am and is filed under Addiction Recovery (Life After Treatment), Exploring Addiction, Geoff Thompson, On Line Support - Alumni, shame and guilt. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.