The impact of the drug overdose epidemic in the United States has increased greatly in the last two decades, taking the lives of at least 130 people everyday. Despite the number of people who have been impacted by substance abuse, society has always held a negative perception of those suffering from addiction.
Victims of substance abuse are more stigmatized than individuals with other mental health disorders, as substance users are not typically seen as mentally ill. Rather, users are seen to be weak-willed and are held more responsible for their actions resulting in them beingmore likely to face structural discrimination.
There exists a disconnect and lack of awareness surrounding how substance abuse affects the brain’s capability to make decisions and produce hormones, instead society attributes relapse to weakness and carelessness. Additionally, many healthcare professionals are not properly educated and trained to treat substance abuse victims, and contribute to the negative stigma, according to Dr. Boekel’s review. Healthcare professionals perceive substance users as more violent and manipulative than other mental health patients. Today’s medical system also often utilizes a more task-based approach, which results in decreased personal engagement with substance using patients and decreased empathy in patient treatment. The attitudes of healthcare professionals thus contribute to a lower quality of care for substance users.
Despite social stigma, substance addiction is a debilitating disease that affects the brain. Drug use negatively alters three parts of the brain. First is the basal ganglia, known as the brain’s “reward center” that gives us positive, pleasure-filled emotions. By overactivating this center, drugs create a temporary euphoria. However, if drug use repeats, the reward center becomes less sensitive, making it impossible to feel pleasure from any activities besides drugs. The extended amygdala, which controls feelings of stress and anxiety, becomes overactivated when a drug user falls into withdrawal, which motivates users to seek more drug use to rid themselves of these stressful emotions. Lastly, the prefrontal cortex, primarily responsible for problem-solving, decision-making, and control over impulses, is also impacted by drugs.
Victims of substance abuse will seek drugs with significantly less impulse control or awareness of repercussions. Due to these changes in the brain of a user, substance abuse becomes incredibly addicting, and harder to combat as more drugs are taken.
Today, there are some treatment options available for addicts, the primary ones being behavioral counseling, medications, biotechnology used to alleviate withdrawal symptoms, and long-term follow-ups focused on providing support and community for addicts. Opioid agonists, such as methadone and buprenorphine, are specific opioid medications that have been proven to be the most effective method of preventing overdose. On a wider scale, when populations have access to opioid agonist therapy, many communities see a greater than 50% decrease in heroin overdose deaths. Starting opioid agonist medications reduces the risk of overdose death by 50% as soon as the following year. Access to life-saving medication, in combination with effective behavioral counseling and family support, can help more substance users to reach sobriety.
Unfortunately, despite research and proven success behind treatment plans for addicts, accessibility and affordability of these medications is incredibly limited. Around the world, less than 10% of addicts are actually receiving opioid agonist therapies and behavioral therapy. Society’s stigma around substance addicts is a significant factor that contributes to the lack of access to opioid agonist therapy and other treatments. Many people in society have the misconception that addiction is a choice, rather than a disease. This misconception is one reason why addiction treatments are separated from the rest of the medical system.
The stigma around medication-assisted treatment of substance abuse is another misconception that often bars patients from seeking the correct treatment. Many believe that recovery must come from willpower, and abstinence from all types of opioids, including treatment opioids. Therefore, addicts who use opioid agonists are often shamed by the substance treatment community, barring them from mutual support group membership. The criminal justice system in the United States also fails to consider medical judgments in their rulings on defendants with addiction. Drug use is heavily criminalized in the US, leading to the incarceration of vulnerable populations, where proper treatment is even less accessible.
Even once addicts are able to recover and reach sobriety, recovered individuals still face stigma that makes it more difficult to reassimilate into society. Due to stigma-related rejection, addicts are less likely to be employed and have access to adequate housing. Stigma-related rejection is also related to if an addict has sought treatment; recovered addicts who have been in treatment cited increased stigma-related rejection in job, housing and social opportunities than those who have never received treatment. These barriers make it harder for addicts to support themselves, often causing recovered addicts to relapse due to this added stress.
Societal stigma and its effects on accessibility to treatment are the reasons why substance abuse is so common and difficult to overcome across the United States. Because treatment is so difficult to receive, addicts often cannot get the help and support they need to recover. Even addicts who are able to receive treatment are subsequently ostracized by society, which causes many to relapse. Rather than pointing the finger at the laziness of substance abuse victims, the lack of accessible treatment and societal stigma need to be recognized as the root of the problem. Fighting stigma, increasing medical education and creating accessible treatments can help in slowing down the toll of the drug epidemic and help save the lives of substance abuse victims.