Understanding the Stigma toward Addiction
Like other types of mental health issues, substance use disorder has a long history of being treated as “other” or “different”, and this type of stigmatization has had a real and lasting impact on quality and accessibility of care. Stigmas can be powerful social mores that occur in the context of power, labeling, stereotyping, separating, discriminating, and generally leading to the loss of social status concerning the person, place, or thing being stigmatized. Most often, they are expressed and manifested in prejudice and discriminatory practices or attitudes– this is especially true for people suffering from mental illnesses or substance use disorders.
Much of these stigmas can be seen in expressions and descriptions of those struggling; in fact, it wasn’t until 2015 that the International Society of Addiction Journal Editors, the leading research publishers on addiction, released a consensus statement advocating for the use of less stigmatizing terminology, recommending against words like “abuser” and “abuse” in addiction science journals. Evidence shows that the stigma around dental and general health care for those in recovery and currently struggling contributes to substandard care and treatment of their patients. More so than changing the language around substance use disorders, we must also introduce the human element and strive to provide a more accurate and empathetic view of people who are struggling.
Stigma’s Role in Patient-Providers Interaction
Many healthcare professionals lack adequate education, training and context surrounding issues of substance use disorder; a reality that can lead to biases and negative attitudes that disempower patients and ultimately diminish their engagement in the treatment process. They are also at least partially influenced by a conscious or unconscious bias that has emerged through embedded perceptions of substance use disorder as a “weakness” or a “moral failing.”
All of these negative attitudes are exemplified through low-quality or inaccessible care. Many patients’ experiences with discrimination involve being rejected by health professionals in important situations, particularly in hospitals and the emergency room, due to their experiences with substances.
These stigmas have also impacted the relationship between patients and their dentists, with many participants from one study describing that their dentists would implicitly blame them for their oral health. Many dentists believe that as a result of their substance abuse “[they] wrecked [their] teeth,” and shift the blame onto the shoulders of the patient.
Remedying the Healthcare Rift
Addressing the deeply embedded stigma toward addiction and its role in the creation of healthcare and insurance policy is key to making care more accessible to the nearly 19 million Americans who currently struggle with substance use disorder. By looking at their patients as more than just “alcoholics,” “addicts,” “crackheads,” “junkies,” or any other iteration of names commonly associated with substance use, and approaching them with empathy and clear communication, healthcare professionals can help their patients feel more encouraged to seek out the help they need and more validated in their health concerns. Patients often feel negatively stereotyped during visits to their healthcare providers, believing that they are excluded from the decision-making process and neglected as a result inadequate communication concerning their care.
Evidence suggests that by integrating care and proper training for substance use disorders into mainstream healthcare practices, we can increase the quality, effectiveness, and efficiency of healthcare overall. These efforts can also be bolstered by reducing prejudice and discrimination towards patients by providing healthcare practitioners with the training and education. It has been proven that those struggling with substance abuse are just as likely to adhere to treatment as others suffering from chronic medical conditions when recognizing that they need to change their lifestyles– so why are they still treated as “unworthy” or “different” when compared to other patients?
Recognizing the Need for Recovery-Oriented Care
Ample evidence indicates the continued separation of substance use treatment and mainstream healthcare has negatively impacted the possibility of patients receiving the quality of care that they need. This is not only costly and harmful, but may even be fatal for some individuals seeking care for serious issues. Despite the national need for treatment-integrated and treatment-friendly care, our current healthcare system has yet to train professionals to care for patients who suffer from substance use disorders.
One solution with potential is recovery-oriented care. On top of supporting efforts to integrate assessments, interventions, specialty treatment and other types of care, recovery-oriented care is characterized by approaching recovery with a more optimistic view and empowering the patient by giving them a voice in their healthcare experience. It also aligns the providers’ goals with those of the clients’ recovery, creating a healthy and communicative relationship that benefits both parties.