Stigma, Addiction and Recovery

Here is the section ‘Overcoming Stigma’ in my article Factors That Facilitate Addiction Recovery on this website. I have followed it with links to various of my blog posts relating to other people’s work on stigma which I have featured on this website. I hope you find this content of interest and help.

‘Stigma can be defined as social disapproval of personal characteristics, actions or beliefs that go against the cultural norm. It can occur at a variety of levels in society, i.e. individuals, groups, organisations and systems. A person can be labelled by their problem (e.g. addiction to drugs and/or alcohol) and they are no longer seen as an individual, but as part of a stereotyped group, e.g. a ‘junkie’, ‘alkie’, etc. Negative attitudes and beliefs toward this group create prejudice which leads to negative actions and discrimination.

For example, people addicted to heroin are often considered to be carriers of hepatitis C and other blood-borne viruses, thieves who rob old ladies of their handbags, and dirty, weak-willed junkies who will never get over their problems.

‘Once a junkie, always a junkie’ is a saying I’ve even heard in discussions amongst drug treatment agency workers. Our Wired In research has not only shown the strong prejudice that exists towards heroin users, but also towards recovering heroin addicts.

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Recovery, Reintegration, and Anti-Discrimination: Julian Buchanan

Key research highlighting the social exclusion that dependent drug users experience, and the difficulties they face in trying to reintegrate. Julian Buchanan describes a model for integrating problematic drug users back into mainstream society. (2,756 words)

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Fighting Stigma and Discrimination When Recovering From Problem Drug Use

Yesterday, I described the difficulty that people recovering from problem drug use face in becoming accepted by mainstream society. They are shunned and socially excluded at a time they need to reintegrate into mainstream society in order to facilitate their recovery and allow them to live a normal life. Here is a related story.

Early in February 2008, I attended with my colleagues Lucie James and Kevin Manley, the first Drink and Drugs News (DDN) / Alliance Service User Conference, which was organised by Claire Brown and Ian Ralph of DDN and held in Birmingham. Around 500 people attended, two-thirds of them service users, a very successful conference.

Lucie, Kevin and I enjoyed our day and made some new friends. A special issue of DDN, which was the leading UK magazine focused on drug and alcohol treatment, was devoted to the conference. Prejudice towards service users was obviously an issue that was discussed during the afternoon’s discussion tables.

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‘Tackling Problem Drug Use: A New Conceptual Framework’ by Julian Buchanan, Part 3

Here is the Conclusion to Julian Buchanan’s excellent 2004 paper on the the debilitating nature of marginalisation and social exclusion that many long term problem drug users experience.

‘This paper has argued that the key issues that drug users face are related to discrimination, isolation and powerlessness. Those drug users, who become long-term and dependent, tend to have been disadvantaged and socially excluded from an early age prior to their taking drugs. For many of these people an all-consuming drug centred lifestyle was not the problem, but a solution to a problem.

Social work has a long standing tradition of highlighting injustice, discrimination and inequality, and seeking to empower the service user. Social workers are then, ideally placed to make a significant contribution to draw attention and develop increasing awareness and understanding to the issues of oppression and discrimination that many drug users experience.

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‘Tackling Problem Drug Use: A New Conceptual Framework’ by Julian Buchanan, Part 2

In my last blog post, I introduced a 2004 paper from Julian Buchanan the focuses on helping people overcome problematic drug use. The paper draws upon the messages from drug users in Liverpool, highlighting ‘the debilitating nature of marginalisation and social exclusion that many long term problem drug users have experienced. It concludes by suggesting a new social model to understand and conceptualise the process of recovery from drug dependence, one that incorporates social reintegration, anti-discrimination and traditional social work values.’

In his paper, Julian presents a new conceptual framework for practice that incorporates and promotes an understanding of the social nature and context of long-term drug dependence. Julian’s ‘Steps to Reintegration’ model model is based on the stage-orientated model of Prochaska and DiClemente. He describes six phases, four of which occur before what he terms the Wall of Exclusion and two afterwards.

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‘Tackling Problem Drug Use: A New Conceptual Framework’ by Julian Buchanan, Part 1

My apologies for not posting for a while on the website, but I have been busy writing a new book… and also feeling a little burnt out. Anyway, I want to mention a 2004 paper by Julian Buchanan that I came across last week, which describes his important research with problematic drugs users and a ‘new conceptual framework for practice that incorporates and promotes an understanding of the social nature and context of long term drug dependence.’

Julian’s paper is based on his twenty years of research and practice with dependent drug users in Liverpool, England. It draws upon three separate qualitative research studies that involved semi-structured interviews with 200 problem drug users. The studies sought to ascertain the views, suggestions and experiences of drug users in respect of what was helping or hindering them from giving up a drug-dominated lifestyle.

The paper highlights ‘the debilitating nature of marginalisation and social exclusion that many long term problem drug users have experienced. It concludes by suggesting a new social model to understand and conceptualise the process of recovery from drug dependence, one that incorporates social reintegration, anti-discrimination and traditional social work values.’

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Learning About Addiction Treatment, Part 8

In my third blog post focusing on what I learnt from the treatment agency BAC O’Connor back in 2004, I focus on two themes. Firstly, how staff deal with people who relapse during the treatment programme. Secondly, how the agency works with ‘clients’ to help them integrate (back) into their community.

BAC O’Connor were more realistic about relapse than many other treatment agencies. Relapse was considered part-and-parcel of the recovery process, and was an issue that was addressed in a pragmatic and humanistic manner. Clients who continually relapsed and left the Centres were always given the opportunity to return and receive the help they needed. Noreen Oliver said to me:

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‘People with psych labels suffer discrimination: mental health professionals are often guilty of such prejudice’ by Monica Cassani

Epiphany - 2014-03-23_240560_sense-of-place.jpgExcellent posting from one of my favourite blogs.

‘People with psychiatric labels suffer discrimination that is not only demeaning but can also be dangerous.

A 2007 UK study by the Royal College of Psychiatrists revealed that prejudicial treatment of mentally ill patients extends to physical medical care; they receive poorer quality of care and doctors spend less time with them possibly leading to higher rates of death and preventable disease.

Though tragic, the more scandalous aspect of the phenomena is the fact that mental health professionals apply the same prejudices to those whom they attempt to treat. The worst thing someone in mental distress can experience is dehumanizing treatment from other human beings who are supposed to be caring for them.

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Stigma and Discrimination of Injecting Drug Users

“I think what we need to do is to just talk about fundamental rights. I think it is such a basic right that someone who is coming for healthcare should receive that healthcare without any judgement.”

An excellent video from the Australian Injecting & Illicit Drug Users League (AIVL). ‘A short video of professionals and drug users discussing the impact of stigma and discrimination towards people who inject drugs.’

Recovery as an organising construct – Bill White interviews Larry Davidson

UnknownI have just been reading a Bill White interview of Larry Davidson – the two people who have most impacted on my work – and I was very interested by Larry’s response to these two questions about the mental health field. What is said is of course highly relevant to the addiction field.

Bill White: How is the emergence of recovery as a new organizing paradigm changing the design and delivery of mental health services in the United States?

Larry Davidson: I think the biggest change that the recovery paradigm has introduced, and the change that poses the most difficulty for traditional clinicians to understand and accept, is that recovery is primarily the responsibility of the person rather than the practitioner.

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