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.

One speech during the conference caused me concern. Paul Hayes, CEO of the government department in charge of all government-funded addiction treatment, the National Treatment Agency (NTA), emphasised that service users had to understand the reality of the world in which they operated, rather than having a ‘rose-tinted view’. He pointed out that service users as a group were unpopular with the public, ‘compared to old ladies who need hip replacements or babies in incubators. They are seen as the authors of your own misfortune—there is no way we can hide from that.’

Paul continued by saying that, ‘substance misusers’ were also far from a priority in the NHS, as tobacco and alcohol were seen as far greater issues from a health harm perspective. Drug users were more likely to be seen as a danger to public health, community safety and the economy. ‘Because you are seen as a threat, the government is prepared to spend money on drug treatment.’

While maybe I can understand Paul Hayes thinking he needed to portray the reality as he saw it, I thought his message caused more harm than good. In fact, I found it offensive. It was sad to hear the person in charge of the country’s drug treatment stating that the only reason service users were helped was because they committed crimes. The UK drugs strategy itself, and the way it was being implemented and portrayed, was in reality demonising people with substance use problems, and those people on the journey to recovery, thereby reducing the likelihood that they would be accepted as normal by so-called ‘normal’ society and also gain employment. They were fuelling the fire of prejudice towards a vulnerable population, and creating/maintaining a barrier to recovery. By the nature of his comments, he was indirectly implying that people who took heroin and did not commit crime, were not a priority for treatment… even if they wanted help. 

I was touched by a letter from Hayley Brooks in the 10 March edition of DDN, in which she challenged Paul Hayes’s statement that people at the conference needed to reject the fantasy ‘that if everyone would stop stigmatising you everything would be all right.’ Hayley had stopped using illicit drugs seven years earlier and had been off methadone for four years. She was finishing her final year on a social work degree but was having great difficulty finding a job because of her past heroin using career and criminal record. Apparently, she was considered ‘vulnerable’. She went on to say:

‘I am constantly faced with this type of discrimination from people. I am determined to succeed and have a successful career. In response to Mr Hayes, I feel that he is the one who needs a reality check, as I am a prime example of someone who has turned their life around and battles on a regular basis against prejudice, due to past mistakes.

I can indeed sometimes understand why some service users feel that there is no point in changing, as I thought I had won the battle by staying clean. However, the real battle begins when you have to constantly fight for your rights to be treated as an equal, especially when you work hard to achieve a career and are constantly faced with brick walls.’

Whilst this happened over 14 years ago, this sort of situation is very unlikely to have improved. In fact, it is very likely to be worse.