Huff 1 Tiffany Huff Professor Johnny Lew ENG102 Academic Research and Writing 2 15 May 2022 The Stigma Surrounding Substance Abuse and Mental Health The concept of stigma can be described as a set of negative beliefs held by a society or a group of individuals about a topic or group of individuals. World Health Organization reports that stigma is one of the major causes of discrimination, exclusion, and abuse of human rights. When a person experiences stigma, their health status is perceived as being less than. Through education, the negative impact of stigma can be prevented or diminished. Stigma is rarely based on facts, but on assumptions, preconceptions, and generalizations. It causes prejudice, avoidance, rejection, and discrimination against those who have a socially undesirable trait or engage in culturally marginalized behaviors, such as drug use. Drug use and behavior can lead to negative feelings among family, friends, and the general public. People may even use derogatory terms, such as "junkie," "alcoholic," or "crackhead." These thoughts, feelings, and labels can perpetuate stigma. Most of us have experienced stigmatization or have stigmatized others at some point in our lives. In a study conducted by the Johns Hopkins Bloomberg School of Public Health, the public was found to have a negative attitude towards drug addicts. This was in contrast to those who suffer from mental illness. Furthermore, researchers found that people do not support policies that benefit drug users in terms of insurance, housing, and employment. Each year, untreated drug and alcohol abuse contributes to tens of thousands of deaths as well as Huff 2 a great deal of suffering. A number of these deaths could be prevented by effective medications for opioid use disorder and alcohol abuse disorder. However, they aren't being used widely enough and people who could benefit from them aren't even aware of their availability. The stigma attached to addiction also contributes to their underutilization. The stigma attached to addiction persists despite significant progress. People with addiction continue to be blamed for their disease. It has long been acknowledged in the medical community that addiction is a complex brain disorder with behavioral components. Addiction continues to be viewed as a moral failing and a character flaw by the public and by members of the healthcare and justice systems. An individual who experiences stigma is seen as being less than others. In general, stigma is based on assumptions or misconceptions. The stigma of substance abuse impacts not only individuals who suffer from addiction, but also health care providers, researchers, policies, and society as a whole. Individuals who are in recovery may also be stigmatized because they use prescribed medication to assist them in their recovery process. Stigma surrounds medicationassisted treatment (MAT) due to the belief that using medication to treat substance use disorder is just "trading one drug for another". A stigma surrounds medication-assisted treatment (MAT) as a result of the belief that using medication to treat substance use disorder is just "trading one drug for another". This stigma continues to be a barrier to individuals seeking help, entering treatment, and accepting medications. The stigma associated with mental health refers to social disapproval, or when society places shame on people who have a mental illness or seek treatment for mental distress, such as anxiety, depression, bipolar disorder, PTSD, or schizophrenia. Mental health stigma can arise from a variety of sources, including family, friends, and colleagues as well as society at large. Stigma can also be politicized by groups. It can prevent Huff 3 people living with mental illness from finding help, becoming integrated into society, and leading happy and comfortable lives. Stereotypes can play a part in mental health stigma, which can be seen as simplified or generalized beliefs, or representations, of entire groups of people that are often inaccurate, negative, and offensive. By using these characteristics, a person can quickly determine whether a person belongs to a specific group based on a few defining characteristics, and then apply those same characteristics to anyone in that group. For instance, people who suffer from depression are often viewed as lazy, while those who suffer from anxiety are viewed as cowardly. It is common for people to fear being labeled as 'crazy' for simply seeking support from a therapist. The ideas expressed in any of these characterizations are completely false, and all of them are misinformed, causing pain to people and preventing them from getting the help they need. There is a widely propagated stereotype about people with mental illness that is often politicized because they are perceived as violent or dangerous. Despite this, a small minority of people living with mental illnesses commit violent acts. According to the United Nations Children's Fund, they are 10 times more likely than the general population to be victims of a crime, making them a vulnerable group that we should be looking out for instead of frightening. It is estimated that more than half of the people with mental health disorders do not receive treatment for their illnesses. Oftentimes, people avoid or delay seeking treatment because they are worried about being treated differently or fear of losing their jobs and livelihood if they seek treatment. In fact, stigma, prejudice, and discrimination against people with mental illnesses are still very much present in our society today. Many people suffering from serious mental illness are faced with a double challenge. On the one hand, they struggle with the symptoms and disabilities that can arise as a result of this condition. Additionally, they Huff 4 are confronted with stereotypes and prejudices resulting from the misconceptions about mental illness that I mentioned earlier. Both of these factors lead to a robbery of the opportunities that define a quality life for people with mental illnesses, which includes good jobs, safe housing, quality health care, and affiliation with a diverse group of people. There have been several studies showing that substance use disorders are more stigmatized than other types of health problems. The relationship between stigma and substance use disorders can manifest differently from that between stigma and other stigmatized health conditions, thereby creating difficulties for efforts to build social acceptance of people with substance use disorders. Substance use disorders are viewed as moral and criminal issues, rather than health concerns, which is why they are often treated as such. The criminalization of substance-using behaviors exacerbates stigma and drives exclusionary processes that deepen the marginalization of people who use illegal substances. Consequently, the social processes and institutions that are created to control substance abuse may contribute to its continuation. The stigma associated with substance use is a significant concern for those with substance use concerns, as they often experience negative labeling, discrimination, and prejudice from others. It Huff 5 is an unfortunate reality of our society that people with substance use problems are often subjected to prejudice and discrimination on an individual, interpersonal, and institutional basis. Despite the increasing popularity of illicit substances, there remains a substantial public belief that those who use them simply need to take responsibility for their actions. In addition, individuals with SUDs report that they have been subjected to judgment, mockery, inappropriate comments, overprotection, and hostility as a result of their condition. Patients using substances are often perceived negatively, even by health professionals, as they are often viewed as aggressive, rude, aggressive, violent, manipulative, dangerous, and irresponsible, not to mention dangerous in their behavior. It has been shown that individuals who perceive stigmatization from their health care providers are more likely to drop out of treatment, are less satisfied with their treatment, and perceive themselves as having less access to care. Furthermore, people with substance use concerns may also experience perceived stigma as a result of the impressions they receive from society and through their own and others' past experiences. Stigma is also related to low self-esteem, high levels of depression and anxiety, and sleep problems, as well as perceived stigma. As a result of public stigma, people who have experienced it can develop self-stigma (i.e., stigma that is internalized), and this negatively impacts their attitudes towards getting help. Individuals may see a person struggling with alcohol use disorder portrayed in the media as being malign, selfish, and incompetent and come to believe these stereotypes about themselves as well. As a result of social rejection directed at drug use, it is greater than social rejection directed at other psychiatric conditions, such as depression and anxiety. This may lead to the social exclusion of substance users and prevent them from seeking and receiving treatment. Several common practices of stigma and discrimination (e.g., judging, mockery, inappropriate comments, overprotection, and hostile looks) have been identified in participant testimonies. It is clear from the narratives provided that there is a structure of discrimination surrounding addiction. There are several conditions of social and gender inequality, as well as experiences of violence and abuse which are an obstacle to treatment. These conditions are evidence of a structural context of discrimination surrounding addiction. In 2001, the World Health Organization (WHO) reported that an estimated 25 percent of the worldwide population Huff 6 is affected by a mental or behavioral disorder at some time during their lives. This mental and behavioral health issue is believed to contribute to 12 percent of the worldwide burden of disease and is projected to increase to 15 percent by the year 2020 (Hugo, Boshoff, Traut, ZunguDirwayi, & Stein, 2003). Within the United States, mental and behavioral health conditions affect approximately 57 million adults (National Institute of Mental Health [NIMH], 2006). Despite the high prevalence of these conditions, recognized treatments have shown effectiveness in mitigating the problem and improving individual functioning in society. Nonetheless, research suggests that (1) individuals who require care often do not seek services, and (2) those that begin receiving care frequently do not complete the recommended treatment plan (Corrigan, 2004). For example, it has been estimated that less than 40 percent of individuals with severe mental illnesses receive consistent mental health treatment throughout the year (Kessler, Berglund, Bruce, Koch, Laska, Leaf, et al, 2001). There are several potential reasons for why, given a high prevalence of mental health and drug use conditions, there is much less participation in treatment. Plausible explanations may include (1) that those with mental health or drug use conditions are disabled enough by their condition that they are not able to seek treatment, or (2) Huff 7 that they are not able to identify their own condition and therefore do not seek needed services. Despite these viable options, there is another particular explanation that is evident throughout the literature. The U.S. Surgeon General (1999) and the WHO (2001) cite stigma as a key barrier to successful treatment engagement, including seeking and sustaining participation in services. The problem of stigma is widespread, but it often manifests in several different forms. There are also varying ways in which it develops in society, which all have implications for social work – both An extensive literature search was conducted using three major databases: PubMed, PsychINFO, and Web of Science. If you are searching for information on alcoholism, alcohol abuse, alcohol dependence, or alcohol addiction, you can also think about searching on addiction, addiction, addiction, addiction, substance use or addiction, drug abuse or addiction, addiction or drug problems, and (stigma, stereotypes, prejudices, and social distance) or representative versus (population). Using this search strategy, 1461 articles were retrieved in PubMed, 439 in PsychINFO, and 938 in Web of Science. All studies included in this review met the following criteria, public stigma: attitudes toward drug users or people with substance-related disorders; studies that solely focused on alcohol were excluded. In a recent study, the authors found that substance abuse liability, or the degree of addiction attributed to the substance use disorder, was the most significant factor in distinguishing between stigmatizing judgments, which may be a result of perceptions that substance use disorders are unlikely to change without treatment. It was found in a study conducted by Sorsdahl (2012) that subjects displayed similar levels of negative emotions (e.g., anger, fear) when confronted with hypothetical characters who became addicted to either alcohol, cannabis, methamphetamine, or heroin. Nevertheless, there appears to be a mix of evidence regarding whether individuals with SUDs are more restricted from participating in society in comparison to individuals with any other mental illness. There is evidence, in the studies reviewed, that the public's perception of substance use disorders is one of stigmatization. Huff 8 As a result, people with SUDs are generally viewed as dangerous, unpredictable, and unable to make informed decisions about their treatment and finances, and they are at great risk of being blamed for their behaviors. As a result of this increased stereotyping, people with SUD may experience negative emotions similar to those seen in individuals without SUD, such as compassion, emotion, anger, fear, and a desire to be detached from others. In addition to stereotyping, discrimination can also be caused by highly negative assumptions, especially in light of the high willingness of participants to force treatment on people with SUDs and to obstruct them from fulfilling their societal responsibilities. There were ninety-one articles identified. Several conceptual confusions, methodological inconsistencies, and the lack of measures that are developed and have been tested psychometrically with adolescents were observed. Most commonly, mental illness stigma and beliefs about seeking help were measured; however, the frequency of assessment varied according to the definition used and the design of the study. In the survey, the recognition and knowledge of mental illness were assessed more frequently than the knowledge about seeking help. Although there have been a few articles to Huff 9 assess knowledge of mental health promotion, the mental-ill health approach continues to dominate the field. There is an increase in studies using adolescent samples in MHL research. There is a need for a better understanding of what MHL means for this population to develop reliable, valid, and feasible measures of adolescent mental health, and to uncover mechanisms for change to improve adolescent mental health. The recommendation is to move away from 'mental disorder literacy' and to move toward critical 'mental health literacy'. It is suggested that future MHL research should focus on using integrated, culturally sensitive models of health literacy that acknowledge the interaction between individuals' ability and social and contextual demands and address the issue of health literacy in the context of life stages. As a whole, stigmatizing reactions towards SUDs were stronger than stigmatizing reactions towards other psychiatric disorders. Huff 10 Words Cited https://drugabuse.com/addiction/stigma/ https://nida.nih.gov/about-nida/noras-blog/2020/04/addressing-stigma-surrounds-addiction https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-020-00288-0 https://www.medicalnewstoday.com/articles/mental-health-stigma#mental-health-stigma https://www.psychiatry.org/patients-families/stigma-and-discrimination https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248273/#:~:text=In%202001%2C%20the%20 World%20Health,some%20time%20during%20their%20lives. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3248273/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5854406/ https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08734-1 Livingston J. D., Milne T., Fang M. L. Amari E. “The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review,” Addiction. 2012;107(1):39–50 Gutierrez Daniel, Crowe Allison, Mullen Patrick R., Pignato Laura, Fan Shuhui. “Stigma, Helping Seeking, and Substance Abuse.” The Professional Counselor, Volume 10, Issue 2, Pages 220–234 http://tpcjournal.nbcc.org. 2020 NBCC, Inc. and Affiliates doi:10.15241/dg.10.2.220 Huff 10 Mora-Ríos, J., Ortega-Ortega, M., & Medina-Mora, M. E. (2017). Addiction-related stigma and discrimination: A qualitative study in treatment centers in Mexico City. Substance Use & Misuse, 52(5), 594–603.
