Our nation’s office of Drug Control Policy has designated September 2004 as National Alcohol and Drug Addiction Recovery month. According to publications produced by the U.S. Department of Health and Human Services in 2002:
• “An estimated 22 million Americans age 12 or older were considered to have an alcohol or drug use disorder.”
• “As many as one in four children-(19million) lives in a home where problems with alcohol alone are a fact of daily life.”
• “Only 10.3 percent of Americans age 12 or older who needed treatment for an alcohol or drug use disorder actually received treatment.”
• “Of those who recognized that they needed treatment, 35 percent (266,000 persons) of Americans suffering from alcohol use disorder-and an estimated 88,000 people suffering from a drug use disorder (24.4 percent)-tried but were unable to obtain treatment.”
As of 1997 the annual financial cost for alcohol and drug problems in the U.S. was almost $300 billion. The social cost in terms of human pain and suffering is practically incalculable.
None of the above statistics is likely surprising to many of us. We know there are enormous problems. We also know that treatment can be effective, but access to treatment and the willingness to engage treatment (even when available) are significant obstacles.
The social stigma for persons with alcohol or drug problems impacts accessibility to treatment. While there are serious hurdles accessing treatment for the uninsured with coronary disease, diabetes, or cancer, these health problems don’t carry much in the way of stigma. Not everyone with coronary disease, diabetes or cancer runs right to the doctor, but most people simply find it much easier to tell employers, family and friends they went in for a by-pass as opposed to saying, “I went to drug rehab.”
Social stigma is powerful. Stigma affects the willingness of society to provide adequate treatment options. Stigma affects the chemically dependent person’s willingness to seek help. Stigma can contribute to family members being reluctant to seek help because of their own fear and guilt. Stigma also influences society’s willingness to utilize long jail sentences for non-violent drug offenders.
There is a lot of judgment in our society for persons who struggle with alcohol or drug problems. The greater the stigma the more likely it is that an individual will resist treatment. Uncle John may stubbornly drag his feet about looking into his chest pains due to fear of the diagnosis. Yet, if Uncle John’s problem is with alcohol or drugs, fear of the diagnosis is compounded by the social embarrassment and personal humiliation that is associated with addiction.
The Mental Health field has made gains in reducing the stigma associated with the common difficulty of depression. Society has become more aware that depression is something that touches many of our co-workers, family members and friends. Depression is increasingly seen as something that can be discussed without shame and viewed as a condition that is very treatable with medications, therapy and lifestyle adjustments.
Social stigma is a result of assigning blame or fault to a person for their problem or condition. And blaming persons who have alcohol or drug addiction problems results from a major myth that continues to exist in our society. The myth is that addicted persons are at fault for their condition.
We know that many major health problems such as, cancer, diabetes, and heart disease run in families. Just 2 years ago scientists pinpointed a gene that has been found to be a major cause of asthma in a significant proportion of cases. Alcoholism and drug addiction also run in families. There is strong evidence that there are genetic factors and vulnerabilities that contribute to addiction.
The AA and NA (Alcoholics and Narcotics Anonymous) communities, as well as the majority of alcohol and drug treatment professionals, recognize alcohol and drug addiction as a disease process. (The American Medical Association, the American Psychiatric Association and the World Health Organization also consider Alcoholism a disease). Part of what this means is that there is a biological component to addiction. The body of a person who becomes addicted does not react in the same manner to alcohol or drugs as a person who does not become addicted.
The communities of AA and NA have always taught that it is not lack of intelligence, will power or moral character that leads one into addiction, but rather an experience of “powerlessness.” Millions of us have chosen to use alcohol or drugs, yet it is only a fraction that loses control and become addicted. It makes no more sense to blame them than to blame someone who lives in Los Angeles for developing asthma.
The reality is that people don’t choose to become addicted to alcohol or drugs. In all the years that I have worked with folks on this issue, no one ever said “I recall it clearly now, it was June 12, 1987, that I woke up and decided to become addicted.”
People choose to move to Los Angeles, but they don’t “choose” to acquire Asthma. Why would anyone choose that and why would anyone choose the misery that comes with addiction?
While it is not the person’s “fault” for becoming addicted, it is most certainly their responsibility to deal with the consequences of their addiction, to abstain from alcohol/drugs and to work on a program of recovery. We can reduce the stigma by stopping the blaming of addicted people and encourage viable options for treatment and recovery.
Congress and governmental officials contribute to the stigma problem as they continue to allocate the majority of the federal drug budget towards law enforcement and incarceration. It’s not that these are unneeded. It’s just that our jails and prisons are already overloaded with people who have alcohol and drug problems.
Law enforcement and incarceration will continue to be a necessary part of society’s response to the enormous alcohol and drug problem. Yet, shifting our priorities toward prevention and treatment (which is cheaper and more effective than incarceration), not only makes economic sense, but it sends a powerful message that our society is seeking to de-stigmatize alcohol and drug addiction.
– – –
Al Heystek, MA, LPC, MDiv
Al is a Licensed Professional Counselor who has worked professionally with men’s issues since 1994. He has been a therapist with the Men’s Resource Center at Fountain Hill since 2002. Prior to that Al worked for OAR, Inc. in Holland, Michigan as a therapist in both outpatient and residential men’s chemical dependency programs. Al also worked for Gateway Foundation, an Outpatient Treatment center in Chicago and prior to that was on a ministerial team for 10 years in an urban ministry in Chicago. Al is also an ordained minister in the United Church of Christ.