Shame, Stigma, and Addiction

Lying and hiding seem easier.

Lying and hiding seem easier.

With addiction, stigma can crush you. Stigma is what says your drug and alcohol use is a character flaw. It’s what says you're a bad mother, it is what says you are a bad son, or a bad husband.

Lying and hiding seem easier.

It took me a while to get to rehab. I spent years bashing around, harming myself and the people around me before I finally went. I knew I had some serious issues with booze, drugs and sex that I could not get under control on my own, but still, at least people didn’t know I had those problems, and at the time that was all that mattered. It wasn’t like my parents, friends, employers, wives and lovers, knew I was a drunk, a freak and a loser. Sure, it might help if I went to rehab, but as ridiculous as it sounds to me now, the embarrassment of going, and the stigma attached to it, outweighed the fact that I actually might be able to get help. I was terrified of people finding out what my problems were. I had fallen victim to shame, that was perpetuated by stigma.

If you are suffering with an issue of addiction, stigma can crush you. Stigma is what says your drug and alcohol use is a character flaw. It’s what says you're a bad mother, it is what says you are a bad son, or a bad husband. It is what says you are weak, that you are crazy, that you are a piece of crap. It is why you are afraid to tell your boss that you need some time off to go get help. It is why you would rather lie than tell someone that you are not doing okay. It was why I would rather steal than let people know I needed help.

That was ten years ago. Now, when I look around at the people I know who are struggling with similar issues, there seems to be much less stigma attached to addiction and getting help for one's problems, at least when it comes to the younger people I know. I am a member of Generation X, my generation hid everything we could about our issues as a rule, but with the coming of Generation Y, otherwise known as millennials, things finally seem to be changing.

Mike Reis, CEO and Founder of DecisionPoint Wellness, had this to say to me about stigma and the younger generation over an email interview: “A big factor that prevents many people from getting the help they need is the stigma associated with being labeled an addict. This is especially true for older Americans who isolate and feel an overwhelming sense of shame. Surprisingly, millennials are leading the way to remove the social stigma. I’ve learned a lot from the millennials that have come through our intensive outpatient program at DecisionPoint in Johns Creek, Georgia. They are connecting to others in recovery through technology and social media. Millennials openly share their recovery stories and daily journey on the Internet too. Unlike previous generations that came into recovery through the anonymity of AA, millennials don’t feel the need to be shackled to those traditions. They are more focused being individuals, and building a community of support. It’s common to see them proudly posting their sober anniversary dates on Facebook. Millennials seem to understand that the way to maintain their sobriety long-term is to publicly share their personal stories as survivors, and bring truth to the spotlight while creating a community of support. In doing so, they help others realize that addiction is a disease, and it needs to be treated as such without shame.”

Many millennials just don’t care a whole lot about what anyone thinks. A good example of this is Kassia Kristoff, a 30-year-old woman who once went to rehab to get help with her heroin use. "Fortunately for me, I have never cared much if at all what 'society' thinks of me, and as a result, felt no shame going to rehab. My world by the end consisted of only other addicts, so the only shame might have been in throwing in the towel. What I do feel shame about is the fact that people in this country are judged so harshly for being addicts. As someone who now works in a rehab and works with addicts in my personal life as well, I have seen the devastation that addiction causes to all who suffer from it. Most addicts, when clean, are extremely loving, caring and productive people. They simply need to be taught how to live without using first. Rehab is very helpful in this regard, because it teaches addicts (a term I use for all who suffer from addiction to any substance, including alcohol) about their addiction, and ways to cope without the crutch of their substance. Rehab gives addicts an opportunity to temporarily thrive in a safe and compassionate controlled environment, and to allow their brains and bodies to 'sober up.'"

According to Karen Wolownik Albert, LCSW, who is executive director of Gateway Foundation Alcohol & Drug Treatment, social and traditional media has a lot to do with this change. She said to me in an interview: “More prevalent coverage of substance use disorder-related issues in media and depictions on television of individuals who are not only struggling with drugs and alcohol but also seeking treatment and sobriety, is helping reduce the shame and stigma associated with addiction. Younger generations are more likely to openly discuss the topic and be more transparent with their families and friends about their desire to seek help, compared to previous generations that kept their struggles private due the negative stigma of being an 'addict.'"

Of course, it isn’t easy to go to rehab, no matter what generation you are in. But the stigma is way harder to deal with when you are going to get help than it is once you come out on the other side. As an obvious example, I have gone from someone who was terrified about letting anyone know about my issues, to writing about them in forums such as this one. Someone else who has done that is Lindsey Hall, who writes for many websites about her experiences with her eating disorder, including her own.

She told me that “I do not feel stigma around my eating disorder. Not anymore, at least... but I also write about it publicly and have connected with hundreds of people who have been through what I experienced, and I think that has slowly worn away the fear of stigma. Also, we live in a world where opioid addiction and eating disorders are on the rise, so it's more likely than ever that you have a loved one or you yourself have experienced addiction. Due to social media, people talk about their 'issues' more openly than ever and for an eating disorder, there are so many body positive Instagram accounts as well as recovery websites and essays and blogs (including mine) about this exact topic that make you feel like you're actually in a community. However, before I went to rehab in 2013, I absolutely did feel stigma. I was terrified to tell people I was going. I wanted people to respect me and think of me as someone who had her life together, and I felt like rehab had this whole stigma of 'Oh, you went to rehab? You must be like super messed up. You're crazy. I can't take you seriously anymore.' At the end of the day, I'm not going to say it's easy to proclaim, when meeting new people, that I've been in rehab. But, it's just becoming more of an acceptable reality in a culture where drug addiction/binge drinking/and eating disorders are rampant.”

David Rosenbloom, PhD, is a professor of Public Health at Boston University where he directs Join Together, a program that helps communities prevent and reduce alcohol and drug problems.

Dr. Rosenbloom told me that he believes millennials are more tolerant of a much broader range of human conditions than their parents or prior generations. When I asked him what we could do as a society to decrease stigma, he said, “We need to significantly expand access to medication-assisted treatment and conduct a public education campaign in support of their long-term use. We also need to apologize for past excesses in the criminal justice system, and systematically review and release hundreds of thousands of people who are in prison or jail because of their substance use disorder. We should repeal all laws that prevent individuals with criminal records associated with drug or alcohol use from getting jobs, housing or education, and expand public investments to provide jobs for these people.”

When it comes right down to it, more and more people of the millennial generation are not only not ashamed of their seeking help for their issues, they make a point of that for all to see. One of those people is Seth Leaf Pruzansky, who is shopping a book about his spiritual awakening that came when he was incarcerated for a drug-related offense.

Seth told me that, “The stigma of being an addict shouldn't stop anyone from getting help. Taking responsibility for getting it is squarely in the lap of the addict him or herself. Until they really own the fact that despite the circumstances leading to their addiction, they are the ones who ultimately made the choice of devolving into their current station in life, they will remain in a state of not believing that help is available. They will continue to play the victim card because in the short run, it's a lot easier to stay in that rut rather than to get help and clean up. But in the long run, the continuing spiral into de-evolution and death is all but inevitable. I know. I personally climbed out of that hell.”

By Brian Whitney