Written by: Savanna Payne
Edited by: Christine Huang
Nora Volkow, director of the National Institute on Drug Abuse, states that “addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions… (Hall et al., 2015). Addiction can come in many forms and levels of severity. One prevalent form of addiction is substance abuse disorders (SAD), an “umbrella-term” for a disease that affects an individuals' behavior and brain chemistry, which could lead to uncontrollable misuse of drugs. In the past year, more than 48.5 million Americans have battled with a substance use disorder, meaning over 14.5% of the population has directly been affected by just one form of addiction. Of that population, an estimated 107,543 drug overdose deaths occurred in the same year. However, even with the dramatic impact of addiction on the nation, the necessary level of urgency for change has not been met (American Addiction Centers, 2024). Why is one of the most prevalent mental illnesses continually seeing an increase in diagnoses and higher mortality rates year after year? Many people with substance abuse disorders not only experience issues with maintaining issues involving their diagnosis, but also experience the backlash involved with the debilitating stigma regarding drug and alcohol abuse. However, with these issues becoming more public, more innovative solutions may also be revealed.
Although addiction does show a large effect on American society, the general population’s knowledge on the impact of SADs does not reflect this. Even with the growing “de-stigmatization” of many mental health issues, substance abuse disorders continue to have high rates of stigma, especially regarding their perception of the individual themselves (Barry et al., 2014). One study surveyed over 700 participants on their perspective of drug addiction versus other mental illnesses. The results revealed a high percentage of the sample were unwilling to interact closely with a person living with a drug addiction, and were opposed to supporting them financially compared to other mental illnesses, perceiving them as dangerous and unstable. However, even with this bias, participants were still more likely to view discrimination against individuals with drug addictions as “not a serious problem” (National Institutes of Health, 2020). These shocking results indicate that people tend to view substance abuse disorders as a “moral shortcoming”-- a lifestyle based on the fault of the person rather than the fault of the disease itself. Subsequently, society expects individuals to simply “work harder” on themselves. This limited perspective greatly impacts the mental health of the substance abuser. Constant negative feedback in their addictive patterns can affect how the victim views themselves and can cause an increased tendency to “self-stigmatize”, which could lead to a reduction in seeking therapy as a possible solution (Matthew et al., 2017). Negative mindsets on addiction can also largely decrease funding in research and treatment development, as well as its accessibility to those who need it. Overall, public opinion has a massive effect on how addiction is perceived and handled in society, for better and for worse.
Along with dealing with the struggles of negative public opinion, individuals living with a substance abuse disorders are also more likely to experience higher risk factors. Of those who are diagnosed with a substance abuse disorder, more than half tend to have another comorbid mental illness that is less likely to be diagnosed or treated (National Institutes of Health, 2020). This can cause further complexity to an individuals' treatment needs, and can limit the efficiency of therapy intervention or rehabilitation. Furthermore, SAD victims are more vulnerable to high risk environments due to substance seeking. This can cause many negative effects from infection and STI from needle sharing to death by drug overdose or suicide. With all this said, all these risk factors greatly reduce treatment seeking and greatly increase stigma around substance abuse. What can be done to help more people? Educating the public on what substance abuse disorders are and the signs of abuse can help begin turning the public image of SADs to be seen as a treatable mental illness. The Collaborative Care Model is an example of therapeutic services that is targeting this very problem, and has begun viewing mental health issues as a part of primary healthcare services. The Collaborative Care model is a holistic treatment method for substance abuse that involves a diverse treatment team of primary physicians, psychiatrists and sober-living staff that works with the individual to treat, educate and manage their condition (National Institutes of Health, 2020). With more services like Collaborative Care, addiction may begin to see lower diagnoses statistics for the first time.
Mitch Hedberg, famous American comedian as well as a victim of drug abuse stated that, “addiction is a disease, but it’s the only one you get yelled at for having” (“Addiction Recovery”, 2024). Substance abuse disorders can affect people of any background and at any time of life. With the growing opioid crisis across the country, it is more urgent than ever to enact changes in our communities' hearts and mindsets. Mental illness not only affects one individual, but can impact family members, friends, loved ones and more. By promoting an open and accepting dialogue, anyone can help nurture an environment that can better support and treat people with an addiction.
References:
Addiction Recovery Quotes: The Ultimate Collection. (2024, January 8) https://ridgeviewhospital.net/addiction-recovery-quotes/
American Addiction Centers. (2024, April 26). Alcohol and Drug Abuse Statistics (Facts About Addiction). American Addiction Centers; American Addiction Centers. https://americanaddictioncenters.org/addiction-statistics
Barry, C. L., McGinty, E. E., Pescosolido, B. A., & Goldman, H. H. (2014). Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness. Psychiatric Services, 65(10), 1269–1272. https://doi.org/10.1176/appi.ps.201400140
Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises? The Lancet Psychiatry, 2(1), 105–110. https://doi.org/10.1016/s2215-0366(14)00126-6
Matthews, S., Dwyer, R. & Snoek, A. Stigma and Self-Stigma in Addiction. Bioethical Inquiry 14, 275–286 (2017). https://doi.org/10.1007/s11673-017-9784-y
National Institutes of Health. (2020, May 19). When Addiction and Mental Illness Collide. NIH HEAL Initiative. https://heal.nih.gov/news/stories/collaborative-care
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