Commentary: For those who experience addiction, wounds can be physical and emotional
Years ago, I started a friendship with a wonderfully wise addictions nurse who taught me several things about mental health and recovery. One thing that especially stuck with me was her use of a term I was previously unfamiliar with: stigma injury.
Stigma injuries, she explained, occur both physically and emotionally when patients don’t seek the care they need because they’re worried about being shamed, discriminated against or otherwise stigmatized.
In a medical setting, this might happen when a patient with an infected abscess from IV drug use avoids visiting the emergency room to receive emergent medical care because they’re worried about the judgment they might receive from medical professionals. This person now suffers additional harm resulting from the very professionals we trust to help us in medical settings.
Stigma injury isn’t isolated to medical settings; it surrounds us in most of our culture. Many of us stigmatize addiction, and this stigma is often fueled by fear and misinformation. We do this partly because addiction can really bring out the worst in someone. There are countless stories of the harshness of substance use disorders. Both the complex variables that contribute to addiction and that come from addiction contribute to antisocial behavior such as manipulation, lying and stealing.
What we need to realize is that many times stigma doesn’t help or cure addiction, it makes it worse. Stigma marginalizes individuals struggling with drug use, leading to a cycle of shame, isolation and low self-worth. And while it might be tempting to think that shame and loneliness would be factors that lead someone to sobriety, they rarely are. The Centers for Disease Control and Prevention estimated that our nation lost over 105,000 individuals to overdoses in 2022, and it’s easy to understand that many of those deaths occurred in isolation.
It’s essential to recognize that addiction is a complex and multifaceted issue affecting people from all walks of life, irrespective of age, gender, race or socioeconomic status. It’s rarely, if ever, just a matter of choice or moral failing. Until we embrace this truth, we cannot hope to make significant progress in addressing the root causes of drug use and its adverse effects on communities.
Challenging the stigma around drug use is not an endorsement of drug consumption but rather a call for empathy, understanding and a focus on evidence-based solutions. We need to acknowledge that people who use drugs are fellow human beings deserving of love and care.
To quote the philosopher Arthur Schopenhauer: “Whatever folly men commit, be their shortcomings or their vices what they may, let us exercise forbearance; remembering that when these faults appear in others, it is our follies and vices that we behold. They are the shortcomings of humanity, to which we belong; whose faults, one and all, we share; yes, even those very faults at which we now wax so indignant, merely because they have not yet appeared in ourselves. They are faults that do not lie on the surface. But they exist down there in the depths of our nature; and should anything call them forth, they will come and show themselves, just as we now see them in others.”
Everyone needs the gift of the opportunity for redemption. Everyone needs a compassionate hand. We should applaud those who seek help, acknowledge their courage,and stand beside them on their journey to recovery. We need to build communities of support and understanding that heal not only the wounds of addiction but also the injuries of stigma.
Eric Bottelberghe is an addictions nurse and a nursing instructor in Weber State University’s Annie Taylor Dee School of Nursing, which is celebrating its 70th anniversary this year.