How to Reduce the Guilt, Shame, and Stigma of Addiction

Nzinga Harrison, MD
November 6, 2023

The US says substance use disorders are a health crisis, but harmful stereotypes still hurt people with addiction. As a result of stigma, many people hide their substance use because they fear social rejection or criminal punishment. These feelings of guilt and shame only allow addiction to continue and for some people, it may even intensify their substance use.

Additionally, the lack of social understanding and support may cause individuals struggling with substance use to avoid seeking treatment. They may feel that getting treatment would cause their friends, family, or coworkers to judge them. 

@eleanor_health How to get rid of the shame, guilt, and stigma surrounding addiction. 🚫💔🙅‍♀️🚭💪🌟 #eleanorhealth #addictionrecovery #recoveryispossible ♬ original sound – Eleanor Health

Stigma creates barriers to recovery, which only allows the cycle of addiction to carry on and worsen. Reducing stigma and shame is one of the most important steps in supporting people with addiction. To help support people struggling with substance or alcohol use and reduce addiction stigma so they can recover, there are small but meaningful actions that you can take.

Recognizing that addiction is a complicated psychiatric condition

  • Addiction is often seen as a moral problem caused by someone making bad choices or lacking self-control. In reality, medical research has proven that drug or alcohol addiction is a complex brain illness that can affect any person, regardless of their character, strength, or lifestyle. Oftentimes, individuals with great strength and motivation succumb to addiction and willpower alone is not enough to prevent relapses.
  • Addiction can be caused by various factors, not just willpower or choice, and treatment is not always easy. Genetics, age of first use, history of trauma, lack of social support, access to substances, brain changes and unstable psychiatric disorders such as bipolar disorder, schizophrenia, depression, anxiety and ADHD can all increase the risk for continued substance or alcohol use and make it more difficult to stop. 
  • Supporting people who struggle with alcohol or drug addiction includes avoiding blame and being aware that their drug or alcohol use is often not within their control. Working with them on reducing their risk factors can help them achieve a better chance at stability and recovery.
An infographic showing more compassionate terms for referring to those with a drug or alcohol addiction

Communicating with compassion and respect

  • To help someone with addiction, it’s important to understand the causes and offer support in a caring and respectful manner. One easy first step is to take more care in what words you use when discussing addiction. 
  • Using neutral and non-judgmental words helps by removing negativity and blame associated with certain words.
  • Using person-first language to discuss substance and alcohol use is important because it acknowledges that people should not be defined by their addiction and at their core they are a human being who deserves respect. 
  • The National Institute on Drug Abuse recommends these terms:
    • Instead of saying “addict” or “junkie,” say “person with a substance use disorder”
    • Instead of saying “alcoholic” or “drunk,” say “person with an alcohol use disorder.”
    • Instead of saying “drug abuse,” say “substance use” or “medication misuse / use other than prescribed”
    • Instead of saying “alcohol abuse,” say “person who misuse alcohol” or “person who engages in unhealthy/hazardous alcohol use.”
  • Using these terms helps reduce stigma for those struggling with addiction and can increase their likelihood of recovering. Additionally, asking individuals directly what terms they feel most comfortable with can help them feel supported and valued.

Having open conversations about addiction with loved ones, friends, and your community

Stigma will persist if we don’t openly discuss addiction and substance use. Talking about addiction as a medical condition with empathy and genuine concern for those who suffer helps to humanize it and remove negative connotations from the general public opinion.

These conversations are beneficial on multiple levels. When talking directly about substance or alcohol use with someone you want to support, opening up the conversation in a safe, nonjudgmental manner can help show them how much you care about them and want to work with them on their recovery journey. By pushing addiction out of the shadows and into compassionate conversations, more people with substance or alcohol use disorders may feel comfortable seeking treatment and starting their recovery journey. Additionally, by bringing up these conversations to others who lack education about addiction or who can increase access to evidence-based treatment, more people can receive the support they need to recover.

If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in Florida, Louisiana, Massachusetts, North Carolina, New Jersey, Ohio, Texas, and Washington.

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Nzinga Harrison, MD

Dr. Harrison serves as the Chief Medical Officer for Eleanor Health with more than 15 years experience practicing medicine. She is a double-board certified physician with specialties in general adult psychiatry and addiction medicine. Dr. Harrison has spent her career as a physician treating individuals from marginalized communities with substance use and other psychiatric disorders. As a physician executive, she has served as Senior Vice President and Chief Medical Officer roles committed to creating and improving systems-based delivery of psychiatric and substance abuse care. She is a vocal advocate for stigma reduction, and is passionate about the necessity for whole-person care as individuals and communities seek to recover from and prevent substance use disorders.

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