NO SHAME IN THEIR GAME –   

August 7, 2021 – Our understanding of substance use disorders as chronic but treatable health conditions has come a long way since the dark days when they were thought of as character flaws — or worse. Yet societal norms surrounding drug use and addiction continue to be informed by myths and misconceptions. Among the most harmful of these is the scientifically unfounded belief that compulsive drug-taking by individuals with addiction reflects ongoing deliberate antisocial or deviant choices. This belief contributes to the continued criminalization of drug use and addiction.

While attitudes around drug use, particularly use of substances like cannabis, have significantly changed in recent decades, the use and possession of most drugs continue to be penalized. Punitive policies around drugs mark people who use them as criminals, and so contribute to the overwhelming stigma against people contending with an often debilitating and sometimes fatal disorder — and even against the medical treatments that can effectively address it.  Stigma has major negative impacts on health and well-being, which helps explain why only 18% of people with drug use disorders receive treatment for their addiction. Stigma impedes access to care and reduces the quality of care individuals receive. People with addiction, especially those who inject drugs, are often distrusted when presenting for care in emergency departments or when visiting other providers, and are often treated in demeaning and dehumanizing ways. And physicians holding stigmatizing attitudes may not provide adequate evidence-based care for patients with addiction.

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