Ending The Stigma: Supporting People Who Use Substances

Stigma is a heavy word, but for people who use substances, it’s more than just a word — it’s a constant presence. It shows up in healthcare settings, in family conversations, in job interviews, and even in their own minds. It’s the voice that whispers: You’re not good enough. You’re broken. You’ll never change.

And that’s not just unfair — it’s dangerous.

What Is Stigma?

Stigma is the social disapproval or devaluation of a person because of a particular characteristic or behavior. When it comes to substance use, stigma paints people as “junkies,” “alcoholics,” “failures,” or “criminals.” It reduces a human being to their behavior and ignores the complex reasons they might be using substances in the first place.

But substance use doesn’t define a person’s worth. Every individual has a story — and that story often includes trauma, pain, or a desperate search for relief. Stigma erases that humanity and replaces it with shame.

Not Everyone Who Uses Substances Has a Problem

It’s important to recognize that not everyone who uses substances has a problem with it. Many people use substances recreationally, socially, or culturally without experiencing negative consequences. For example:

• Social drinking at gatherings or celebrations is common in many cultures and does not automatically signal a problem.

• Cannabis use is increasingly legal in many places and some people use it responsibly for relaxation or stress relief without experiencing addiction.

• Psychedelic use (like psilocybin mushrooms or LSD) is sometimes explored for spiritual growth or therapeutic purposes, and not everyone who tries these substances develops a disorder.

Judging people simply for using substances without understanding their relationship to it reinforces stigma and can actually drive people away from help if they do need it.

How Stigma Hurts People Who Use Substances

1. It Blocks Access to Care
   When people feel judged, they’re less likely to seek help. Research shows that stigma is a major barrier to accessing mental health and addiction treatment services (Livingston et al., 2012). No one wants to walk into a doctor’s office or treatment center and feel like they’re already labeled a failure.

2. It Fuels Shame and Isolation
   Stigma doesn’t just live outside — it seeps inside. People internalize the judgment they receive and start believing that they’re unworthy of care or love. This shame can keep people stuck in cycles of use, because using substances might feel like the only relief from the pain of feeling less than.

3. It Reinforces Negative Stereotypes
   Stigma makes it easy to blame individuals for their substance use without acknowledging the systemic factors that contribute to it — things like trauma, poverty, mental health, and lack of access to care. Instead of offering help, society often offers punishment.

The Role of Language

Language shapes perception. Words like “junkie,” “dirty,” or even “clean” versus “dirty” urine tests reinforce stigma. We need to shift our language to be more person-centered: “person who uses substances” instead of “addict”; “in recovery” instead of “clean.” Small changes in language can lead to big changes in attitudes.

Breaking the Cycle of Stigma

If we truly want to support people who use substances, we need to dismantle stigma at every level:

• In Healthcare: Train providers to use nonjudgmental, trauma-informed approaches.

• In Communities: Educate about the root causes of substance use and the power of harm reduction.

• In Ourselves: Examine our own biases and commit to seeing the humanity in every person, no matter where they are on their journey.

Recovery Happens When People Feel Seen

Recovery is possible — but it starts with safety, compassion, and connection. When people who use substances are met with empathy instead of judgment, they’re more likely to engage in care, build trust, and begin the process of healing.

We can all be part of that change.

References

• Livingston, J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction, 107(1), 39-50. https://doi.org/10.1111/j.1360-0443.2011.03601.x

• SAMHSA. (2015). Language matters: Substance use terms and stigma. Retrieved from https://store.samhsa.gov/product/Language-Matters/Substance-Use-Terms-and-Stigma/PEP20-03-01-010

• Corrigan, P. W., & Nieweglowski, K. (2018). Stigma and the public health agenda for the opioid crisis in America. International Journal of Drug Policy, 59, 44-49. https://doi.org/10.1016/j.drugpo.2018.06.015