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This book calls attention to the impact of stigma experienced by people who use illicit drugs. Stigma is powerful: it can do untold harm to a person and place with longstanding effects. Through an exploration of themes of inequality, power, and feeling ‘out of place’ in neoliberal times, this collection focuses on how stigma is negotiated, resisted and absorbed by people who use drugs. How does stigma get under the skin? Drawing on a range of theoretical frameworks and empirical data, this book draws attention to the damaging effects stigma can have on identity, recovery, mental health, desistance from crime, and social inclusion. By connecting drug use, stigma and identity, the authors in this collection share insights into the everyday experiences of people who use drugs and add to debate focused on an agenda for social justice in drug use policy and practice.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
From the author of The Presentation of Self in Everyday Life, Stigma is analyzes a person’s feelings about himself and his relationship to people whom society calls “normal.” Stigma is an illuminating excursion into the situation of persons who are unable to conform to standards that society calls normal. Disqualified from full social acceptance, they are stigmatized individuals. Physically deformed people, ex-mental patients, drug addicts, prostitutes, or those ostracized for other reasons must constantly strive to adjust to their precarious social identities. Their image of themselves must daily confront and be affronted by the image which others reflect back to them. Drawing extensively on autobiographies and case studies, sociologist Erving Goffman analyzes the stigmatized person’s feelings about himself and his relationship to “normals” He explores the variety of strategies stigmatized individuals employ to deal with the rejection of others, and the complex sorts of information about themselves they project. In Stigma the interplay of alternatives the stigmatized individual must face every day is brilliantly examined by one of America’s leading social analysts.
Stigma leads to poorer health. In The Oxford Handbook of Stigma, Discrimination, and Health, leading scholars identify stigma mechanisms that operate at multiple levels to erode the health of stigmatized individuals and, collectively, produce health disparities. This book provides unique insights concerning the link between stigma and health across various types of stigma and groups.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
This book explores the stigma of addiction and discusses ways to improve negative attitudes for better health outcomes. Written by experts in the field of addiction, the text takes a reader-friendly approach to the essentials of addiction stigma across settings and demographics. The authors reveal the challenges patients face in the spaces that should be the safest, including the home, the workplace, the justice system, and even the clinical community. The text aims to deliver tools to professionals who work with individuals with substance use disorders and lay persons seeking to combat stigma and promote recovery. The Stigma of Addiction is an excellent resource for psychiatrists, addiction medicine specialists, students across specialties, researchers, public health officials, and individuals with substance use disorders and their families.
Winner of the Donald W. Light Award for the Applied or Public Practice of Medical Sociology Medical marijuana laws have spread across the U.S. to all but a handful of states. Yet, eighty years of social stigma and federal prohibition creates dilemmas for patients who participate in state programs. The Medicalization of Marijuana takes the first comprehensive look at how patients negotiate incomplete medicalization and what their experiences reveal about our relationship with this controversial plant as it is incorporated into biomedicine. Is cannabis used similarly to other medicines? Drawing on interviews with midlife patients in Colorado, a state at the forefront of medical cannabis implementation, this book explores the practical decisions individuals confront about medical use, including whether cannabis will work for them; the risks of registering in a state program; and how to handle questions of supply, dosage, and routines of use. Individual stories capture how patients redefine and reclaim cannabis use as legitimate—individually and collectively—and grapple with an inherently political identity. These experiences help illustrate how stigma, prejudice, and social change operate. By positioning cannabis use within sociological models of medical behavior, Newhart and Dolphin provide a wide-reaching, theoretically informed analysis of the issue that expands established concepts and provides new insight on medical cannabis and how state programs work.
The study of addiction is dominated by a narrow disease ideology that leads to biological reductionism. In this short volume, editors Granfield and Reinarman make clear the importance of a more balanced contextual approach to addiction by bringing to light critical perspectives that expose the historical and cultural interstices in which the disease concept of addiction is constructed and deployed. The readings selected for this anthology include both classic foundational pieces and cutting-edge contemporary works that constitute critical addiction studies. This book is a welcome addition to drugs or addiction courses in sociology, criminal justice, mental health, clinical psychology, social work, and counseling.