Stigma and Substance Use Disorder

Photo by Indiana Recovery Council

By Ahmed Farah, MSSW Student at University of Louisville and Practicum Student at McNary Group

Does someone you care for struggle with an addiction related to legal or illegal drugs? Chances are, most of you have at some point in your life helped a family member with the effects of addiction. In my experience working in the community, I have assisted many individuals who suffered from Substance Use Disorders (SUD). So, I have learned a few things about the needs of those affected. Given the community impacts of SUD, I was very excited to be able to attend a virtual summit related to SUD and the stigma that surrounds the issue. The summit called Stop the Stigma & Save Lives: Ending Kentucky’s Opioid Crisis was hosted on 10/01/2020 by a local Opioid Taskforce. The main purpose of the summit was to break down the stigma associated with SUD, to educate about the science of addiction, treatment options, and the recovery landscape while highlighting the changes and trends within the opioid crisis. This summit was sponsored by Purchase Area Health Connections (PAHC), which is a regional coalition that services the Purchase Area of Western Kentucky. The McNary Group is currently working with PAHC to evaluate a federal HRSA Grant for Community Health Workers and they shared the information about the summit with us.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) SUD “occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.” The summit speakers discussed how those dealing with SUDs are negatively viewed by society and service providers. They are often blamed for their mishaps, stating that it is a choice made freely, when in reality, it is far from the truth. This is something that I learned through my work with those who suffer/deal with SUD, as well as, through my schooling (e.g. substance use course). SUD (previously known as addiction) is now considered a diagnosable mental disorder, shifting the focus from the person as the problem to focusing on the mental disorder as the problem.

Kentucky has had its fair share of negative effects of SUDs. In Kentucky, there was a total of 989 overdose deaths related to opioids in 2018, alone. Furthermore, the Centers for Disease Control and Prevention stated that the state of Kentucky’s rate of opioid prescription in 2018 was the third highest rate (79.5 per 100 persons) in the U.S., after Alabama and Arkansas. This puts things into perspective when understanding SUDs and its effects on communities, as well as consideration for the necessary supports and resources to address it. An important consideration for service providers, is aiding without stigma and judgement, as they often deter those in need from seeking services. An example of this is the START program which was discussed during the summit. The Sobriety Treatment and Recovery Team (START) is utilized by the Cabinet for Health and Family Services’ (CHFS) Child Protective Services, in Kentucky. The START program is an evidence-based program that assists parents who are dealing with SUDs. It was adopted by CHFS a few years ago as a result of the increased child abuse and neglect reports, due to parents dealing with SUDs. Research completed by CHFS has indicated its efficacy (e.g. children in START are 50% less likely to enter foster care, for every $1 spent on START $2.22 is saved on foster care placement costs). Additionally, START provides parents with the necessary supports, resources, and tools to overcome SUDs while ensuring child safety. Moreover, peer mentors (employees who are in long-term recovery with similar history) are utilized to help better empathize with persons dealing with SUDs when providing services. So, we know through research that programs such as START are often able to meet the needs of those who SUDs while mitigating the stigma around it.

Many people believe that for someone to “overcome” SUDs, abstinence is necessary. However, recent research has shown that there are other viable options backed by research. The approach that will work often depends on the person and their needs at the time. The Harm Reduction Model is an example which has recently gained popularity through research and implementation. The National Harm Reduction Coalition states that “Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.” An example of a Harm Reduction program is the Syringe Exchange Program (SEP). Louisville adopted the SEP recently, due to concerns related to the HIV outbreak, through drug injections, in Scotts County Indiana, in 2015. Louisville utilized the syringe exchange program as it was a “A Proven Practice to Reduce the Spread of HIV and Bloodborne Diseases.” Harm Reduction is crucial in addressing the stigma associated with substance use and SUDs while decriminalizing it.


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