Sunday, August 26, 2012

History of the Stigma with Opiate Addiction: Part 2

Here is the second part of my last post, continuing the history of stigma.  Enjoy!

The stigma has been exacerbated through media reports linking drug addiction and crime over the years.  In the 30s, the ‘Reefer Madness’ portrayal of marijuana became mainstream, scaring people away from the drugs that were often considered to be parts of lower society.  In these various examples, the government often used biases against certain racial profiles to proliferate this stigma of drug uses and abuse.  In the 30s, the black population was the target, as marijuana flourished in jazz clubs across the country.  Heroin also flourished in this scene, and though many jazz musicians were persecuted for their drug use, the media targeted the marijuana.  Later on, as the psychedelic 60s began to take hold, stories arose in the media, demonizing the portrayal of PCP, citing crime sprees as a result of taking this drug.  The media campaign did have the intended effect, steering many away from the hallucinogens of the 60s.  Again in the 80s, the media reported a vast number of gang-related crimes, attributing them to the users of crack cocaine.  It is no secret today that the explosion of crack cocaine affected crime, although the crime was not always on the shoulders of the desperate addict, but instead many of the crack related crimes were on the shoulders of the dealers, and the greed of the industry.  Today, the explosion of strange tales in regards to bath salts are viewed by some as simply another media demonization, featuring a lot of stories without the cold hard facts to back them up.  Only time will tell if this, too, will only help to further the stigma of drug use. 

Often, opiates are stigmatized the most.  Heroin is often considered to be the devil’s drug, and those who are addicted to heroin are regarded as a lower rung of society, and many view them with a skewed oral compass. This stigma began in the early 1900s and still carries the flag today.  Even in treatment, the intravenous heroin addict is the center of conversations, as other addicts marvel at the depths that this individual would have suffered.  So many in recovery also tend to further this stigma with heroin use, listening voraciously to the heroin addict’s tale, simply so they can rest assured that they, too, did not reach these dark places of the IV opiate user. 

When methadone was introduced in the 60s, the use of opiates for purposes of treating addiction was still illegal.  This era still viewed addiction as a moral weakness, rather than a disease.  Dr. Vincent Dole fought hard to spread the theory of addiction as a disease, thus finally convincing the government to approve methadone for the treatment of addiction.  In essence, Dr. Vincent Dole was one of the first to fight against this stigma of addiction, fostering the disease model that has become so widely accepted in the addiction field today.

Again, I find an interesting parallel in the recovery world today.  The followers of Bill W. also adhere to the disease model of addiction, adamantly fighting to reduce the stigma associated with addiction.  Yet, they stand against the use of methadone.  But, it turns out that the man, who introduced methadone for treating addiction, also introduced the disease model of addiction into law, at least in regards to the use of methadone.  I find it interesting that some, who fight vehemently for the disease model, also fighting against the stigma of addiction, help to add to the stigma surrounding methadone, demonizing its use at some 12-step meetings. 

The fact of the matter is that stigma of drug use still exists today, and it proliferates in various circles, some expected and some unexpected.  The stigma with addiction and mental health are still hard at work in our society, and we cannot hope to shed this stigma without educating the general population about addiction, and also the various methods for recovery.  

Social stigma keeps many from seeking treatment.  This is very prevalent among the military.  The effects of combat can be devastating sometimes, and many of these men need painkillers or other prescription drugs to treat various psychiatric conditions directly related to their service in the military.  But, often times, treating these disorders also means the end of a military career.  So, these illnesses go untreated, for fear of the stigma associated with them.  And occasionally, these underlying problems explode, such as was the case with the soldier who shot and killed many civilians in two Afghan villages.  Sixteen innocent people died, and the father who shot them will probably not be returning home to his family any time soon.  The results of this widespread stigma are devastating. 

The stigma with drug use often affects the care and treatment the addict receives.   A number of insurance companies do not cover treatment for addiction, and treatment is often too expensive to afford without insurance.  As a result, many people receive lesser care and treatment.   Furthermore, Methadone Maintenance is often viewed with disdain, and many times it is the only affordable option for treatment for the uninsured opiate addict.  Yet, they are still bombarded with the stigma rather than commended for their efforts.  Research clearly shows that people respond better to positive reinforcement, yet the methadone patients is still given the stigmatized death sentence of the intravenous heroin addict still living under a bridge.  

This battle against the stigma of drug addiction is a slow and painful process.  Seems to me like the only ones who even bother fighting against the stigma are those in recovery, those of us who still suffer the brunt of it.  We need to stand up, telling our stories of recovery.  We need to look at the cold, hard facts associated with treatment, especially with the various treatments of opiate addiction.  And we need to evaluate those facts, searching for more viable solutions.  The fact of the matter is that we DO recover, and the stigma still persists.  But, we can speak out, fighting this stigma and thus not only improving our own path to wellness, but also maybe even lighting the way for others to follow. 

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