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Understanding SUDs: eliminate stigma by not judging

HOUGHTON — One of the major challenges facing people suffering with Substance Use Disorder (SUD), is the social stigma attached to those either suffering, in treatment, or in recovery from SUD. In order to help those suffering with SUDs, it is crucial that people come to understand that casting judgements and condemnation upon those suffering with addictions will not accomplish anything for the addicted person. It is important that stigmas of all kind be eliminated completely, including from the public, as well as the medical establishment. This can only come through understanding.

Stigma is a pervasive force that alienates those who experience addiction from medical care and recovery support, Jennifer Atkins, Anna Legreid Dopp, and Edna Boone Temaner stated in their Nov. 9, 2020, National Academy of Medicine commentary, titled “Combating the Stigma of Addiction – The Need for a Comprehensive Health System Approach.”

“The added stress of the COVID-19 pandemic on the health system has sharply exposed these barriers, separating patients with addiction from their care teams and in-person recovery groups,” they stated.

The authors go on to state that previous to the COVID pandemic and its subsequent lockdowns, only 10 percent of those with SUDs received treatment, contributing to the 70,000 annual deaths from drug overdose, of which more than two-thirds are opioid-related. In the current context, the opioid crisis is being acutely aggravated.

“The pandemic has exacerbated the weaknesses of an already fragile system–a system rife with both individual and structural stigma against patients and medications for treatment,” the article states, “–that many individuals with opioid use disorder (OUD) found difficult to enter and navigate. The need to address stigma has never been more pressing.”

An SUD is a term to describe the disease of addiction. It has replaced the ages-old terms “alcoholic” or “drug addict,” because these terms do not accurately describe the disorders. SUD is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.

It is considered a disease because drugs, including marijuana and alcohol, change the structure of the brain and how it works. The substances attach to receptors in the brain that are usually filled with a naturally-produced hormone called dopamine. When a person takes drugs, an abnormally high amount of dopamine is produced, causing euphoria (a really intense high).

Addictions are commonly accompanied by a sense of shame or self-stigmatization, Steve Matthews, Robyn Dwyer and Anke snoek explain in their May 3, 2017 Journal of Bioethical Inquiry article, titled, Stigma and Self-Stigma in Addiction. Self-stigmatization results from public stigmatization in a process leading to the internalization of the social opprobrium attaching to the negative stereotypes associated with addiction. In other words, those who are suffering with addictions feel an intense shame and self-stigma, because of the social stigma associated with those suffering the addiction. External and internal shame and stigma do nothing to help the person with SUD, but tend to compel the person to isolate.

Addiction was not always seen as a disease by the medical community or society at large, the 2018 Upper Peninsula Community Health Needs Assessment. It was looked upon as the result of a free choice on the part of the addicted individual or the result of a weakness in self-discipline or character. As such, addiction carried a significant stigma which persists to the present day. Alcoholism was first recognized by the American Medical Association (AMA) as a disease in 1956, Addiction itself was defined as a disease in 1987.

It must also be understood that Individuals may become addicted to many things: Tobacco, alcohol, gambling, food, sex and of course, legal and illegal drugs…to name a few, states the assessment. Addiction, however, is not a certain, long-term death sentence. Addiction can be effectively prevented, treated and managed by healthcare professionals in combination with family or peer support. In the western Upper Peninsula, finding resources for addiction recovery is not as difficult as one might think.

One resource is an organization through the Western Upper Peninsula Health Dept. (WUPHD), called FACE — Facing Addiction Through Community Engagement. The vision of the FACE project is “to help Upper Peninsula families facing addiction end the cycle to protect future generations. We connect families to recovery by raising awareness, reducing stigma, and providing support,” the FACE website states. One of the topics FACE addresses is stigma, by helping the public to understand that addiction is not a choice, a moral failing, or a lack of willpower.

“When someone is addicted to alcohol, opioids, or other drugs,” the site explains, “their brain is literally re-wired to seek that drug above all else. Addiction is complicated and includes many factors, including genetics, upbringing, trauma, and other influences. Just like many other diseases, treatment is available and recovery is possible.”

For more information on the FACE program, visit the website at https://906face.com; or please call 906-281-6061, or email 906face@gmail.com.

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