[This is the third part in a series that examines what stigma looks like and how it damages those who receive it.]

Central Connecticut State University’s John Lewis Institute for Social Justice defines social justice as a communal effort dedicated to creating and sustaining a fair and equal society in which each person and all groups are valued and affirmed.

Oxford University Press’ OUPblog states: “Social justice generally embraces values such as the equal worth of all citizens and their equal right to meet their basic needs.” But who embraces stigma against addiction and mental illness through the lens of social justice?

A 2001 article published by the National Library of Medicine, stated that although much has been done in recent years to improve the status quo, it is evident that a great deal more needs to be done to improve the moral standing of and to achieve social justice for the mentally ill.

Yet, a book titled “Recovery of People with With Mental Illness: Philosophical and Related Perspectives,” published by OUP in 2012, in one chapter, addresses stigma and social justice as they relate to recovery from mental illness.

“Stigma towards people with mental illness has been identified as a primary impediment to people’s recovery from mental illness and inclusion as full members of a community,” the book states. “Recovery has long been understood as an issue of social justice.”

Yet, it has long been established that substance use disorders and mental health issues are among the most stigmatized of all medical conditions, regardless of social justice.

“The stigma surrounding substance use disorders can be viewed as similar to the stigma surrounding mental health issues such as anxiety, depression, and PTSD,” states Wayfair Recovery Center. “Since many people with substance use disorders also have co-occurring mental health conditions, this only serves to exacerbate barriers to recovery.”

Just one example of stigma, says Wayfair, is the use of derogatory names to refer to people with an addiction, such as “junkie” or “crackhead.” These names are intended to be demeaning and hurtful.

The 2016 book, “Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change,” discusses the negative impact stigma has on those in recovery.

“As people with mental and substance use disorders become aware of public stigma and of related discriminatory practices, they internalize the perceived stigma and apply it to themselves,” the book states. “The effects of self-stigma include lowered self-esteem, decreased self-efficacy (a person’s belief in their ability to complete a task or achieve a goal), and psychologically harmful feelings of embarrassment and shame. Low self-esteem and low self-efficacy can lead to what (is referred) to as the ‘why try’ effect, meaning why should a person try to live and work independently if he or she is not valued.”

While there is abundant research on the importance of social support for the recovery of those with substance use disorders, the book states, stigma instead contributes to social exclusion.

Its consequences appear in shame, depression, anger, isolation, reluctance to seek help, and even relapse. As Stepping Stone Center for Recovery relates to the stigma faced in recovery:

“When you think back on how you used to be in active addiction, it probably makes you cringe. You vow to work hard to never go back to that place again. Since you have entered recovery, you have made many changes in your life and within yourself. It’s a lot of work on your part and you’re doing your best to make things right. But it’s hard to shake off the old you because people have labeled you ‘the addict’ and that label is loaded with negative connotation. These people treat you differently because of the past you are trying so hard to escape. It is frustrating and discouraging to work so hard on your recovery, yet still, be stigmatized.”

Coping with Stigma in Addiction Recovery