STIGMA

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‘ Living the stigma : understanding addiction and overcoming prejudice ’ was the theme of this year ’ s NHS Addictions Provider Alliance ( APA ) conference . DDN reports

’ re making progress – people are talking about this more ,’ NHS APA chair Danny Hames told delegates at the organisation ’ s Living the stigma conference . Stigma was now being considered in terms of how policy was written and services developed , but ‘ there ’ s still a job to be done ’, he said .

Chair of the Drugs , Alcohol and Justice APPG , Dan Carden MP – who shared his personal story of recovery in the House of Commons ( DDN , June 2022 , p10 ) – said he ’ d chosen to talk about his experience partly to challenge the stigma . ‘ Having overcome the grip of alcoholism , keeping my recovery hidden was never going to be an option for me . I wish I could tell you that the political will to prioritise addiction has been found , and attitudes towards those living with substance use disorders is changing – but that wouldn ’ t be true .’

This meant it was now vital to reach parity between addiction and other chronic mental health conditions , he said . ‘ Addiction thrives on isolation , and the remedy is human connection . Reconnecting with my family and friends and community is what keeps addiction at bay ’, with stigma undoubtedly the biggest barrier to recovery . ‘ Intolerance towards addiction is well-known , well-researched and often denied by those setting policies ’, with many still seeing substance issues as a moral affliction . ‘ We ’ re fed an unhealthy diet of stereotypes . It ’ s not all – or even mostly – about the substance . It ’ s about reconnecting people to the world around them , treating trauma , and providing hope .’

On the question of how to go about influencing organisations , a significant misconception was that addiction was a choice , said clinical director at South London and Maudsley NHS Foundation Trust , Dr Emily Finch . ‘ One of the best ways we can answer that is to educate people on what we know works .’ For people who had already developed a problem this was about making sure they had truly effective treatment , she said – ‘ in the same way as someone with diabetes getting treatment that works . I think that ’ s the route to genuine understanding , rather than the moral weakness argument .’

‘ Challenging at every point ,’ was vital , said programme manager at North East

‘ We ’ re making progress – people are talking about this more ... but there ’ s still a job to be done .’

DANNY HAMES

Lincolnshire Public Health , Mike Hardy . ‘ I ’ ll be in meetings and the language that ’ s used is not just old and antiquated , it ’ s offensive – but there ’ s no awareness of that . It ’ s also about making sure that everything we put out uses language that people with lived experience – or who are currently using – are comfortable with .’

It was also important to challenge definitions of recovery that had been externally imposed , said Jon Findlay , harm reduction lead at Humankind . ‘ If I don ’ t stop using drugs , I ’ m not a successful treatment outcome – I ’ m not a success until I can tick a box on the NDTMS form . I ’ m measured on that , and I can ’ t volunteer or work for an organisation because of somebody else ’ s version of recovery . From a stigma point of view , we set the bar really high .’ It was also important for people in the sector to challenge themselves , however . ‘ To a certain degree we ’ ve created this closed community ,’ he continued . ‘ Drug and alcohol treatment services are very confidential spaces . They ’ re a bit mystical – unless you ’ ve got a reason to , you ’ d never go in . It creates a kind of “ it ’ s just for those people ” attitude , whereas a GP ’ s surgery is for everyone .’ While it was clearly crucial to maintain confidentiality and dignity , it was also important to be more open and honest , he said .

Language was undoubtedly important , but it was also vital not to let it get in the way of other things , said Hames . ‘ I think sometimes we can get so consumed with this , we miss the point of moving forward and doing something positive .’

‘ I would always use “ alcohol use disorder ” or “ substance use disorder ”, but I recognise that for some individuals the words “ alcoholic ” or “ alcoholism ” can be useful and have a meaning for them ,’ Finch stated . ‘ For some people understanding that they are an “ alcoholic ” can be a pivotal moment of change , so I would listen to the individual . We don ’ t have one person with one problem – individuals are individuals , and they have different needs . And once you recognise that you get rid of some of the stigma , because it becomes more about the person .’ DDN

Look out for more reports from this conference online at www . drinkanddrugsnews . com

NHS APA is a founding member of the Anti Stigma Network ( ASN ) – find out more at www . antistigmanetwork . org . uk

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