Addiction & Stigma

Recently, I had the privilege of taking a friend to see an endocrinologist as she needed an adjustment in the medication she is taking for her autoimmune condition. I waited for her in the waiting room and as we rode down in the elevator after her appointment, I asked her if she liked the doctor. My friend hesitated and then quietly said, No. After some prodding, she finally admitted that when the doctor saw the evidence of her drug addiction, which is healing now but still a relatively fresh track record on her arm, the doctor’s demeanor instantly changed. The doctor’s words and tone felt condescending, judgmental, shaming.

When my friend shared this with me, I was horrified. I think she was still in shock, and I think that being so early in her recovery, she is like a timid little bird who is not quite sure of her footing, her view of the world, or most of all, her view of herself. I know enough about the disease of addiction to know that nobody gets to that level of self-destruction (and other-destruction) because they were blessed with good things and relationships and genes and all that stuff. Chances are, they are struggling with some level of trauma, and chances are pretty high they have inherited pain and suffering that their parents, grandparents, and other ancestors endured and never transformed - so they transferred it to the children they raised (or abandoned). In recovery, we build ourselves back up, and this is done with the help of people and a network who operate from a place of compassion.  Ideally, this compassion eventually seeps into the blood and soul of the person in recovery, and one day they start to believe that they are worthy. But it is a long process, and my friend is in the early stages.

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“Far more than a quest for pleasure, chronic substance use is the addict’s attempt to escape distress… Addictions always originate in pain, whether felt openly or hidden in the unconscious.  They are emotional anesthetics.” - Gabor Maté

As we rode in the car I was driving, I helped her process what had just happened. I explained to her that the contempt she had just felt from the doctor was unprofessional, and my friend deserved better treatment. I said, “if you had told her that you had diabetes, or cancer, or heart disease, I am pretty sure she would have treated you with more dignity.  The fact that she didn’t is a reflection on HER, not YOU. In medical school, doctors take the Hippocratic Oath, which states that they will first, do no harm. Unfortunately, doctors still are not taught about the disease model of addiction, nor are they taught, or given refresher courses, on how to treat someone who struggles with this awful disease.”

A friend of mine is a nurse in an ER that is on the frontlines of the disease epidemic in the U.S., and she is horrified by the way the doctors and nurses treat, and speak about, the patients who come in with every level of injury, disease, and overdose due to addiction. These medical professionals are exhausted, and understandably frustrated, especially when the “frequent flyers” show up - again. And again. I get it. It must be incredibly triggering of every medical professional’s fear that no matter what, they cannot fix this person. And they are on the front line of a medical establishment that is absolutely inadequate when it comes to addiction and other mental health dis-eases. So, their lack of compassion is in many ways understandable - it is a side effect of caregiver burnout.

And medical professionals are just one segment of the population that is ignorant and ill-equipped to effectively help people in active addiction, as well as in recovery. I have Fakebook friends (just a couple, phew) who share stories in the media that effectively shame people with addiction. Every time I see one of those posts (eg couple overdoses in car, kids in the back seat) I am deeply saddened. How can this be helpful? Again, I return to what I stated earlier - when a person becomes this sick, it is something that is beyond their control. And it is rare that someone is shamed into changing, and I am quite sure that shame does not lead to positive change in systems or in society, but rather, builds up and strengthens everything negative, from the individual to the global levels.

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“We cannot grow when we are in shame, and we can’t use shame to change ourselves or others.” - Brené Brown

As we drove, I explained to my friend, that she is basically a Recovery Ambassador. I told her that next time she goes to a doctor, or interacts with anyone, really, she has the opportunity to educate them. Not in a shouty, emotional, indignant way, but from a place of compassion.  I do believe that we are all doing our best, and it’s important to always see the other person’s point of view, and consider that their perspective is shaped by their experience up to that point. I told her, “You may be the only person in recovery that someone meets, and you have the chance to show them that you are human, and smart, and worthy, and dignified. And, you have the right to hold people accountable when they are not giving you the same respect and compassion that they might if you revealed you had a more “socially respectable” disease.”  I have said this in different forums, that I believe that one of the reasons there is such a fear and misperception of people with addiction and other mental health dis-eases, is that the tradition of anonymity means that most people are not aware that millions of people can, and do, recover and lead incredibly productive, joyful lives. Imagine if the only way we heard about cancer is by obituaries and other stories of the horrors of cancer relapse. Instead, we have all kinds of events and media stories celebrating cancer survivors. I dream of the day when the millions of people in recovery, who are today contributing in meaningful and successful ways to the world, are also mentioning their recovery status along with “CEO/surgeon/coach/mother/lawyer/teacher/senator” etc.
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I believe that change begins with you, and me, and trickles around and upward and downward. So, if you are reading this, and you are a medical professional, an educator, a parent, a sibling, a law enforcement officer, a first responder, a neighbor - whoever you are - you can be part of the change. Great change happens with tiny steps taken on a consistent basis. It happens when we become more self-aware. And when we do that - pay attention to our thoughts, feelings, and actions - we may realize how much of what we think, feel and do is based on fear.

When that doctor saw my friend’s track marks, she probably thought, “Oh shit” for all sorts of reasons that boiled down to fear. Which is no different from what drives medical policy, insurance policy, public policy, DARE programs, zero tolerance programs at school, and Fakebook shares. So, once we admit that, we can talk about it, and that is where change starts to happen.

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” - Margaret Mead