The Social Construction of Stigma & Problem Drug Use

This PowerPoint presentation on Stigma was originally
presented at a Scottish Drug Forum Conference on
Drug Use and Stigma

Copyright © Buchanan 2008

People who may suffer stigma
• A person with disability
• A person from Black Minority Ethnic Group
• A Gay/Lesbian person
• A person with a drug problem
• A person with mental health difficulties
• A person from a religious minority
• A person who is HIV+
• Any person who is defined as ‘different’


What is Stigma?
The concept of stigma refers to negative
stereotypes assigned to a people when
their attributes are considered both
different from or inferior to societal
norms.

For Goffman stigma was about the social
interactions between ‘stigmatized’ and
‘normal’ persons in society.

The process of stigma is deeply discrediting.
(Goffman 1963)


Process
stereotypes
of stigma STIGMA &
– involves severe social labels
disapproval of a persons
characteristics or their
beliefs which at the time
are considered to be
unacceptable to
dominant cultural norms Internalised
roles
& reinforced
&
tainted identity
expectations

diminished
opportunities

Impact of Stigma
Isolation – lack of social capital
Rejection – reduced life opportunities
Hostility – even violence (e.g. Stephen Lawrence)
Marginalised – face discrimination and exclusion

Restricts a person's ability to develop their potential and impact
negatively upon:

– Relationships
– Housing
– Health
– Employment
– Insurance
– Education
– Travel

Stigma reflects cultural shifts in norms
• What was acceptable in the past may be
unacceptable today.

• What was unacceptable in the past may be
acceptable today.

• What is unacceptable today may be
acceptable in the future.

• What is acceptable today may be
unacceptable in the future.

Smoking
was once an
approved
and
promoted
cultural
norm


Smoking is no longer an approved
cultural norm

Smoking now attracts stigma


The
stigmatization
of
tobacco
users


In the UK opium was once a
socially acceptable and widely used
drug
for recreational as well as medicinal
purposes.

The Lakeland poets were a
distinguished group of opium users

Samuel
Taylor
Laudanum, a solution of Coleridge
opium and alcohol


Opiate use today carries
considerable stigma and is
presented as an evil in our society


Drugs & Drug Users - the Enemy?
‘hardly a family is unaffected by the evil of drugs… Drug-related
drugs
crime blights our communities. It destroys families and young
lives and fuels a wide range of criminal activity, including
burglary and robbery….. We won’t tolerate the menace of
robbery
drugs in our communities – it causes misery and costs lives….
lives
This new money will enable agencies to step up their fight
against drugs and the crime it breeds. It will get drug dealers
breeds
off our kids’ backs and into prison and help safeguard our
communities’

HM Treasury Press Release, 49/01 09 April 2001


Drug use is portrayed in the media
as the key causal factor in violent
and abhorrent crimes

- as if taking an illicit substance
turns people into monsters


Demonizing drugs and drug users
Government Voices
– ‘Drug misuse can ruin individual lives, tear open families and
blight whole communities with the menace of dealers and crime
driven by drug abuse… more drug dealers – people who profit in
the misery of others – behind bars… more addicts into
treatment…further powers for police to drug test suspected
addicts on arrest… vicious circle of drugs and crime …dealers will
face harsher sentences where they prey on children …Drugs are a
scourge on the world’ (2005)

Media Voices
– ‘Cannabis caused a 14-year-old to kill’ …. ‘Woman murdered was
deliberately run down by suspected drug addicts’


Demonizing drugs and drug users (2)
Community Voices
– ‘there’s always junkies … they fight people are
aggressive, do dealing in houses, break-ins and
steal from cars …..get rid of all the junkies…nuke
the junkie scum’

Drug User Voices
– ‘They look down on me as scum of the earth and
as someone not to be associated with’ another
said ‘They see me as a drug addict, a smackhead
and they think I’d rob them’

The
Drug
Divide

Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use, in R. Carnwell & J. Buchanan (eds)
Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Second edition, Open University
Press, Maidenhead.


The Barrier of Exclusion
‘it is evident that the anti-drug campaigns over the past
20 years have added to the isolation and
marginalization of the discarded working-class youth
…. In addition to having to overcome their addiction,
one of the biggest hurdles they have to face is
breaking through the barrier of social exclusion.

JULIAN BUCHANAN & LEE YOUNG
The War on Drugs -a war on drug users?
Drugs: education, prevention and policy, Vol. 7, No. 4, 2000


House of Commons Science and
Technology Committee: Evidence 2006:
Ev 114


Problem drug users
‘The motivations for using illegal drugs are largely the same
as the motivation for using legal drugs – a pleasurable habit,
to be social, to relax and generally enjoy the affect of the
drug. However, a small proportion of people who use drugs
(legal and illegal substances) develop serious drug problems
(UNODC 2007). The vast majority of drug users are
recreational users who use drugs in a controlled manner
without incurring significant social, psychological and/or
physical problems to themselves or others around them. In
contrast the minority who develop problems sometimes
referred to as ‘problem drug users’ become socially,
psychologically and/or physically dependent and this lack of
control tends to have a detrimental impact upon their social,
psychological and/or physical well-being, and is likely to have
a negative impact upon those around them.’

Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds)
Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.

The USA & UK War on Drugs
- locking up drug users?
In 1996 the US prison population was 1.6m
 Today it exceeds 2.3m

In 1985 the UK prison population figure was 47,500
 Today it exceeds 83,000

Many prisoner have severe social and psychological problems:
 reading, writing, numeracy, mental health, dyslexia, drugs, no
qualifications, poor family support

Institutionalised stigma has
invited widespread
discrimination
Discrimination involves those in positions of power
exercising prejudicial beliefs, actions, or judgments and
using their power against the less powerful. The
discrimination is based on difference and serves to maintain
division and power by drawing upon and reinforcing stigma
and stereotypes.


Discrimination – more than just being rude

DISCRIMINATION =

POWER + DIFFERENCE + PREJUDICE


PCS Model
Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave

• Personal
• Cultural
• Structural P
C C S

Discrimination occurs at
three distinct levels


Damaged identities
‘The constant experience of this
marginalization has led many problem
drug users to internalize their problems
and blame themselves for their plight. This
loss of self-esteem then becomes a
serious debilitating factor as they feel
isolated and excluded from society.’ (p.394)
Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on
Problem Drug Use Vol 51 No.4 pp.387-397

Mixing with ‘Non’ Drug Users
‘I feel a bit beneath them, they make you feel like that’

‘I used to avoid them like the plague’

‘I’ve got to watch what I say so I don’t land myself in it. They blame
smack heads for everything.’

‘I feel labelled … like they thought I was dirt’

‘Most people look down their noses if drugs are mentioned’

Stigma & discrimination worse than
the drugs?
‘In an environment frightened with powerful moral
and legal reactions to the use of drugs, the stigma
attached to drugs may come to be a more
important factor than the biology of addiction. The
demonization of drugs and the criminalization of
the drug user (i.e. the war on drugs) could be
more damaging to the individual and society than
drug use or addiction’ (p.31)
Drucker, E. (2000) ‘From Morphine to Methadone: Maintenance Drugs in the Treatment of Opiate Addiction’, in J.A. Incardia
and L.D. Harrison (eds) Harm Reduction National and International Perspectives, pp. 27–45. London: Sage.


Impact of drug users
‘I’m sick of it. I see people with their own houses, family and
friends. I’d like friends who don’t use’

‘I’ve been wanting to change for five years’

‘I want to be drug free, get a job and lead a normal life’

‘It is difficult you feel divorced from the mainstream. I want to
get back into it’

Arguably the biggest hurdle a recovering
long term problem drug user has to
overcome is not physical addiction, nor
psychological cravings - but trying to break
through the ‘wall of exclusion’ that keeps
them in a drug ghetto. This makes it
extremely difficult for them to acquire new
routines, friendships, skills, hobbies and
lifestyle. They are often ostracised, criticised
and distrusted.

The struggle for re-integration

Adapted from Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework,
pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth press
Free article download from http://epubs.newi.ac.uk/siru/1/

Re-integration or integration
‘When considering treatment and rehabilitation it must be recognised that
many problem drug users have had such limited options in life, that they
lack personal resources (confidence, social skills and life skills) and have
limited positive life experiences to lean upon or return to.

This client group need social integration not social reintegration, they need
habilitation not re-habilitation – it seems that many have never really been
able to get started in life in the first place. This makes living without drugs a
very tough option indeed.’ (p.397)

Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on
Problem Drug Use Vol 51 No.4 pp.387-397


Challenging Stigma & Discrimination
• Must happen at all three levels: personal, cultural and
structural.

• Requires an ongoing public campaign to challenge
existing stereotypes and promote positive images.

• Requires a challenge to existing language, notions and
images used to make sense of drugs.

• Require education and training to inform people.

Challenging Discrimination
high
It is easier to have impact at
tackling personal attitudes and
behaviours but tackling cultural
and structural discrimination
Degree of (institutional) is much more
difficult.
Influence

low
Personal Cultural Structural

Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave(Thompson N 2006)

A different way of seeing?
We are all drug users

Low risk High risk
‘All drug taking presents a degree of risk and some legal drugs will pose greater risk than some illegal
drugs. It is argued then that rather than consider legal drugs as safer and illegal drugs more harmful,
and rather than assess drugs according to a hierarchical table of risk posed by different drugs, there is
a need for a comprehensive individual assessments to be made for each person according to the
nature and context of the drug taking and this is best placed upon a broad continuum of risk which is
applicable for all {legal user and illegal users alike] … it should be remembered then that virtually
everyone uses drugs, and all drug taking presents some risk’ .

Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R
Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach,
Open University Press, Maidenhead.

julian.buchanan@vuw.ac.nz

Home page:
http://julianbuchanan.wordpress.com/

PLEASE NOTE:

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The Social Construction of Stigma & Problem Drug Use

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