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October 3, 2017
Stigma is described in the Oxford Dictionary as a “mark of disgrace”1, and occurs when an individual or group of people are discredited in relation to how they live, the actions they take, or for one or more of their behaviours.
To be stigmatised is to be held in contempt, shunned, or rendered socially invisible because of a disapproved status or behaviour. Consequently, stigmatised individuals or groups don’t receive the same level of respect as others.
Stigma is often used as a tool to discourage and marginalise people by highlighting behaviours others see as ‘unhealthy’, or not being ‘like us’.
Groups of people may become stereotyped through generalisations or assumed characteristics associated with their behaviour. This stereotyping can often lead to prejudice, antipathy and discrimination.
The impact of stigma and discrimination towards people experiencing a range of health, social and welfare issues can’t be overstated or ignored. Stigma and discrimination devalues a person’s presence in society.
People who use drugs are particularly vulnerable to the effects of stigma and discrimination.
Drug misuse is often not seen as a medical condition, but rather as a “personal choice or moral failure”.2
Those who become dependent on drugs are more likely to be considered responsible for their condition, more unpredictable, and as a result, more likely to be avoided and judged by society.
A growing body of evidence shows that stigma related to drug use disadvantages the stigmatised and is a major cause of stress for people who are drug dependent.3 The stress that stigma causes can be a central driver of morbidity and mortality; on par with some other “social determinants of health” including socioeconomic status, education and social relationships.
A major impact of discrimination and stigmatisation can be social exclusion. Social exclusion is considered a significant health-risk factor, and can restrict access to opportunity and services.4
The stigma associated with drug use can prevent people from seeking treatment, testing, and other important health services. People who use drugs are also very likely to experience discrimination and stigma within health services.5 This exclusion often results in people being less likely to engage in broader society, causing further health and social inequities and greater harms to the person.
It’s well recognised that stigmatisation is a barrier to seeking help.
Fear of being judged and rejected through the forced disclosure of their drug use, can lead some individuals to avoid close contact with others.6
Stigma meets all the criteria to be a fundamental cause of a range of health inequalities.7
Greater emphasis needs to be paid to stigma as a social determinant of health, and to taking action to address the health issues that result.