Nico Bodkin
Writing 101.08
Research Paper Final
March 12, 2017
They are Worth Saving:
How the Stigmatization of Addiction is Hidden in Public Debate
Drug addiction has become an increasing problem in the United States, with overdose deaths doubling and opioid overdose deaths tripling since 1999 (Rudd, 2016). While communities are trying to combat this issue from different perspectives, they are often met with backlash. Though programs and medical innovations have the opportunity to save the lives of drug abusers, the debate surrounding their use reveals something hidden in our society. The 1961 UN Single Convention on Narcotic Drugs referred to drug addiction as a “serious evil for the individual” and a “social and economic danger to mankind” (Pickard, 2017). Has this perception of addicts changed with time or has this stigmatization remained stagnant? The widespread, often political, debate concerning public funding for lifesaving programs that help drug addicts reveals a hidden social stigma that blames those suffering with addiction for their illness. Two of these lifesaving programs include needle exchanges for the prevention of HIV transmission and the relatively new drug, naloxone, which can effectively reverse an opioid overdose.
The stigmatization of addicts in our society can be related to the “moral model of addiction” which assigns blame solely to drug users. The “disease model of addiction,” views addiction as a “chronic, relapsing neurobiological disease characterized by compulsive use despite negative consequences.” The repeated drug use by addicts render the desire for drugs irresistible (Pickard, 2017). In this model, addicts are seen as responsible for their choice to begin using drugs, but are then classified as having a neurobiological disease in which they cannot stop using. Contrary to this model, the moral model of addiction, which was most prevalent in the first half of the twentieth century, views drug use as a choice, even for addicts, and adopts a moral stance against said choice. Addicts are then considered selfish, lazy people who prioritize pleasure and escape (Pickard, 2017). Because this model views drug use a consistent choice to prioritize pleasure, drug users are blamed for the situation they put themselves in. This is exemplified in a study performed by Bowling Green State University researchers studying stigmatization and the public perceptions of addiction where they found that participants in their study were generally unwilling to affiliate with individuals that suffer with any type of addiction. Specifically, they found that participants were significantly less willing to affiliate with individuals who suffer heroin addiction compared to other common addictions (Lang, 2017). These participants, who were chosen to represent the population, thus identify with the moral model of addiction, by essentially labeling drug users as undesirable instead of treating their addiction as an illness or disease. Therefore, those whose ideologies identify more with the moral model of addiction help to stigmatize drug addicts in our society.
Needle exchanges effectively prevent HIV transmission, but the debate on its funding reveals hidden stigmas of addiction and the blame that is placed on addicts in Western culture. This is exemplified by Congress’ ban of federal funds for needle exchange programs in 1988 which was in place, with the exception of a few years, until 2016, though countless studies and systematic reviews from the WHO and UN have proven that needle exchanges are effective, safe, and cost-effective (Frakt, 2016). This is confusing because when the government is given the opportunity to prevent HIV transmission and help some of its citizens with a safe and effective program, any possible funding is banned. This example shows that the lives and well-being of drug users are valued less than those of others in the eyes of Congress, thereby revealing a stigmatization present in government officials who represent the citizens of the United States. These stigmas can also be seen in more local governments, such as New York City. Former councilman Hilton B. Clark and Dr. Woodrow Myers, Jr. believed that distributing syringes in minority communities would “encourage users to continue their self destructive behavior to their own and the community’s detriment” (Page, 1997). This claim was refuted by a study which proved that needle exchanges are instead associated with increased participation in treatment programs (Strathdee, 1999). Nevertheless, the blatant assumptions made by the New York City elected officials while discussing needle exchanges that align with the moral model of addiction, demonstrates the stigmatization against drug users in our society. Similar to the claims of the New York officials, opponents of needle exchanges often cite that the programs will increase drug use in their community, however this claim is unfounded. Studies that define the impact of syringe exchanges have generally come to the conclusion that, although the people who participate in the exchange programs tend to use more drugs than people who do not participate, their drug use “has not necessarily increased as a result of the exchange”, and that “drug use in the community does not increase as a result of free or easy access to needles” (Page, 1997). Because this common claim is proven false, it can be seen how people in today’s society, whether consciously or not, identify more with the moral model of addiction by placing blame on addicts for their illness. The public debate on the need and funding for needle exchanges thus exhibits the stigmas surrounding drug users and addiction.
Though the overdose-reversal drug naloxone has the power to save a life, similar to needle exchanges, the current debates on its use reveals the stigmatization of addicts and the perception of their value. This stigmatization can be seen in a letter to legislators written by the governor of Maine, Paul LePage, stating that, “Naloxone does not truly save lives; it merely extends them until the next overdose,” adding later that naloxone creates a sense of normalcy and security around heroine use that will perpetuate the cycle of addiction (Grim, 2016). In this statement, the governor alludes to his belief that those suffering from opioid addiction are not worth saving. He is thereby devaluing the lives of addicts which can be associated with blaming drug users for their illness. Therefore, the governor must closely identify with the moral model of addiction which relates to the stigmatization of addicts in our society. Many opponents of the drug, like LePage, believe that naloxone enables addicts to use more and more opioids, acting as a safety net. However, one addiction treatment provider referenced by a Brown University study stated, “Drug users want to have euphoria. And so, if one is passed out, one’s not high, one’s unconscious. And there’s not euphoria attached with unconsciousness.” Continuing that, “I have never met a patient in 15 years who has wanted an injection of Naloxone, for any purpose. And even when it saved their life, they’ve been generally upset at the fact that they’re now in withdrawal… I am not worried about my patients abusing Naloxone, at all” (Green, 2013). Thus this claim by naloxone opponents is unfounded yet their persistent opposition reveals the stigmatization of addicts and the perception that their lives are of less value. Fire Captain Wade Ralph of Marion, Ohio said in a statement to the Associated Press that his service has been relying on donations from health organizations to pay for naloxone. He stated that, “There’s a human factor to (overdose) that some people, I think, just forget about or maybe they ignore it and say, ‘Hey screw it, let them die’” (Sewell, 2016). The human factor that this emergency responder describes is something that many opponents of the drug cannot understand. Opponents often follow the moral model and view drug users as having a choice rather than having a disease that can be treated. Thus they exhibit their social stigmas by viewing naloxone as a problem instead of a part of the solution. The debate on the use and funding of naloxone in communities therefore exhibits stigmatization in our society against drug addiction.
References
Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305-325. doi:10.1086/382250
Frakt, A. (2016). Politics are tricky but science is clear: Needle exchanges work. Retrieved from http://search.proquest.com/docview/1816619462
Green, T. C., Bowman, S. E., Zaller, N. D., Ray, M., Case, P., & Heimer, R. (2013). Barriers to medical provider support for prescription naloxone as overdose antidote for lay responders. Substance use & Misuse, 48(7), 558-567. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=87447876&site=ehost-live&scope=site
Grim, R. (2016, April 21). Maine gov. paul LePage to heroin addicts: Drop dead. Huffington Post Retrieved from http://www.huffingtonpost.com/entry/maine-governor-paul-lepage-heroin-addicts_us_5717ef01e4b0479c59d6e865
Lang, B., & Rosenberg, H. (2017). Public perceptions of behavioral and substance addictions. Psychology of Addictive Behaviors, 31(1), 79-84. doi:10.1037/adb0000228
Page, J. B. (1997). Needle exchange and reduction of harm: An anthropological view. Medical Anthropology, 18(1), 13-33. doi:10.1080/01459740.1997.9966148
Pickard, H. (2017). Responsibility without blame for addiction. Neuroethics, , 1-12. doi:10.1007/s12152-016-9295-2
Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016, Dec 30,). Increases in drug and opioid-involved overdose deaths–united states, 2010-2015. Morbidity and Mortality Weekly Report doi://dx.doi.org/10.15585/mmwr.mm655051e1
Sewell, D. (2016, Sep 25,). Just say no to narcan? heroin rescue efforts draw backlash. AP Worldstream Retrieved from http://search.proquest.com/docview/1822896898
Strathdee, S. A., Celentano, D. D., Shah, N., Lyles, C., Stambolis, V. A., Macalino, G., . . . Vlahov, D. (1999). Needle-exchange attendance and health care utilization promote entry into detoxification. Journal of Urban Health; New York, 76(4), 448-60. doi://dx.doi.org/10.1007/BF02351502