Stigma kills

Stigma kills

Reported by Andria Efthimiou

Published on Tuesday, July 9th, 2024

Equality Health healthcare access

Stigma kills

Stigma kills

Written by Andria Efthimiou

Published on Tuesday, July 9th, 2024



healthcare access

Stigma kills people who use drugs daily (PWUDD) by perpetuating beliefs about them being criminal, weak, immoral, greedy or insane.

Given this group are often arriving at addiction due to cumulative trauma and mental health problems, this labelling can be crushing and force people into isolation, leading to withdrawal from treatment services and an increased risk of depression, if not suicide.

For me this is all personal. I used to inject drugs until 1993 and I’ve been diagnosed with mental exhaustion, depression, bi-polar and complex Post Traumatic Stress Disorder (PTSD).

cartoon of a person sitting down next to drug paraphernalia

Recently I decided Attention Deficit Hyperactivity Disorder (ADHD) is also an issue for me and Lord knows how many other mental health or neurodivergent conditions I’d consider applicable to me if I researched more!

So I know what it’s like to feel the sting of stigma while already living with addiction, trauma and mental health challenges.

It’s hard for drug users to do anything without being negatively stereotyped. Even if we try to get help by going to addiction specialist programs we are stigmatised.

2020 saw record-high numbers of drug & alcohol-related deaths, with 79.5 drug-related deaths and 130 alcohol-related deaths per million people in England alone. This is the highest recorded figure since records began. This shocking statistic can be largely attributed to stigma.” (Stigma Kills campaign paper)

You might be able to access a day program where counselling and skills development are an option on the way to rapid-abstinence… but again, if people find out you’re a client there; oh the stigma! (Nice to learn new skills and get support though!)

Or you could always go to your GP to explain your situation and they could prescribe a substitute medication like Subutex, heroin (very unusual) or methadone if you’re hooked on opiates.

But medical professionals often make judgements and assumptions so talking to them about these things can also be an uncomfortable experience.

cartoon of one person admonishing another person at a table.
Medical professionals often make judgements and assumptions.

Even self-help groups, like Narcotics Anonymous are somewhat responsible for stigmatising people who use drugs, by, for example, describing ex-users as ‘clean,’ which by definition, implies people are ‘dirty’ if still using. Moreover, their quasi-religious programs are implicitly about admitting wrongness and then eventually ‘making amends.’

And the criminalisation of many of us has somehow become overlooked as one of the causes of the  stigmatisation of drug users, which I find extremely odd.

In the US, addiction became known as a disease and I used to think, “at least that will make our fellow citizens more merciful” but not necessarily! One of the regulars on nextdoor.com particularly abhors “junky whores” – a very vulnerable group, as the Ipswich murders uncovered years ago.

In short, I cannot think of any spaces, where declared ‘addiction’ at any rate would not be stigmatised.

That said, in my opinion, more and more people are now trying not to stigmatise, which is a good thing.

Sadly, some of them have the habit of trying to identify with you because they smoke weed now and then (or whatever) The fundamental way those two groups are similar is because of the archaic outdated drug legislation which criminalises both. But the recreational users’ relationship with substances is quite different.

No wonder, we become kinda-elitist, only feeling safe in rooms with others, who have suffered repeated drug-related crises.

So anyway, what to do? Get as many people who use drugs daily (frequently or not) out of the closet, but especially encourage ex-users to speak up and campaign about the impact of stigma. We know from the campaign work of Re-think Mental Illness that programmes like theirs can break down stereo-types and fears.

My own personal experience is … every time I’ve ever told a doctor that I smoke cannabis they go: ‘Well, that’s why you’re depressed.’ and I go ‘No, the depression started seven years before I even smoked a joint.’ and they’re like … you just can’t get past that as soon as you say you smoke cannabis most G.P.’s go ‘Well that’s it! That’s the problem!” (Stigma Kills campaign paper.)

I say more ex-users should be doing this work as they are, of course, not in danger of arrest. And that points to another area where stigma could be tackled: the decriminalisation of drug use.

Cartoon image of a man with his hands cuffed behind his back being marched by a police man.
The possession of hard drugs has been decriminalised in Portugal, the Netherlands and Switzerland.

This idea is not a pipe-dream. Recreational marijuana use is now legal in Brazil and 15 US states and the possession of hard drugs has been decriminalised in Portugal, Switzerland and the Netherlands.

Language plays a big role in stigmatisation so surely ceasing to label drug-users as criminals merely for possessing and using drugs would help break down the streo-types about them.

One more crucial thing, People Who Use Drugs Daily need to find a way to stop the ‘internalised oppression’, a term I learned fighting AIDS in the AIDS Coalition to Unleash Power (ACT UP). The truth is our own power and confidence can only become viable when we cut out our own inner critics.

Drug users’ lives matter but stigma is killing them. We need to fight the stigmatisation of drug users now to save lives.


Written by Andria Efthimiou

My name's Andria and I'm a local lone Mum, with a fab teen daughter. I have an MSc in Social Policy from the London School of Economics and I've been involved with Disabled people's activism since 1988.

I was widowed by AIDS and then became a drug policy reformer, helping to instigate a reversal of the trend for adopting criminalising drug policies at the UN. In 1998, I arranged for Marshall Burnett, an African American woman, to address the UN General Assembly Special Session(UNGASS) on the World Drug Problem about the failures of the War on Drugs, really a war on vulnerable communities around the world.
I edit the usersvoice.org, an online magazine about drugs policies.

Read all of Andria Efthimiou's articles


Equality Health healthcare access

Leave a Reply

Your email address will not be published. Required fields are marked *