Substance Use Disorders and Stigma
Kallen Thornton, MSSW, LCSW
Manager of Gender Responsive Services for the Colorado Department of Human Services, Office of Behavioral Health
Substance use disorders affect millions of people every year. Like many other diseases, substance use disorders are both preventable and treatable. However, people who suffer from these disorders are forced to navigate a profound degree of stigma when seeking support, education, and treatment.
First, we will unpack substance use disorder. The most common reason people use substances like alcohol, marijuana, and other drugs is that they change the way we feel. Sometimes people use substances to create or enhance a feeling they want to have, and sometimes people use substances to take away feelings they don’t want to have. The initial decision to use a substance is often viewed as a choice. However, many things that are thought to be individual choices can be heavily influenced by factors outside of a person’s control. Pollution of a person’s air and water, the effects of systemic racism, and access to safe housing are some of the many examples of these outside factors.
Over time, our brains and bodies can begin to rely on a substance to feel ‘normal’, which is referred to as ‘dependence’. By then, substance use has become less of a choice and more of a survival impulse. If we lessen or suddenly stop using a substance we are dependent upon, we may feel physically and emotionally very sick, which is referred to as ‘withdrawal.’ This can be dangerous and is not recommended for pregnant people without medical supervision and support.
It’s important to know that many people who struggle with addiction have experienced trauma. The risk of trauma and its long term health impacts is especially high for women, who are more likely to have experienced childhood abuse and are more likely to experience abuse and violence in adult relationships. Substance use can be seen as an individual’s best attempt to cope with the large toll that trauma takes on one’s emotional, mental, and physical well-being.
Stigma, which results in discrimination against people with diseases such as substance use disorder, is one of the greatest barriers to treatment for pregnant and parenting people. Due to cultural beliefs and gender expectations for women and mothers, pregnant and parenting people who struggle with substance use and addiction are among those most profoundly harmed by stigma. They (and their children) pay a high physical, mental, emotional, social, and economic price due to the stigma around addiction that is woven throughout our healthcare, legal, and social systems.
Examples of stigma include:
- Healthcare providers failing to universally screen for (and subsequently treat) substance use disorder among pregnant and parenting people, due to the misconception that perinatal substance use isn’t common in their patients.
- When someone becomes pregnant, the focus shifts from the person who is struggling with a substance use disorder to a child who may be impacted by a substance use disorder. This conflicts with the fact that investing in and taking good care of the pregnant person is integral to infant/child mental health and well-being.
- Laws that penalize pregnant and parenting people with substance use disorders prevent them from receiving the care they deserve and increases the likelihood of poor health outcomes.
- Perpetuation of the narrative that parents who struggle with substance use are “selfish”, “immoral”, or “don’t deserve” their children. Instead, we should recognize that they are parenting while suffering from a chronic and treatable disease and deserve treatment and support.
Pause and think for a moment about your own experiences related to substance use. It is very likely that you have friends and loved ones who have struggled with addiction, and you may have had seasons of your life in which you personally struggled or are struggling. If you know of a pregnant or parenting person who could use additional support around substance use concerns, tell them about Colorado’s Tough as a Mother campaign. Tough as a Mother exists to decrease stigma around maternal substance use disorder and to connect pregnant and parenting people to the support they deserve. Their website and social media accounts feature Colorado moms who are recovering out loud so that other moms don’t have to suffer in silence. There’s also an interactive treatment map to help moms find gender-responsive treatment providers in their communities. Colorado also has many peer-led supportive groups, like Circle of Parents in Recovery, where you can connect with other parents who may have similar experiences. If you’re the family member or loved one of a person who is struggling, there’s support for you too. Check out a local Community Reinforcement & Family Training (CRAFT) group, which is the leading evidence-based program for family members with loved ones struggling with addiction or in recovery.
The intersection of substance use disorders and stigma among pregnant and parenting people is multi-layered and complex, but just the knowledge of how common it is can decrease stigma. If you or someone you know is struggling, please remember you are not alone and support is available. Don’t ever forget that people can and do recover every day.