Matters of Substance: Ways to think and talk about addiction and stigma


The Community Opioid Response recently held an open discussion, "Ways to Think about and Talk about Addiction," at the Brooks Memorial Library. COR is a collaboration between various community partners including Vermont Department of Health, Brattleboro Area Prevention Coalition, Turning Point Recovery Center, Nar-anon Family Groups, Brattleboro Retreat, and concerned community members.

Too often society is unfair to people with addiction — a fact that disturbs most people with active addiction, most people who are recovering from addiction, and most people who advocate for those groups. Fortunately, we can do something about it. Don't be daunted — small steps can have a powerful impact.

Social stigma exists within culture. Culture may be understood as the collective knowledge, beliefs, and behaviors of a group of people that is often stable across generations. Stigma occurs when a characteristic of a person or subgroup is perceived as different from others, is labeled, and the label becomes associated with a negative stereotype.

Not only is the culture that surrounds a person important, but also the culture he or she has internalized. For example, the labels "alcoholic" and "addict" may evoke prejudice and distancing in the general population, but acceptance and warmth in the population committed to 12-Step recovery. Individuals who find themselves dependent on alcohol or illicit drugs, if they carry the same culture as the general population, may attempt to hide their addiction and avoid seeking help because they are afraid of becoming labeled and of the consequences that may follow. The consequences of those labels can indeed be formidable and may include separation from social supports and demoralization of the stigmatized individual, along with discrimination in important life areas such as employment, housing, justice, and access to healthcare.

Sociologist Erving Goffman famously characterized stigma as "spoiled identity," which sounds much like our understanding of shame, a dominant emotion in sense of self. If we were to posit a neurobiology of stigma, it would be much like that proposed for shame. This is hopeful, because it views the adverse effects on the individual of both stigma and shame to be caused by unhealthy interpersonal relationships — and amenable to healing through healthy interpersonal relationships.

Stigma recedes as people focus more on what they have in common and focus less on their differences. It doesn't matter whether incremental positive changes take place in society or in the individual; everything interacts. As people become more real and human with one another, stereotypes become irrelevant.

Side note: Please come to the next Community Opioid Response conversation on "Ways to Think about and Talk about Addiction: Safety and Law Enforcement" on Tuesday, Oct. 11, from 5 to 6:30 p.m. at the Brooks Public Library. If you can't make it, it will be live-streamed on BCTV.

View the "Ways to Think about and Talk about Addiction" video at or

Geoff Kane is the Chief of Addiction Services at the Brattleboro Retreat and has articles on to help us understand what people with addiction are up against and pass that understanding on to them so they can apply it and establish safety, balance, and satisfaction in their lives. Matters of Substance is a collaborative column of Brattleboro Area Prevention Coalition. BAPC works to prevent and reduce substance abuse in the Windham Southeast area.


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