First, do no harm…

In health, there is an adage that practitioners should do no harm.

I believe that when it comes to health this should also apply to journalists, politicians and those who identify as community leaders. For many years we have seen people with substance use disorders or issues harmed by dehumanising language and attitudes reflected by people in these positions.

The World Health Organisation has found that people with a substance use disorder face the most significant stigma and discrimination of any health condition.

Stigma related to substance use stems from outdated and inaccurate beliefs that dependence is a moral failing, instead of a chronic, treatable disease from which people can recover and resume healthy lives. Substance Use Disorder (or ‘dependence’ – the term ‘addiction’ is tainted by the stigma associated with referring to someone as an addict) is primarily treated with counselling, sometimes with medication and occasionally by a stay in a rehabilitation facility. Most people who get treatment will get better.

A rehabilitation facility is a safe and secure place where a person who has been through detoxification and withdrawal can stay whilst being supported to develop new understanding, behaviours and habits around substance use. Detox and withdrawal are processes where they are supported until the substance they have been using has completely left their body and they are in a state of mind where they can commit to change. Alcohol is the most common drug of concern, followed by methamphetamines, cannabis and heroin. Most people are treated for a combination of substances.

Once detox and withdrawal have been completed a person goes into a residential facility for treatment. They will be abstinent from alcohol and drugs for the duration of their stay. On completion of their treatment, they may remain or seek to remain abstinent for the rest of their lives. Some may change their behaviour around their substance use and manage it more functionally without abstinence.

Stigmatising language and policies results in people with substance use disorders experiencing real harm, often worsening their condition…

In 2021 in South Australia around 10,000 people were treated via a range of modalities. Nationally the figure was around 200,000 people. Given SA is about 8 per cent of the national population we should have treated about 16,000 people, indicating SA is lagging behind with treatment availability.

More concerning is that work by Professor Alison Ritter from the Drug Policy Monitoring Program at UNSW indicates that around 500,000 to 750,000 Australians would benefit from treatment. This would suggest demand in South Australia is likely to be somewhere between 30,000 and 40,000 people. We need a massive injection of resources to meet the need for free, accessible, and evidence-based treatment and support, early intervention, prevention and education.

Stigma drives this underfunding.

Studies on stigma have repeatedly found that it has a negative impact on the mental health and well-being of people experiencing problematic alcohol and other drug use.

It occurs in a wide range of settings including hospitals, prisons, police interactions, government agencies, workplaces, employment agencies, child protection agencies, schools and day-care facilities, It even occurs in drug and alcohol services.

Stigma also affects treatment. People using or having used drugs, or having a blood-borne virus, are more likely to be treated poorly in the healthcare sector. They may be denied treatment altogether or provided a level of care far below the quality that other members of society would consider appropriate within the community.

Stigma can compound social disadvantage, trapping people in cycles of transgenerational poverty and exclusion.

It creates barriers to people seeking and receiving help to address problematic alcohol and other drug use through feelings of shame or embarrassment, or because they do not identify with the negative stereotype attached to dependence.

It can also impact other important areas of life such as employment, housing and education, and can hinder people’s ability to reconnect with their family and community due to shame.

It is time for our politicians and journalists to stop abusing people affected by a significant health condition.

Stigmatising language and policies results in people with substance use disorders experiencing real harm, often worsening their condition, increasing the likelihood that their dependence will be exacerbated and take longer to recover from.

Over recent decades we have learnt the importance of language when discussing issues such as mental health, gender and suicide. For decades the alcohol and drug sector has been calling on the media and politicians to adopt similar care in discussing people affected by their own or a loved one’s alcohol and drug use. Guidelines for appropriate use of language have been developed by the Matilda Centre at the University of Sydney, the Media, Arts and Entertainment Alliance (the journalist union) and by the NSW Alcohol and Drug Association in partnership with the NSW Users and Aids Association.

All these organisations call for the adoption of person-centred language (‘a person who uses drugs’, ‘a person with a dependence’) and never using language that slurs a person for their use.

In recent weeks there has been a discussion of the suitability of establishing a residential treatment facility in Glenelg. Whilst the community has the right to discuss the appropriateness of this,  what is not acceptable is the stigmatising language being used by politicians, community members and the media towards people who are seeking health care.

Stigma is enabled by misunderstanding and misinformation spread in the media and by people who speak with authority but often without understanding.

It is time for our politicians and journalists to stop abusing people affected by a significant health condition.

Using stigmatising language to score political points or increase the number of clicks they get online at the expense of lives and the treatment outcomes of those affected by substance use disorder, their partners, children, parents, siblings and communities is unacceptable.

There is no other defined medical condition where we would tolerate people being demonised in this way that places barriers to receiving life-changing, often life-saving care.

Michael White is executive officer of the SA Network of Drug and Alcohol Services (SANDAS) – the peak body for non-government organisations working in the alcohol and other drug sector.

If you need help with alcohol and other drug issues for you or a family member you can contact:

• The Alcohol and Drug Information Service (ADIS) on 1300131340
• Go to the Know Your Options website www.knowyouroptions.sa.gov.au
• Family Drug Support 24/7 Family support line:  1300 368 186