Dealing with stigma & discrimination

NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added, e.g. ‘I want to maintain [my current level of consumption]’. Ellipses within square brackets […] show where text has been removed, e.g. ‘Counselling was good but […] I would have liked more information about other treatment options’.

A key concern for many of the people interviewed for this website is coping with the stigma associated with addiction and drug use. ‘Stigma’ refers to negative attitudes, judgements and stereotypes based on assumptions about a particular group of people. It can lead to exclusion and unfair treatment (often referred to as ‘discrimination’). Stigma and discrimination can also change the way people think of themselves: they may come to accept as true the negative judgements expressed by others. This can impact on self-esteem, mental health and general well-being. The ways in which the media reports drug use and how it is handled in the criminal justice system also produce and reflect stigma. Many of the people we interviewed for this website say they experience stigma and discrimination in relation to their drug use. They describe the impact of stigma on everyday life, including its role in healthcare and relationships with family, friends and work colleagues. Some say it contributes to isolation and marginalisation. For example, Andrew (M, 41, works in education, cannabis and alcohol) comments that being a ‘cannabis addict who doesn’t work and who has got disabilities’ puts him at ‘the bottom of the food chain’ where he faces ‘obstacles and […] afflictions every day’.

Some suggest that the degree of stigma depends on the drug as some are more heavily stigmatised than others. As Zadie (F, 33, works in the health sector, heroin) puts it: ‘A lot of my friends still have quite stigmatising and discriminatory attitudes to people who use opiates and ironically, most of them use coke [cocaine]. But you know, there’s always been that thing of: it’s fine to snort cocaine, but you’re somehow a seedy junkie if you do heroin’. A few describe stigmatising experiences in which others called them offensive names and repeated negative stereotypes about addiction.

Stigma influences whether or not people tell others about their drug use. Many of our participants say they’re concerned that if they tell others they will be judged, marginalised or otherwise discriminated against (see also Relationships, confidentiality & telling others). Some feel too embarrassed to discuss their concerns with health professionals, and in some cases this discourages them from seeking treatment. Concerns about experiencing stigma and and discrimination within the healthcare system can also lead people to delay seeking medical help and when they do, an initially minor health problem may have become much more serious and difficult to treat.

Some of our participants comment on the role of the media in creating and reinforcing the stigma associated with addiction and drug use. Several say media coverage can be sensationalist, exaggerating the harms of drugs and relying on misinformation and negative stereotypes. Others talk about how media reports impact on the everyday lives of people who take drugs by reinforcing negative assumptions about them, and contributing to social isolation and marginalisation.

Experiences of stigma and discrimination in the criminal justice system are described by some. They share experiences in which police officers, lawyers or judges expressed negative attitudes towards them or treated them unfairly (see also Contact with the criminal justice system).

While many of our participants describe how experiences of stigma discourage them from telling others about their consumption, some say they prefer to talk about it openly in an effort to challenge negative stereotypes. Common views about addiction or dependence are criticised by some who suggest they produce stigma and discrimination.

Read on to find out more about experiences of stigma and discrimination in relation to family and friends, in the health system, the workplace and the criminal justice system, and about how some people challenge stigma in their daily lives.

Family & friends

Many of those interviewed say family and friends express negative attitudes towards their drug use and treat them unfairly because of it. They talk about how these stigmatising attitudes hurt them and affect their confidence and self-esteem. In some cases, these experiences shape whether our participants talk about their consumption or keep it confidential (see also Relationships, confidentiality & telling others).

Anika (F, 19, studying, cannabis) says some of her friends judge her for taking drugs and suggest that she is going ‘off the rails’. (Note: strong language) (Played by an actor)

When I […] did acid [while travelling…] I told my friends about it and they were just like, ‘You are going to go off the rails’ […] And then the next minute they see all this amazing artwork [that I did…] and they’re like, ‘This is great’. And I’m like, ‘Well, you were calling me a druggo […] and here you are applauding me when I’m a normal person doing normal things’. [As soon as] the word ‘drug’ pops up [people start suggesting I have an] addiction and [I’m a] druggo, and all those negative things. And that’s what the shit thing is: there are people who look at the word ‘drugs’ and go, ‘Oh no, you are going to be a bad person when you grow up’. [But] there are people like me and my other mates [who] are just like, ‘It is not that bad’.

Nick (M, 50, not working due to illness, heroin) says his family discriminate against him because of his heroin consumption and this really hurts him.

The relatives didn’t want their kids associating with me any more, my cousins. Even though I didn’t encourage them to take drugs or anything of the kind. Yeah, that hurt a bit […] It had a big impact.

[…]

They don’t trust me. And they think that a user is a junkie, a stereotypical junkie that’ll steal from anybody. And I noticed that, you know, at a family do–[…I] went to my cousin’s place with the family and they were looking at me, where I was going and what I was doing. And after ten minutes I went home […] and from then I have never been back to any relatives’ houses.

[…]

They have got their own view and told me not go to their house and things like that […] It really hurt me. It really hurt me […] After that, all I wanted to do was use more.

Bobby’s (M, 49, not working due to illness, heroin and alcohol) mother judges him for taking drugs and refuses to let him stay with her when he visits from out of town.

My mother is still around but I can sense the discrimination from my own mother. Like, last time when I had my accident, I went [interstate to visit her] in hospital. So I got all the way [there] and […] I’m her son and I needed somewhere to sleep, and my own mother doesn’t want me to sleep at her place. That says a hell of a lot. That means my mother has written me off. My father would never have done that. He would’ve said, ‘Come on’, you know. My mother is [colder] in that regard. I’ve even told her like, ‘There are no drugs’ and everything, but her actions speak louder. So you can lose your own mother because she has got preconceptions about drug use.

Among those living with illness or a health condition, some say they have a double burden, dealing with the stigma associated with their illness as well as the stigma of addiction (see also Living with illness or a health condition).

According to Jason (M, 34, studying, ice), his drug problem and his HIV status are both linked to the shame and stigma that he actively challenges in his daily life.

I just thought, ‘Okay, I’m going to call my mother and tell her I have got a problem’ so I did and I said, ‘Look, I’m going away for a little while’, that’s when I went to the hippie commune […] Yeah, so family and friends know. Everyone that I know, knows. I think they do anyway, I certainly don’t hide that […] In addition to my HIV-positive status, that’s also something that I don’t want to hide so they’re all interlinked in this shame and stigma. [I’m] just trying to give a face to all of these things. I think [that’s] very powerful and yeah, that’s part of the reason why I’m here on this earth.

Ethan (M, 39, works in hospitality, ice) makes a similar point below in relation to his sexuality, saying he feels doubly stigmatised and for this reason, prefers to keep both his sexuality and his drug use confidential.

Ethan (M, 39, works in hospitality, ice) found it hard to ask for his family’s support to stop taking ice because he felt rejected by them. He says this was linked to feelings about his sexuality. (Played by an actor)

I think I didn’t know how to let support in […] A lot of it was because I felt I was being rejected, but I also didn’t know how to let people love me […] I was always kind of running from something […I mean] I think being gay is a big thing and yeah, actually I think that was probably one of the biggest [parts of feeling rejected…by] my family.

[Like, I wasn’t] comfortable with being who I am […and I didn’t] want people to know, so I was always kind of hiding something. And then my drug use, I was hiding something as well […] I was probably good at hiding things anyway. I don’t know, when you’re hiding stuff, it’s hard to let people in. It’s very controlled. My life was very controlled about who knew what.

Experiences of stigma and discrimination shape whether or not many of our participants decide to tell others about their consumption (see also Relationships, confidentiality & telling others). For example, Harry (M, 52, works in the arts, heroin) says, ‘Because of [heroin’s] prohibition and [the fact] that it’s stigmatised, you can’t admit to people around you, even sometimes close friends, that you might use that drug. Because they will think you’re a […] “junkie”, which […] basically frames you as being something less than human or less than normal. And so there’s the stigma attached’. Some say they talk about their drug use only with select family members, partners or a few trusted friends.

Lucy (F, 34, works in retail, cannabis) describes her mother’s response when she told her about her cannabis use. (Note: strong language) (Played by an actor)

I finally thought that I could maybe open up to my mum because my mum and I have a lot of problems. I thought I could open up to her and that was the worst mistake of my life because my mum […] just used it against me. She went and told everybody I was on drugs. It became her story. It became about pity[ing] her because her daughter was on drugs. And she just lost it. She just didn’t have a rational sense [that…] it wasn’t even that bad [She didn’t ask] ‘Why?’ or, ‘Are you okay?’ or anything, you know. She just went like, ‘Holy shit, you’re a druggo. Oh my God, my daughter’s a druggo’. And she’ll still say that about it. And I’m like, Jesus, you know […] So my family […] judge me for it too really […] They’re definitely not […] understanding of it.

The health system

Many of our participants have had contact with the health system in relation to alcohol and other drugs (see also Living with illness or a health condition; Formal & informal detox; Talking therapies; Pharmacotherapy/Medication treatment). Some describe experiences in which healthcare professionals treated them differently from other patients, with several commenting that they feel like staff ‘look down on’ them or judge them more harshly than other patients. As David (M, 25, unemployed, heroin) explains in relation to his experience of accessing opioid pharmacotherapy treatment (methadone):

Just at the chemist, I feel like they are looking down on us. They don’t treat us [like] a normal patient. Like, we’d go in there for a prescription [and we] are always second best. Like [the staff will] push you to the side or push you back, and deal with their people first and then deal with the ‘druggies’. That’s what we look like [to them].

Past experiences of stigma and discrimination in the health system mean that some of our participants are hesitant to discuss their consumption with health professionals or access healthcare. In some cases, this acts as a barrier to accessing healthcare in a timely manner: it can mean that people seek medical help belatedly by which stage an initially minor health problem may have become much more serious and difficult to treat. For many, the impact of stigma endures, colouring their attitudes and experiences for a long time.

Several say they found it hard to get medication for pain relief because of their medical history of alcohol and other drug dependence. For example, Zadie (F, 33, works in the health sector, heroin) describes how she was refused treatment for a health condition because she says the doctors ‘assumed [she] was just trying to scam some opiates’. Commenting on being denied pain medication, she says, ‘[If] you treat people like this, you leave them with little […] option other than to do what they can to deal with that pain. And certainly, it was easier to go and score some illicit drugs to deal with it. What else was I going to do?’

According to Helen (F, 53, not working due to injury, heroin), the ‘gulf’ between alcohol and other drug workers and clients contributes to the shame and stigma surrounding drug use. (Played by an actor)

It’s funny, because I feel much more ashamed of [my heroin use] now. I feel that shame and guilt and embarrassment, and the stigma around using much more now, whereas in the past […] I didn’t disclose it to people because I didn’t think I needed to […] It’s a bit ironic that it’s when I’m trying to stop using that I feel more stigmatised because I’m disclosing it more.

[…]

I don’t know if things have changed over the years but I feel like people in organisations that work with drug users now are encouraged to be professional, so it’s sort of ‘us’ and ‘them’. Like when I used to work in outreach programs and NSPs [needle exchanges…] I don’t remember much distinction being made between clients of the program and people that worked at the program. But now there’s a complete gulf, they are not the same kind of people at all. So yeah, I don’t like standing behind the bullet-proof glass and being the client, and being seen as a drug user and that’s all there is to me, you know. And that’s how I’m being dealt with.

Dean (M, 35, works in hospitality, ice) says he’s been refused service at chemists when trying to access sterile injecting equipment. (Played by an actor)

Getting needles when you need them is a hard deal. Like, there’s a couple of machines around the inner city, but there’s nothing out in the [suburbs…] Even going to chemists and asking them, they’re like, ‘No, no […] we don’t have them’ […] I just sort of wanted to get out of there [after being told that] because I felt about this [small]. So yeah, I went to a few different ones. One big one that I knew stocked them around here, and they said, ‘No’ as well, and I was just like, ‘Okay’. It was just a matter of coming back in to the city. But, I mean, I’ve never used somebody else’s needle and I wouldn’t want to. I’ve only ever reused my needle twice and even that I don’t like. I don’t like doing it. So to find it so difficult to actually get clean needles is a bit of a worry.

Zadie (F, 33, works in the health sector, heroin) describes a distressing experience of stigma in the health system and highlights the need for stigma and discrimination training in the alcohol and other drug sector. (Played by an actor) (Note: strong language)

I’ve overdosed quite a number of times, actually, and one time it was so bad that I was in intensive care for two weeks. Actually, when I came in, apparently I was dead for about eight minutes. You know, all the Narcan [naloxone: used to reverse the effects of opioid overdose] they gave me didn’t bring me around. I was unconscious and I came to in the hospital […] I became conscious but I couldn’t move a muscle […] I could feel pain but I couldn’t move, and I could hear what the doctors and the paramedics were saying about me [which was] just really derogatory, you know: ‘Stupid fucking junkie, get them all the time’. It upsets me even thinking about it [crying]. They were being very, very rough with my body. There was no care.

[…]

The whole time I was in there […] they treated me like shit […] I mean there’s clearly such a high level of stigma and discrimination, and misunderstanding of drug users and drug use, and they’re professionals […] I think there needs to be much more training for healthcare professionals.

Some of our participants shared recent experiences of stigma and discrimination in the health system. Others, like Helen, recalled experiences that happened years before the interview, which show that the impact of stigma lingers and colours people’s attitudes for a long time.

Helen (F, 53, not working due to injury, heroin) describes how she and her baby were singled out and judged more harshly than others while in hospital after his birth.

When I was pregnant, for instance, it was suggested that I stay on methadone [because] it was better for the baby, so I did. So I was doing what I was medically told to do, but then in the hospital, my baby was treated really differently. All the other mothers had their information sheets with them on the bed and mine were kept behind the counter, and groups of nurses and students would be brought through and they’d be [told] ‘Here’s our little narcotic abstinence syndrome baby’, like they were convinced he was going through withdrawals and he wasn’t at all. He was the most healthy baby you could ever see in your life, you know. I felt really lucky that he was because I think [they would have…taken] him away if anyone had thought that there was anything wrong there. Whereas all the other mothers had babies with all kinds of stuff going on, but no one was suggesting state involvement the way that would come up around drug use.

NOTE: Experts debate the prevalence and signs of neonatal abstinence syndrome.

When George (M, 58, not working due to illness, alcohol) was injured, he says that he couldn’t access adequate pain medication due to his ‘history of drug use’.

Once I was hospitalised. And I’d actually been attacked and had fractured my back and they sent me out of the hospital with Panadeine. I couldn’t even get [Panadeine] Forte (paracetamol and codeine) because they knew I had a past history of drug use. So they wouldn’t give me anything stronger than Panadeine. I mean it’s ridiculous. I had a fractured back.

The media

Some of our participants comment on the role of the media in creating and reinforcing the stigma associated with addiction and drug consumption. Several point out that media coverage can be sensationalist, exaggerating the harms of drugs and contributing to misinformation and damaging stereotypes. A few say they avoid news media reports on drug use for these reasons. As Scott (M, 25, studying and working in hospitality, alcohol) puts it:

[If you] turn on the TV, it’s got, like you know, ice addicts, or you open The Herald Sun or even The Age, like, I don’t even bother. I just don’t read it, or it just goes in one ear and out the other […] because [the media presents] like such an extreme view of these people, like me and my friends [who take drugs…] I guess it’s misrepresented.

Others talk about how stigmatising media reports impact on the everyday lives of people who consume drugs. For example, Nick (M, 50, not working due to illness, heroin) says that news reports reinforce negative attitudes towards people who take drugs, and in his case, this has affected his relationships: ‘[Living with a drug habit] you lose contact with friends […] Friends that can help […] are no longer around […] because I think […] they read the paper and the news, and they see crimes committed by people to get drugs. They put me in that category, I suppose’.

Harry (M, 52, works in the arts, heroin) comments on how the media reinforces stigma by presenting inaccurate information and negative stereotypes about drug consumption.

There was a report that came out […] it was on the news, like, in the last few days […] and they were saying […] ‘What about casual heroin use?’ And the guy says, ‘For every casual heroin user, I’ll give you 500 addicted people.’ Hang on, now amongst my friends at the moment, I know of two casual heroin users, and […] I guess, even though I’m regular, I’m still, like I guess, probably casual because I don’t hold a habit at the moment or anything, so who is he looking at? Who is he actually examining? […According to the media] everyone falls into this category [of being addicted] They’re the junkie, you know, they’re the useless person on the street, they’re the bottom feeders, you know […] It’s not questioned in the mainstream media and that’s the unfortunate thing […that there is] that level of stigma [in the media].

Kate (F, 36, works in the health sector, prescription drugs and ice) criticises the negative coverage of drug consumption in the media, pointing out that it repeats stigmatising assumptions.

If you are […] a heroin or an ice addict then […] it’s just so looked down upon and sensationalised as well with the media […] Unfortunately, it’s very demonised […] A lot of people use different substances in different […] ways and for different reasons. You don’t always have to have a troubled past or a problem or, you know, some sort of therapeutic need to self-medicate or anything. It might just be for fun […] I hate the way [drug use] is sensationalised, I very much avoid news […] They just put fear in people with everything, you know. Like, if you watch the news every night […] you’d be scared to use any kind of drug because it will kill you or turn you into someone wearing Adidas and yelling on the street. It puts you into a stereotype. Yeah, like, the mainstream media in particular are so biased.

Artemis (M, 28, works in education, cannabis and party drugs) says that recent media coverage of crystal methamphetamine consumption exaggerates the level of ‘problematic use’, reinforcing the stigma surrounding it.

Certainly in the media, addiction is the only discourse when it comes to drug use. I mean, we have to only look to the recent coverage of crystal meth use to like shake our heads and wonder, you know. Everyone is addicted to crystal meth, I take it. Not that crystal meth isn’t very addictive and problematic for some people, there’s no question about that, but […] there are [many more] who use without issue […] In terms of addiction, I mean it’s stigmatising.

The workplace

Another area of concern for participants was the effect of stigma on their employment opportunities and experiences of employment (see also Work, study & making ends meet). Some say they decided not to tell their employers about their drug consumption because they were concerned they would be judged and lose their jobs. As Jenna (F, 31, cannabis, studying) puts it, ‘I don’t think people judge based on performance […] If they think you’re [a drug] user, then […] the judgment is made that you are not employable’.

Dean (M, 35, works in hospitality, ice) says that if colleagues noticed marks along his arms from injecting ice, they would think he has a ‘problem’. (Played by an actor)

There’s a culture of drinking […] that goes on in the workforce. It’s just accepted […In] hospitality it’s almost encouraged. But yeah, I think every [workplace has a …] lot more of a sort of relaxed feel when it comes to alcohol. But when you go to work with track marks, you don’t even necessarily have to be using at work, or under the influence […but] there’s just this thing that you’ve got a problem […so] most of the time [I wear long sleeves at work].

Some of those interviewed were on opioid pharmacotherapy treatment. Due to limited dispensing hours they had to get their medication dose from a chemist after work hours (see also Pharmacotherapy/Medication treatment). A few avoided telling their employers that they were on treatment for fear of being judged or even losing their jobs.

When David (M, 25, unemployed, heroin) was on methadone maintenance treatment, he didn’t tell his employer because he was concerned about being judged or even fired.

[I never talked to my boss about going to the chemist…] I just didn’t want him looking at me as a druggie […] I always had to [get my methadone dose] before work or after work. And with getting there on time and just a lot of hassle just to make it to the chemist, I thought to myself, it’s not worth it [trying to get my dose during work hours… I thought if I told my boss he would] just look at me different and I know I’m better than that […I was] scared to get sacked or discriminated against.

The criminal justice system

Some of our participants had contact with the criminal justice system in relation to alcohol and other drugs (see also Contact with the criminal justice system). A few describe experiences of stigma and discrimination in their interactions with police officers, judges or lawyers. Some point out that the criminalisation of drugs contributes to the stigma surrounding them. As Jim (M, 21, studying, cannabis) explains, ‘I think if [cannabis] was legal, there wouldn’t be this whole stigma around it. And, like, the anxiety and stuff that comes when people are high, I think, is based around the fact that you have done something wrong now and you can get in trouble’.

Peter (M, 41, unemployed, heroin) describes how police officers have discriminated against him and, on one occasion, strip searched him because they suspected he was carrying drugs.

That’s one of the marks there from using [shows interviewer a mark on his forearm].

[…]

And yeah, as soon as the police see that just, they know and they do treat you different. They treat you with such little respect. I’ve had them drag me into an alley before and fully strip search me in an alley, just because they thought I had drugs on me, they thought I was dealing, and I had nothing on me. And anyone could’ve walked down that alley. And just little things like that, and your lack of dignity really. They really do take away [that] from you.

When Dawn (F, 38, works in manufacturing, alcohol) was facing assault charges, she says she felt like her lawyer judged her conduct and thought she was a ‘drunk’.

I think a lot of [people working in the legal system] are understanding. The guy that represented me […] I really felt that he was judging me for what I’d done. He was also a lawyer for kids and so when he was representing me, maybe I just felt that he […] really felt that I didn’t deserve to go to rehab […] I know that he was being very honest […] but I really felt that he thought that I should just be thrown into jail and I was a drunk. But that’s not the whole legal system. How they’ve dealt with me is all I can say really.

Misja (M, 40, not working due to illness, cannabis and heroin) says the police are very judgmental about people with addiction and often search them for no reason.

If you get pulled over in my area, the first thing [the police] say is, ‘What are you doing in this area? It’s a known drug area. Why are you here?’ I live in the middle of all of it but […] just because someone’s a drug addict, they got to be up to no good. And I don’t find that right at all because, like, I’m a drug addict, and I don’t cause any trouble any more and I don’t want to cause any trouble for anyone. But yeah, I just don’t like how they are so judgmental, and they actually taunt [you]. Yeah, when they pull you over and they try to pin you for something, they’ve got to search you […] To be pulled over in public and searched for no reason at all, just because you are walking down the street, that’s not right.

Challenging stigma & discrimination

Talking openly about their consumption was a way some people felt they could challenge stereotypes. They say that being open helps to destigmatise drug use. As Jim (M, 21, studying, cannabis) says, ‘I suppose I am already labelled as a drug user and I don’t deny it. I tell people I use drugs […] so I’m not really scared of that stigma at all’. Related to this, some people criticise the idea of addiction or dependence. They say that it implies a person is ill and suffering. Challenging this view, they describe regular consumption as an important part of, rather than a threat to, their rich and fulfilling lives (see also What is addiction or dependence?).

Zadie (F, 33, works in the health sector, heroin) has experienced stigma and discrimination related to her drug use, and now challenges those who express negative attitudes towards people who take drugs. (Played by an actor)

On [the] one hand, I do experience that stigma, but I’m thick-skinned so it’s water off a duck’s back to me. But then, on the other hand, people [who] know me know that I’m extremely together: I’m articulate, I’m really motivated, I’m organised, I achieve what I want to achieve. They know that I’m like that so […] a lot of those people think that [my] drug use is in the past and I’ve come good now […] And it’s like, ‘God, little do you know, I’m actually doing what I always did’.

You know, it’s possible that you can be completely together and happy, and a great parent, and have a good life, and a job, and all of those things, and inject heroin […] And recently, I’ve decided to just take the crusade of [ending] stigma and discrimination into my own personal life. I just start challenging people and going ‘No’, especially my friends that do coke and somehow think that it’s cool to do coke, but you’re a scum to do heroin. I’ve hated that attitude my whole life. Drugs are drugs, each to their own.

Jacob (M, 33, works in hospitality, cannabis) challenges his parents’ negative assumptions about drug use.

Talking to mum, she was like, ‘Oh, you know, I can see that you are doing your thing but I still think it’s a very bad thing. And I’ve seen all those people that started with a joint and ended up doing crack and blah, blah, blah.’ And, you know, girls that came to lecture at her school who started with a joint and now they’re prostitutes and selling themselves. Yeah, well I’m not. I started with a joint 15 years ago and I’ve got a full-time job. And I’ve got my degree, and I’m studying again. And, you know, I’ve got my relationship and everything’s fine. But it’s still very hard to convince them to see that side.

Jenna (F, 31, studying, cannabis) says that removing the stigma associated with drug use and addiction will enable her to be more open about her consumption.

[I think] that drug use and addiction [are] not necessarily things that are, like, inherently shameful or problematic but, you know, just things that people can live with. And yeah, like, I guess [I’m trying to overcome] the kind of internalised stigma that I might have around those things […] because if I don’t feel like there’s any shame or whatever attached to it, then I can be very like honest about it. Whereas if I felt ashamed about it, then I would maybe obscure to my friends, or to myself […] what sort of [drugs] I was using and how much.