The Harms of Stigma and Discrimination associated with Substance Use

The Harms of Stigma and Discrimination associated with Substance Use

Substance use is common. It is a complex health issue and has different impacts on people across a continuum of substance use. Substance use health recognizes that substance use ranges from no use at all, to beneficial and low risk use, to problematic and medically diagnosable substance use disorder.

Related to their substance use, people are viewed differently depending on intersecting factors such as socioeconomic status, race/ethnicity, and gender, and are stigmatized in different ways, often causing harm.

As well, specific substances are more susceptible to stigmatizing attitudes than others. Some substance use is criminalized (street opioids), while some is not (alcohol and most recently cannabis), which adds complexity to people’s lives.

Harms in the form of stigmatizing and discriminatory actions can be serious. People are disrespected, judged, have their challenges and problems dismissed, assumed to be drug-seeking. People are often denied health care or services because they are not deemed deserving of care.

The criminalization of specific drugs, such as opioids, leads to people using illegal drug supplies where what or how much is in the drug is unknown, resulting in a toxic drug overdose crisis that kills, on average, 21 people per day in Canada1.

EQUIP Health Care is a research and implementation program to enhance organizational capacity to provide equity-oriented care, providing pathways to better care, especially for people facing barriers to care.

The EQUIP model encourages people to ask

 “What’s happened, and is still happening, to this person and how can I help?”

EQUIP Pathways Project

The main goal of the EQUIP Pathways project, funded by the Public Health Agency of Canada, is to improve care by reducing the substance use stigma and discrimination that people face in health care settings.

The London InterCommunity Health Centre (LIHC) was a key partner. LIHC has deep knowledge, skill and competence in health equity and substance use health.

The Pathways team created evidence-based resources to support equity-promoting care specific to people who use substances.

“We partnered with health and social service providers and people with lived experience to develop guidance, strategies and resources to improve pathways to care for people who experience substance use stigma and related types of discrimination. A key goal is to help organizations, staff and providers to deliver care that is non-judgmental, and that will encourage people to seek help when they need it – not avoid seeking help”  

-Project co-lead Annette Browne, professor of nursing at University of British Columbia (quote from Western News)

The Equity Action Kit guides organizations to implement equity-oriented care and evaluate equity and change.

“The Action Kit encourages practitioners and organizational leaders to engage people with experiences of stigma and poor care in a way that ensures their voices are heard and prioritized”

Nadine Wathen, professor, Arthur Labatt Family School of Nursing at Western University and CRHESI Academic Director (quote from Western News)

Check out media coverage:

Written by Samantha Campanella & Christine Garinger

This series was developed by Samantha Campanella and Hooria Haider, Western University, Health Sciences Students, Community Engaged Learning placement with CRHESI

[1] Government of Canada (2022). Opioid and Stimulant related Harms in Canada

NEXT in the Series – Finding Pathways: The Equity Action Kit