Stigma is an issue that has impacted families affected by substance use for many years. In 2012 Adfam published Challenging stigma, a report which looked in detail at the stigma and prejudice faced by families. Among all else it found that, regardless of their own behaviour, families felt defined by the stigmatising labels attributed to their relatives struggling with substance use. One family member stated that stigma is ‘like being labelled with a big invisible sign that I can’t see but others can’.
The stigma experienced by family members can come from a variety of sources, including neighbours, colleagues, the media and services, but also in many cases, close friends and family. It ultimately makes the experience of having a loved one with a substance use problem even more challenging than it already is. As one person told us, ‘it’s hard enough without judgement from others’. As well as externally imposed ‘stigma by association’, families also reported high levels of guilt and self-blame, particularly parents who felt in some way that they were responsible for their child’s substance misuse, in turn stigmatising themselves through feelings of guilt and low self-worth.
Sadly, more than ten years on from that report, we’re looking at a very familiar picture. Stigma continues to be an issue that discriminates against families affected in this way, and to play a damaging role in preventing those negatively affected by substance use and their families coming forward and asking for help. And it remains a powerful block to families seeking support, causing them to become socially isolated. Imelda, a member of Adfam’s lived experience advisory group was interviewed by Fi Glover on Times Radio during Addiction Awareness Week last month and spoke about this issue: ‘Families fear they’re going to stigmatised,’ she said. ‘Fear of stigma is almost as bad as stigma itself because it prevents you from talking.’
Another family member told us about how stigma leads to them remaining silent about their loved one’s struggles in order to protect them and other family members: ‘We have extended family and friends who still know nothing about the challenges we’ve been through, nor will they. I suspect others will be in a similar position. I doubt I’m unique – and herein lies the problem; the stigma keeps us silenced, not for ourselves, but for those we love and want to protect.’
Family members bereaved due to substance use also often experience stigma and disenfranchised grief, where the grief they experience is not acknowledged or validated by society. In England and Wales in 2021, 4,859 deaths related to drug poisoning were registered, and 9,641 deaths related to alcohol-specific causes. For every life lost there will be several family members grieving their loved ones, many of whom will be feeling the effects of stigma every day.
Despite the issues, several organisations are continuing to work to raise awareness and combat the effects of stigma. Earlier this year Adfam joined the Anti-Stigma Network, an alliance that was created to improve understanding of the stigma and discrimination experienced by people and families harmed by drug and alcohol use. It aims to amplify the variety of anti-stigma work taking place across the UK and enable us all to maximise our shared effort to take action to end stigma.
We must take collective encouragement from the progress made with mental health over recent years, and how mass media campaigns have successfully encouraged public debate on this topic, making it easier for people to talk about what they are going through and to reach out for help. We should aspire for a similar shift in public attitudes to happen when it comes to people with substance use problems and their families.
In 2024 Adfam will celebrate its 40th birthday. We want 2024 to be a year of conversation, where we talk openly, honestly, and freely about the impact of substance use on families so that we can finally overcome the stigma that has damaged the lives of so many. Over our 40 years we have seen families continue to experience and suffer the effects of stigma. We hope that from next year, by working together we can shift the dial on stigma, substance use and families.
This article was originally written by Rob Stebbings, Adfam’s Policy and Communications Lead, for DDN Magazine and published in their December 2023 edition (p12).