Stigma is one of those concepts that most people know about but that, when asked, it is hard to explain. We all agree however that no matter the definition, stigma is associated with negative beliefs about a topic or group of people that result in discrimination, alienation, isolation, and sometimes violence. Stigma is also associated with certain health conditions like obesity, HIV/AIDS, mental health and addiction, placing blame on the individual rather than acknowledging they are diseases like cancer, diabetes, and many others.
It comes from all layers of society, from the systemic level to the patient’s own perception, i.e. self-stigma. My son Jonathan was a very kind, sensitive, loyal, and resilient person. He cared deeply about others but also about their opinions. He was ashamed and suffered in silence, never talking to anyone about his problem, shaping slowly his own perception of self-worth, a distorted image of what he had become: a disappointment to all, he used to say.
Our efforts to break that wall of shame and desperation were unsuccessful. Jonathan’s self-stigma had shaped his acumen of addiction and of himself which prevented him from acknowledging his disease and seeking help. He thought he could do it alone, “I got it mom”, he told me. Jonathan had just started a new job and was so excited about his future that he gave himself permission to dream and make long-term plans. He had signed up with a gym to get in shape and he planning to meet his friends on Thursday at the park to play basketball as they did when they were kids. That was the same day we found him dead in his room due to an overdose.
It is time for us to step-up and look stigma in the eye as we owe it to the individuals and families who struggle with addiction every day and to those who lost their lives to this terrible disease, like my Jonathan.
Cristina Rabadán-Diehl, PharmD, PhD, MPH