The Social Construction of Stigma & Problem Drug Use


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This paper examines the social construction of stigma looking at the way in which drug use and notions of abuse is culturally bound and determined. The role of the media helps shape and firm up these boundaries.
Keynote presentation at the Scottish Drug Forum Conference on Stigma - see also see archives in

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The Social Construction of Stigma & Problem Drug Use

  1. 1. This PowerPoint presentation on Stigma was originally presented at a Scottish Drug Forum Conference on Drug Use and StigmaCopyright © Buchanan 2008
  2. 2. People who may suffer stigma • A person with disability • A person from Black Minority Ethnic Group • A Gay/Lesbian person • A person with a drug problem • A person with mental health difficulties • A person from a religious minority • A person who is HIV+ • Any person who is defined as ‘different’Copyright © Buchanan 2008
  3. 3. What is Stigma? The concept of stigma refers to negative stereotypes assigned to a people when their attributes are considered both different from or inferior to societal norms. For Goffman stigma was about the social interactions between ‘stigmatized’ and ‘normal’ persons in society. The process of stigma is deeply discrediting. (Goffman 1963)Copyright © Buchanan 2008
  4. 4. Process stereotypes of stigma STIGMA &– involves severe social labels disapproval of a persons characteristics or their beliefs which at the time are considered to be unacceptable to dominant cultural norms Internalised roles & reinforced & tainted identity expectations diminished opportunitiesCopyright © Buchanan 2008
  5. 5. Impact of Stigma Isolation – lack of social capital Rejection – reduced life opportunities Hostility – even violence (e.g. Stephen Lawrence) Marginalised – face discrimination and exclusion Restricts a persons ability to develop their potential and impact negatively upon: – Relationships – Housing – Health – Employment – Insurance – Education – TravelCopyright © Buchanan 2008
  6. 6. Stigma reflects cultural shifts in norms • What was acceptable in the past may be unacceptable today. • What was unacceptable in the past may be acceptable today. • What is unacceptable today may be acceptable in the future. • What is acceptable today may be unacceptable in the future.Copyright © Buchanan 2008
  7. 7. Smoking was once an approved and promoted cultural normCopyright © Buchanan 2008
  8. 8. Copyright © Buchanan 2008
  9. 9. Smoking is no longer an approved cultural norm Smoking now attracts stigmaCopyright © Buchanan 2008
  10. 10. Copyright © Buchanan 2008
  11. 11. The stigmatization of tobacco usersCopyright © Buchanan 2008
  12. 12. In the UK opium was once a socially acceptable and widely used drug for recreational as well as medicinal purposes. The Lakeland poets were a distinguished group of opium usersCopyright © Buchanan 2008
  13. 13. Samuel Taylor Laudanum, a solution of Coleridge opium and alcoholCopyright © Buchanan 2008
  14. 14. Opiate use today carries considerable stigma and is presented as an evil in our societyCopyright © Buchanan 2008
  15. 15. Drugs & Drug Users - the Enemy? ‘hardly a family is unaffected by the evil of drugs… Drug-related drugs crime blights our communities. It destroys families and young lives and fuels a wide range of criminal activity, including burglary and robbery….. We won’t tolerate the menace of robbery drugs in our communities – it causes misery and costs lives…. lives This new money will enable agencies to step up their fight against drugs and the crime it breeds. It will get drug dealers breeds off our kids’ backs and into prison and help safeguard our communities’ HM Treasury Press Release, 49/01 09 April 2001Copyright © Buchanan 2008
  16. 16. Drug use is portrayed in the media as the key causal factor in violent and abhorrent crimes - as if taking an illicit substance turns people into monstersCopyright © Buchanan 2008
  17. 17. Copyright © Buchanan 2008
  18. 18. Demonizing drugs and drug users Government Voices – ‘Drug misuse can ruin individual lives, tear open families and blight whole communities with the menace of dealers and crime driven by drug abuse… more drug dealers – people who profit in the misery of others – behind bars… more addicts into treatment…further powers for police to drug test suspected addicts on arrest… vicious circle of drugs and crime …dealers will face harsher sentences where they prey on children …Drugs are a scourge on the world’ (2005) Media Voices – ‘Cannabis caused a 14-year-old to kill’ …. ‘Woman murdered was deliberately run down by suspected drug addicts’Copyright © Buchanan 2008
  19. 19. Demonizing drugs and drug users (2) Community Voices – ‘there’s always junkies … they fight people are aggressive, do dealing in houses, break-ins and steal from cars …..get rid of all the junkies…nuke the junkie scum’ Drug User Voices – ‘They look down on me as scum of the earth and as someone not to be associated with’ another said ‘They see me as a drug addict, a smackhead and they think I’d rob them’Copyright © Buchanan 2008
  20. 20. The Drug Divide Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use, in R. Carnwell & J. Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Second edition, Open University Press, Maidenhead.Copyright © Buchanan 2008
  21. 21. The Barrier of Exclusion ‘it is evident that the anti-drug campaigns over the past 20 years have added to the isolation and marginalization of the discarded working-class youth …. In addition to having to overcome their addiction, one of the biggest hurdles they have to face is breaking through the barrier of social exclusion. JULIAN BUCHANAN & LEE YOUNG The War on Drugs -a war on drug users? Drugs: education, prevention and policy, Vol. 7, No. 4, 2000Copyright © Buchanan 2008
  22. 22. House of Commons Science and Technology Committee: Evidence 2006: Ev 114Copyright © Buchanan 2008
  23. 23. Problem drug users ‘The motivations for using illegal drugs are largely the same as the motivation for using legal drugs – a pleasurable habit, to be social, to relax and generally enjoy the affect of the drug. However, a small proportion of people who use drugs (legal and illegal substances) develop serious drug problems (UNODC 2007). The vast majority of drug users are recreational users who use drugs in a controlled manner without incurring significant social, psychological and/or physical problems to themselves or others around them. In contrast the minority who develop problems sometimes referred to as ‘problem drug users’ become socially, psychologically and/or physically dependent and this lack of control tends to have a detrimental impact upon their social, psychological and/or physical well-being, and is likely to have a negative impact upon those around them.’ Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.Copyright © Buchanan 2008
  24. 24. The USA & UK War on Drugs - locking up drug users? In 1996 the US prison population was 1.6m  Today it exceeds 2.3m In 1985 the UK prison population figure was 47,500  Today it exceeds 83,000 Many prisoner have severe social and psychological problems:  reading, writing, numeracy, mental health, dyslexia, drugs, no qualifications, poor family supportCopyright © Buchanan 2008
  25. 25. Institutionalised stigma has invited widespread discrimination Discrimination involves those in positions of power exercising prejudicial beliefs, actions, or judgments and using their power against the less powerful. The discrimination is based on difference and serves to maintain division and power by drawing upon and reinforcing stigma and stereotypes.Copyright © Buchanan 2008
  26. 26. Discrimination – more than just being rude DISCRIMINATION = POWER + DIFFERENCE + PREJUDICECopyright © Buchanan 2008
  27. 27. PCS ModelThompson, N. (2006) Anti-Discriminatory Practice, Palgrave • Personal • Cultural • Structural P C C S Discrimination occurs at three distinct levelsCopyright © Buchanan 2008
  28. 28. Damaged identities ‘The constant experience of this marginalization has led many problem drug users to internalize their problems and blame themselves for their plight. This loss of self-esteem then becomes a serious debilitating factor as they feel isolated and excluded from society.’ (p.394) Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on Problem Drug Use Vol 51 No.4 pp.387-397Copyright © Buchanan 2008
  29. 29. Mixing with ‘Non’ Drug Users ‘I feel a bit beneath them, they make you feel like that’ ‘I used to avoid them like the plague’ ‘I’ve got to watch what I say so I don’t land myself in it. They blame smack heads for everything.’ ‘I feel labelled … like they thought I was dirt’ ‘Most people look down their noses if drugs are mentioned’Copyright © Buchanan 2008
  30. 30. Stigma & discrimination worse than the drugs? ‘In an environment frightened with powerful moral and legal reactions to the use of drugs, the stigma attached to drugs may come to be a more important factor than the biology of addiction. The demonization of drugs and the criminalization of the drug user (i.e. the war on drugs) could be more damaging to the individual and society than drug use or addiction’ (p.31) Drucker, E. (2000) ‘From Morphine to Methadone: Maintenance Drugs in the Treatment of Opiate Addiction’, in J.A. Incardia and L.D. Harrison (eds) Harm Reduction National and International Perspectives, pp. 27–45. London: Sage.Copyright © Buchanan 2008
  31. 31. Impact of drug users ‘I’m sick of it. I see people with their own houses, family and friends. I’d like friends who don’t use’ ‘I’ve been wanting to change for five years’ ‘I want to be drug free, get a job and lead a normal life’ ‘It is difficult you feel divorced from the mainstream. I want to get back into it’Copyright © Buchanan 2008
  32. 32. Arguably the biggest hurdle a recovering long term problem drug user has to overcome is not physical addiction, nor psychological cravings - but trying to break through the ‘wall of exclusion’ that keeps them in a drug ghetto. This makes it extremely difficult for them to acquire new routines, friendships, skills, hobbies and lifestyle. They are often ostracised, criticised and distrusted.Copyright © Buchanan 2008
  33. 33. The struggle for re-integration Adapted from Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework, pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth press Free article download from © Buchanan 2008
  34. 34. Re-integration or integration ‘When considering treatment and rehabilitation it must be recognised that many problem drug users have had such limited options in life, that they lack personal resources (confidence, social skills and life skills) and have limited positive life experiences to lean upon or return to. This client group need social integration not social reintegration, they need habilitation not re-habilitation – it seems that many have never really been able to get started in life in the first place. This makes living without drugs a very tough option indeed.’ (p.397) Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on Problem Drug Use Vol 51 No.4 pp.387-397Copyright © Buchanan 2008
  35. 35. Challenging Stigma & Discrimination • Must happen at all three levels: personal, cultural and structural. • Requires an ongoing public campaign to challenge existing stereotypes and promote positive images. • Requires a challenge to existing language, notions and images used to make sense of drugs. • Require education and training to inform people.Copyright © Buchanan 2008
  36. 36. Challenging Discrimination high It is easier to have impact at tackling personal attitudes and behaviours but tackling cultural and structural discrimination Degree of (institutional) is much more difficult. Influence low Personal Cultural Structural Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave(Thompson N 2006)Copyright © Buchanan 2008
  37. 37. A different way of seeing? We are all drug users Low risk High risk ‘All drug taking presents a degree of risk and some legal drugs will pose greater risk than some illegal drugs. It is argued then that rather than consider legal drugs as safer and illegal drugs more harmful, and rather than assess drugs according to a hierarchical table of risk posed by different drugs, there is a need for a comprehensive individual assessments to be made for each person according to the nature and context of the drug taking and this is best placed upon a broad continuum of risk which is applicable for all {legal user and illegal users alike] … it should be remembered then that virtually everyone uses drugs, and all drug taking presents some risk’ . Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.Copyright © Buchanan 2008
  38. 38. Home page: PLEASE NOTE: Feel free to use any of this material just make sure you reference. If you want more information do contact me. thanksCopyright © Buchanan 2008
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