Stigma Kills, and Why We Need to Change The Language We Use To Describe Drug Users Now
- Brainz Magazine
- Jun 18
- 8 min read
For nearly 14 years, I've helped individuals navigate the complex landscape of addiction in order to achieve recovery. Nicknamed "The Casual Counselor", my approach is unconventional, but undeniably effective.
“Junkie”, “Drunk”, “Crackhead”, “Tweaker”, “Burnout”, “Scumbag”, “Loser”, “Stupid”, “Crazy”, and, in my own opinion, the worst of them all, “Piece of Shit”.
These are the monikers that my clients use to describe themselves when I meet them for the first time, just about every time. It doesn’t take a rocket scientist or master linguist to understand that these labels are dehumanizing, derogatory, and defaming. They steal away the identity of the very real human being who struggles with a substance or alcohol use disorder, or other mental health issues in general.
They not only self-describe themselves with these labels, but they are also labeled by others with the same terminology. Be it strangers, friends, or even family members, my clients have heard, internalized, and adopted these identifiers for their disorders from an amalgam of different sources. Parents, teachers, coaches, peers, other users, whoever they’ve been labeled as as a result of struggling with a health disorder or disorders, and they have had their “humanness” stripped from them as a result.
Could you imagine meeting someone with a cancer diagnosis and calling them, “chemo-loser”, or something of the like? No? Neither can I. The reason is because it’s just simply wrong. It’s cruel, it’s shaming, it’s unkind. It’s just wrong. Full stop.
I, for many years, adopted the POS moniker, and I described myself as a POS because I truly believed that I was a POS. I had been called this by others, and I had repeated the label to myself probably thousands of times over the course of more than a decade, until it just became my own inner voice, and “who (or what) I was”. I was a POS. Plain and simple.
I remember saying that very statement to my own mother, telling her, “I’m a POS.”. As a parent myself now, I cannot begin to imagine how heartbreaking it must have been for her to hear her son describe himself in such a way. If ever my own child used that term to describe themselves to me, I can’t even wrap my head around how impossibly awful that would feel. How could I even respond? By telling them, “No, you’re not”? I suppose that’s what my response might be, but I also know that it would likely fall on deaf ears at that point in the progression of their disorder.
We are what we tell ourselves we are. We are who we tell ourselves we are.
But wait, looking back with some objectivity, I was, for all intents and purposes, what I told myself I was. I was a POS, wasn’t I? I mean, surely there was some truth associated with that label, as I resorted to doing some pretty shitty things for a very long time in order to make sure I could secure my next fix. When we’re doing shitty things, it’s an accurate description of the behavior we engage in, but it’s not ever an accurate description of who I, or anyone I’ve met within my career as a counselor, is within their deeper parts. Call it their heart, or their soul, or their essence, or whatever. I, like the people I work with now, was in all actuality a young man who was deeply unwell, and who wasn’t getting the help that he needed.
I know that now, I didn’t know it back then, just like my clients don’t yet realize and have not yet reconciled.
It’s the voice of stigma that turns into the voice of shame.
Shame is different from guilt. Guilt is the awareness that we have done something wrong, whether hurting someone else, committing an act of betrayal, or whatever the case may be, and having the awareness to understand and admit that we broke a social pact in whatever the transgression was, and having hard feelings toward ourselves as a result. That’s actually a very healthy response when we’ve done something wrong. What we typically do, or should do, when we commit such a transgression, is to apologize for the wrongdoing, to make a genuine amends, and ask the other person what we can do to repair the hurt we caused.
But shame? Shame is a different beast altogether. Shame is the belief not only that we’ve done things wrong, usually a multitude of transgressions that have caused hurt, but that we as human beings are fundamentally wrong within, and that we are beyond repair. Broken. Damaged goods. Like we came out defective from the factory, the voice of shame tells us that we do wrong because we are wrong as “us”. Essentially, we are indisputably that proverbial POS. And once that voice of shame gets its hooks into us and starts running our internal dialogue about who we are in this world, it’s an absolute killer.
Why is it that we are essentially punished in this culture for having substance or alcohol use disorders? Mental health disorders? The fact of the matter is: here in America, 10s of millions of our fellow citizens struggle with one or more of these conditions, but they are still conditions, however legitimately health related, that cause us to become outcasts, pariahs, and people who are mocked, pushed away, and rejected in large part by the communities that we call home.
What a lonely thing! I’ve been in the presence of moms and dads who have used these slurs to describe their own children, and, if I want to keep my job, I’m forced to bite my tongue and try to be gentle and diplomatic in trying to teach them that those descriptors aren’t helping their loved one. But, if I’m being honest, I’d like to put it to them in a different way. Here’s to personal growth, I suppose!
Prohibition of “illicit drugs” has a lot to do with the stigma and the shame associated with people who use drugs and alcohol, as users often resort to doing those aforementioned shitty things to keep from getting sick once they’ve become chemically dependent on a substance. So, they lie to protect their use from people who care about them. They manipulate and sometimes con others into loaning them money or resources to help them get their next fix. They often resort to illegal behavior, be it shoplifting or petty theft, in order to support their habits, as they can’t walk into a medical clinic in order to get their “medicine”. Sometimes those petty crimes turn into bigger crimes, and those bigger crimes carry heavy consequences should the user get caught in the crosshairs of law enforcement.
What comes after is incarceration, or probation, or something of the sort, and a criminal record that might follow that individual in perpetuity, even if they get well, and prevent them from obtaining gainful employment, renting or buying property, securing loans (even if they’re otherwise qualified), and even gaining back the trust of those who once trusted them.
Substance users, by way of the stigma of their disorder(s), are essentially branded with a “Scarlet A”. One that stands for “Addict”, and it can be a scar that doesn’t heal so easily, even years into recovery.
Imagine, if you will, a world where an adult who made the conscious choice to use drugs, substances like cocaine, heroin, methamphetamine, or whatever else, were able to access those substances at a medical clinic, a few times a day, in order to keep their chemical dependency contained, and to ensure that the drugs they were using were not contaminated with other, more dangerous substances. Do you think that a user would be less likely to break into someone’s car to steal their laptop in order to obtain their next fix? Probably, right?
Now imagine if you put people like me, outreach workers and recovery advocates and other health professionals into these clinical settings to meet, establish relationships and rapport with the users, and ask them questions about whether or not they wanted to continue using (or not), and if they were lacking certain resources that were impeding them to accessing treatment.
Things like health insurance, job training, safe/supportive housing, enrollment in higher education, and so on. What I’m describing to you is what is referred to as a supervised consumption site, with staff at the ready if someone were to accidentally overdose, so that they could get the emergency medical attention they need.
What I’m also inferring is a hypothetical scenario in which we, as a country, legalize these illicit substances, to ensure a safe supply, and to ultimately erase the stigma that comes with being a “street drug user”, and welcoming these people into the community in a way that makes them feel supported. A “part of”, instead of “apart from”. Do you think it would be more likely that it would cut down on crime, the spread of communicable diseases, accidental overdoses, and the shame narrative that is part and parcel for the 10s of millions of people in this country who struggle with substance use disorders?
Would it likely infer to these individuals that they are not, in fact, junkies or crackheads, or scumbags or pieces of shit, who aren’t deserving of a fair shot of becoming productive members of our communities and society at large? I’m gonna give you the answer: it’s an unequivocal, “Yes”.
For reference, reader, I implore you to consider this. The most dangerous drug on this planet, and it doesn’t even have any close competition to the death, destruction, and dysfunction that it causes on an annual basis is not heroin, or cocaine, or methamphetamine, or any of the other “illicit drugs” that tend to grab all the headlines and create so much stigma and fear. It’s actually (drumroll please) alcohol. Yes, alcohol. The most dangerous, and simultaneously most revered and celebrated drug on this planet.
You can’t walk a block through any city in America without passing by a package store, a person wearing a microbrewery t-shirt or ballcap, or a pub. A pub, by the way, is what we can also refer to as a supervised consumption site, though most pubs and bars lack the outreach workers or health professionals who might otherwise be able to assist those inside who are struggling with disordered alcohol use. So it goes.
They tried to make booze illegal once in the early 20th Century, and the results were abysmal. Whether legal or not, Americans continued to drink in speakeasies and nightclubs, and we saw the meteoric rise of a booming and profitable “black market” for the demand that alcohol had on consumers, with the rise of figures like Al Capone and other violent factions. It wasn’t long before the law was rescinded, and now, alcohol adorns our nation's billboards, television ads, popular culture, sporting events, concerts, beer gardens, and on and on and on, despite the fact that it kills nearly 500,000 people annually.
The stigma of the “illicit drug” user the one that causes the voice of shame, and convinces otherwise beautiful and wonderful individuals that they are veritable pieces of shit is doing our society no favors. People are not getting healthier, by and large. They’re being rejected by the very families and communities that raised them, and they’re dying, alone, in abandoned buildings and shadowy alleyways.
We can’t arrest our way out of a public health crisis. People who struggle with disordered substance use are traumatized people, and locking them in cages creates more trauma. Putting them in a position where they don’t know what they are ingesting endangers their lives, and reinforcing the stigma that they are somehow “less than”, when compared to the person drinking a glass of scotch, is stealing away their chance at change. Healing can happen, but only if we allow it to be redesigned and accessible to those who need and want help.
It’s long past time that we, as a nation, learned to pivot and to treat the drug epidemic as what it is: a public health crisis, and not a means by which to bolster the economy through the profits of prohibition. When you look at the facts, prohibition creates a lot of revenue. Imagine for a minute if we prioritized a healthier society over the cash grab of illegality, relegated to certain substances. Though it might take a little time, it would probably amount to a lot more revenue than our current model does, as a healthier society tends to be a more productive society.
Read more from Joshua Bennett-Johnson
Joshua Bennett-Johnson, Licensed Addictions Therapist
After working for 7 years in an amazing clinic, I launched into private practice in 2018. I love my job. I can say that without reservation. Watching people rebuild their lives is something that is worth more than any dollar amount.
