What is the stigma of addiction?
No single theoretical model of stigma guides empirical work on the phenomenon, even though there exists a substantial body of theoretical and empirical work on stigma in general and the stigma of addiction in particular. Canadian sociologist Erving Goffman’s 1963 analysis emphasized the effect of the stigmata (the devalued marker) on one’s sense of social identity and the negative effect of stigma on social interaction with others. The stigmatized person may not feel fully human, and the responses of avoidance and disdain by others serve to confirm this compromised humanity.
In their 1984 work, psychologist Edward Jones and colleagues considered the social-cognitive response of others to a person marked by stigmata. The researchers’ basic claim was that the stigma engenders consensual social attributions about the person’s dispositions. An addicted person, for example, may be consensually judged as weak, out of control, and possibly immoral. Research in 1982 proposed that social stigma legitimizes the social exclusion of a person and that social norms governing everyday social interaction do not apply to the stigmatized person. In the workplace, for example, a person with hypertension may be encouraged by coworkers and supervisors to use stress-reduction strategies, exercise, and avoid salt. An addicted person may not be afforded such normative support, and plans may be laid to exclude the employee from the workplace.
Social psychologist Jennifer Crocker and colleagues (1998) took a social-psychological perspective on stigma and focused on group membership that may be a basis of stigma. From the perspective of non-addicted people, those with an addiction are devalued, likely to be judged negatively, and likely to be seen as interchangeable entities. That is, the addicted person will be judged as inferior and will be undifferentiated; people will use the “they’re all the same” bias when evaluating addicts.
Another theoretical approach to stigma, explored by researchers Robert Kurzban and Mark R. Leary in 2001, conceptualizes this phenomenon from the perspective of evolutionary theory. Their theory assumes an evolved brain mechanism that functions to avoid exposure to those who may carry pathogens that can compromise one’s adaptive potential. This mechanism may have a propensity for false positives such that those who are different on a broad array of dimensions (for example, addicted people, the mentally ill, the obese, gay and lesbian individuals, persons with cancer, and persons from different racial and ethnic backgrounds) are evaluated negatively and avoided. For example, this avoidance might occur when one discovers that a potentially attractive romantic partner is in the process of addiction recovery, leading the discoverer to change his or her mind about pursuing the relationship further. While distinct, all theories of stigma acknowledge the negative effects on the self-assessment of the person with the stigmata and the social avoidance it promotes in others.
Stigma can adversely affect entry into treatment for substance abuse. Research published by Katherine M. Keyes and colleagues in 2010 found that persons with an alcohol disorder who believe that alcoholism is a stigmatizing condition are less likely to seek clinical treatment. In a large national sample of 34,653 people with an alcohol use disorder, those who judged their disorder as stigmatizing were 37 percent less likely to seek treatment. Social interventions are needed to reduce the stigma associated with addiction because of the barriers posed for those who need clinical intervention to recover from a substance use disorder.
Crocker, Jennifer, Brenda Major, and Claude Steele. “Social Stigma.” The Handbook of Social Psychology. Ed. Daniel. T. Gilbert, Susan T. Fiske, and Gardner Lindzey. Vol. 2. 4th ed. Boston: McGraw, 1998. 504–53. Print.
Goffman, Erving. Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs: Prentice, 1963. Print.
Jones, Edward E., et al. Social Stigma: The Psychology of Marked Relationships. New York: Freeman, 1984. Print.
Keyes, Katherine M., et al. “Stigma and Treatment for Alcohol Disorders in the United States.” American Journal of Epidemiology 172.12 (2010): 1364–72. Academic Search Complete. Web. 9 Nov. 2015.
Kurzban, Robert, and Mark R. Leary. “Evolutionary Origins of Stigmatization: The Functions of Social Exclusion.” Psychological Bulletin 127.2 (2001): 187–208. Academic Search Complete. Web. 9 Nov. 2015.
Room, Robin. “Stigma, Social Inequality and Alcohol and Drug Use.” Drug and Alcohol Review 24.2 (2005): 143–55. Academic Search Complete. Web. 9 Nov. 2015.
Smith, Sharon M., et al. “Examining Perceived Alcoholism Stigma Effect on Racial-Ethnic Disparities in Treatment and Quality of Life among Alcoholics.” Journal of Studies on Alcohol and Drugs 71.2 (2010): 231–36. Print.