For centuries, disease has been the subject of stigma and discrimination. From social exclusion to outright punishment, people with illnesses, including Alcohol Use Disorder (AUD), have experienced a history of prejudice grounded in misconception and fear. While this trend is deeply rooted in our culture, physicians, researchers, addiction professionals, and other healthcare specialists are taking steps to debunk the myths surrounding disease to improve health on a global scale.
As Dr. Joanna Eveland, a physician specializing in HIV treatment, writes, “Stigma doesn’t just influence how people feel about themselves—it can influence health.” Studies have shown that stigma can hinder treatment and facilitate the spread of diseases because individuals will forgo medical services and medication. The shame and discrimination associated with their condition prevent patients from seeking and adhering to the treatment they need. According to Dr. Eveland, healthcare professionals are just as guilty of perpetuating stigma and this attitude can harmful on a global scale. As an example, “People living with HIV who encounter ignorance, fear, and disrespect by their providers or other health professionals may be the least likely to remain in care,” she notes. “Fear of stigma can also influence health by preventing people from disclosing their status to loved ones and getting the social and emotional support that they need.”
The influence of stigma can be seen in other areas of medicine, as well, including addiction recovery. Considering that many categorize substance abuse as a chronic illness that requires long-term treatment, this comes as no surprise. Just like any disease, substance abuse often comes with its own set of stigmas that can prevent people from seeking the help they need. People often perceive addiction as a moral fallacy rather than a long-term, chronic illness – and this is a significant misconception. According to The New Paradigm for Recovery, substance abuse is a disease that can be managed through long-term monitoring using devices like Soberlink. Through real-time alerts, cloud-based reporting, and facial recognition, Soberlink supports accountability for sobriety and long-term recovery. In removing stigmas against substance abuse and identifying it as a chronic illness, we can begin to treat it effectively.
To uncover the most powerful ways to combat stigma, we must first explore its history in the medical space. We can trace the first event of prejudice against disease to the medieval era when the emergence of leprosy caused widespread panic. Known as the “Death Before Death,” people with leprosy were categorized as “already dead” by the government and society. Because the public associated the disease with both physical and moral uncleanliness and, those who presented signs of leprosy were often shunned, feared and forced to live in isolation.
The history of stigma and disease continued well into the 1800s with the 1892 outbreaks of typhus fever and cholera in New York City. Although people from all walks of life contracted these diseases, immigrants from Eastern Europe were accused of bringing it to the states. Upon arriving in the U.S., immigrants were often quarantined in unsanitary hospitals, whether or not they were actually sick. This tendency to discriminate as a result of disease stigma evolved into a deep-seated prejudice against entire groups of people. In her article “What can we learn from disease stigma’s long history?” public health writer Sara Gorman explains, “This ‘us’ versus ‘them’ dynamic is common to stigma in general and indicates a way in which disease stigma can be viewed as a proxy for other types of fears, especially xenophobia and general fear of outsiders.”
Gorman also mentions the rise of the HIV and AIDS epidemic as a prime example of stigma against disease. She notes that people were so fearful of contracting HIV that people with the disease were not allowed to enter the U.S. until 2009. When the travel ban was lifted, America was able to host the International AIDS Conference for the first time in 20 years.
While it’s difficult to imagine this level of prejudice today, these examples prove that stigma toward disease is still alive and well. However, how do we combat it? As Dr. Eveland writes, “Recognizing disease stigma’s long history can give us insight into how exactly stigmatizing attitudes are formed and how they are disbanded. Instead of simply blaming the ignorance of people espousing stigmatizing attitudes about certain diseases, we should try to understand precisely how these attitudes are formed so that we can intervene in their dissemination.” Only in looking at the past are we able to gain the insight needed to move forward. History shows us that stigma only creates barriers that prevent society from progressing in a positive direction and it is up to us to prevent those prejudices from growing. Whether it’s ensuring depictions of disease in the media are accurate or sharing testimonials from real-world experiences, ending stigma starts with education.
Learn more about The New Paradigm for Recovery and how this methodology supports the de-stigmatizing of Alcohol Use Disorder.