Often when we talk about the stigma people with substance use disorders face, we are talking about the stigma of others.  This is a big deal.  The opinions of coworkers, doctors, police, and even lawmakers directly affect people’s ability to get the help and support they need.  All too often, problems with substance use are seen as flaws of character, weakness, and even as criminal.  This isn’t the case, and medical evidence supports this.  It is really hard to change other people’s beliefs. Beliefs are as durable as someone’s personality itself--formed through development through life by many collected experiences and by the input of those around us.

But what about self-stigma, or negative opinions of ourselves based on these same ideas?  A paper from the Louisiana State University Health Sciences Center reports that self-stigma can often be the leading barrier to getting treatment.  Self-stigma can be defined as the perceived opinions and biases of others that become internalized and acted upon by the individual. Self-stigma can be so strong that it can keep people from seeking treatment because they want to avoid the judgments of others, or they see themselves as flawed and not worthy of treatment.  Other types of self-stigma include the feeling that they should be strong enough to quit on their own or being pessimistic about if treatment would work.

The paper above reviews 64 studies with a combined total of over 1,500 participants to assess the impact of self-stigma on treatment outcomes.  Nearly a third of people surveyed named self-stigma as the leading barrier to treatment.  That is huge.  What’s more surprising is that participants listed stigma as a bigger barrier than payment and insurance coverage. 

What can you do about it?  The truth is that recovery is rarely a straight path. There will be setbacks and struggles. There are many treatment options from 12-step groups to medicine to private counseling. Not to mention meditation and yoga as tools to support recovery. The first step is to start where you are.  Start having the conversations. Build a tool-kit for your recovery that can include mentors, self-care, and diet and exercise to build the recovery capital you need to succeed.