Stigma manifests itself in four different but overlapping forms:
Structural Stigma
Public Stigma
Stigma by Association
Self-Stigma
Structural stigma refers to how stigma is spread by social beliefs and institutions.
For instance, funding cuts to addiction services, high unemployment rates amongst those who have or have had addiction problems, inequalities in services, law and even policy in relation to those with lived experience of addiction/recovery.
Structural stigma can also take the form of predominantly negative media coverage of stories relating to addictions.
Structural stigma can show up in the form of laws that discriminate against people and directly encourages social stigma, harassment, and violence.
Public stigma is negative emotional reactions to those with lived experience of addiction/recovery.
Words and associated stereotypes like ‘junkie’ and ‘alkie’ are an example. This can be heightened by avoidance behaviours where people don’t want to live near or work with a ‘junkie’ or an ‘alkie’.
Public stigma can also include blaming an individual are blamed for their condition or addiction.
Emotional reactions of fear, blame and pity can often be made worse if the media stories of those with addiction are predominantly negative.
Stigma by association is where a person is stigmatised and devalued because of their connection with someone with a stigmatised condition.
For instance, a person is labelled or judged because their family member or partner has an addiction.
Self-Stigma is where someone is aware of the negative public stereotypes and internalises them, believing them to be true.
Experiencing addictions, mental health issues, poverty and involvement in the criminal justice system are just some examples of areas where many people self stigmatise.
Self stigma is an internalised stigma that eats away at our self esteem and self efficacy.
Social contact is one of the most effective elements in producing measurable change in attitudes.
When people come together and have human interactions it is at that point negative emotional reactions towards the stigmatised group are often reduced.
Tackling Stigma
There are various ways that any of us can take action to tackle stigma.
It is when these interactions are planned and are between key groups, for instance those with experience of recovery and key influencers that it can be most powerful in stimulating behaviour change.
When this contact is repeated, as opposed to a one off intervention, it is much more effective.
Education
Interventions which use education aim to reduce stigmatising attitudes and behaviour by providing extra information which goes against stereotypes.
For example, 'the better than well effect' i.e that people in long term recovery (five years or more) are happier, better adjusted citizens, achieving more of their potential than people who never had an addiction at all.
Education is very important in tackling stigma as many of negative attitudes are rooted in ignorance of the facts.
Education and social contact are commonly used together and can be an effective anti-stigma intervention.
Protest
Protest is often defined as a reactive strategy to challenge negative attitudes when and where they are expressed.
It often takes place in response to negative stigmatising coverage in the media or advertising which in turn contributes to negative public attitudes.
Social media is a useful and rapid way to mobilise supporters to respond to negative coverage.
