Treatment for a substance use disorder is an effective way to break free from drugs or alcohol, but the stigma of addiction may prevent some people from getting the help they need. A review published in Substance Abuse and Rehabilitation titled “Review of the Effects of Self-Stigma and Perceived Social Stigma on the Treatment-Seeking Decisions of Individuals with Drug- and Alcohol-Use Disorders” (2018) examined 64 studies and found that stigma can influence treatment-seeking behavior, although it is rarely the only factor involved.
At FHE Health, we often see how stigma affects people before they enter treatment. Understanding the different forms of stigma can help individuals and families recognize these barriers and take steps toward recovery.
Types of Stigma
Substance use stigma can be defined as a negative label or stereotype attached to people struggling with addiction. You may experience stigma because of drug or alcohol use or because you are seeking treatment.
Stigma may appear through stereotypes or discrimination. Regardless of how it manifests, it can prevent people from seeking or accessing treatment. Research has identified five types of stigma associated with substance use and treatment.
1. Public Stigma
Public stigma refers to society’s beliefs, myths, and attitudes toward substance use disorders and mental illness. People struggling with substance use may be viewed as weak, dangerous, or incapable of change. Studies on the impact of stigma on people with mental illness have found that social avoidance and discrimination are common consequences, with more than 50% of people unwilling to work or socialize with someone who has a mental illness.
When considering treatment, some individuals worry that admitting they have a substance use disorder will lead to judgment from family, friends, or their community. Derogatory terms associated with addiction can reinforce these fears and contribute to the ongoing stigma of mental health treatment.
2. Perceived Social Stigma
Perceived social stigma occurs when people believe others will judge them negatively if they seek help.
Someone may fear disappointing loved ones or changing how people view them. As a result, they may hide their substance use problem rather than discuss it openly. Unfortunately, keeping addiction a secret often delays treatment and allows the problem to worsen.
3. Self-Stigma
Self-stigma develops when a person internalizes negative messages about addiction. Someone struggling with substance use may begin to believe they are powerless, unworthy of help, or incapable of recovery. These beliefs can reduce confidence in treatment and create feelings of shame that make it harder to seek support.
At FHE Health, addressing self-stigma is an important part of recovery because healing often requires changing how people view themselves as well as their substance use.
4. Professional Stigma
Professional stigma involves concerns about how treatment could affect employment or career opportunities.
Many people worry that entering rehab will damage their professional reputation. While these concerns are understandable, employees may have legal protections. The Family and Medical Leave Act (FMLA) allows eligible employees to take protected leave for qualifying medical treatment. The Americans with Disabilities Act (ADA) may also provide protections for individuals in recovery from substance use disorders. Insurance carriers are also generally required to provide equal coverage for substance use and mental health treatment, which can ease the financial concerns that keep some people from seeking care.
5. Structural or Institutional Stigma
Structural stigma refers to policies and institutional barriers that make treatment more difficult to access.
Examples include insurance limitations, treatment shortages, transportation barriers, and discriminatory policies. Even when someone is ready to seek help, these obstacles can discourage treatment or delay recovery. Reducing structural stigma requires ongoing efforts from healthcare providers, insurers, employers, and policymakers.
The Impact of Stigma on Getting Treatment
In most cases, stigma is not the only reason people avoid treatment. Across the studies reviewed, participants ranked stigma anywhere from the most relevant barrier to the eighth-most-relevant barrier, and they often cited other obstacles, including:
- Not recognizing the extent of the problem
- Not being ready to stop using drugs or alcohol
- Negative attitudes about treatment
- Practical or financial concerns
However, stigma can make these challenges more difficult to overcome. When negative attitudes come from family members, employers, healthcare professionals, or treatment providers, the effects can be especially powerful. For this reason, creating supportive, judgment-free treatment environments remains essential to successful recovery.
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Dealing With and Overcoming the Stigma of Addiction
Because stigma often works alongside other barriers, reducing it can help smooth the path into treatment. Overcoming addiction stigma is an important step for many people seeking help and entering recovery.
Changing the Stigma
Changing public perceptions of addiction helps support people seeking treatment. Education remains one of the most effective ways to reduce stigma and discrimination.
When people understand that substance use disorders are medical conditions rather than moral failings, they are less likely to judge those affected by them. Education can also help individuals become more open to treatment options, including residential or outpatient care and evidence-based therapies.
Confronting Self-Stigma
Many people entering recovery carry feelings of shame about their addiction. Tailored therapy and self-care can help challenge these beliefs. Spending time with people who understand addiction and recovery often reduces feelings of isolation.
Choosing a Stigma-Free Treatment Provider
The treatment environment matters. Research suggests that compassionate, nonjudgmental treatment providers can help reduce self-stigma and encourage long-term engagement in recovery. When evaluating treatment options, look for licensed professionals who treat patients with dignity, respect, and understanding.
Person-First Language Matters
The connection between addiction language and stigma is well established. NIDA’s “Words Matter” guidance encourages the use of person-first language when discussing substance use disorders.
For example, saying “person with a substance use disorder” instead of “addict” places the focus on the individual rather than the condition. Similarly, replacing labels such as “abuser” with more accurate clinical language can help reduce shame and encourage treatment-seeking behavior. Small language changes can have a meaningful impact on how people view themselves and others.
Frequently Asked Questions
Get Help Without Fear of Judgment
The stigma of addiction can make it difficult to seek help, but recovery is possible. At FHE Health, we provide evidence-based treatment in a supportive, compassionate environment where patients are treated with dignity and respect. Contact us today to learn more about your treatment options and take the first step toward recovery.
