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Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

Turning voices into action

Margaret Kittel Canale, MEd, and Ellie Munn, MSW

Reprinted from "Stigma & Discrimination" issue of Visions Journal, 2005, 2 (6), p. 13-14

Society tends to stigmatize behaviours that are seen as different and less desirable than what is considered the acceptable norm. Substance use, and moods and behaviours often associated with mental illness, clearly fall into this category. The stigma (prejudice and discrimination) associated with substance use and mental health problems creates barriers to accessing necessary care and support for individuals and their families.

Stigma refers to negative ways in which society views people with addiction and mental health problems. But if we were talking about racism, sexism, homophobia or ageism, we’d use the words prejudice and discrimination instead.

A few years ago, the Stigma of Addiction project of the Centre for Addiction and Mental Health (CAMH) set out to identify strategies for communicating anti-stigma messages to various audiences. Literature reviews and the voices of people directly affected by stigma informed this process.

Through interviews and focus groups, we heard from people with past or current substance use problems, as well as from family members and service providers across Ontario. They talked to us about stigma and stereotypes, and suggested ways to reduce prejudice and discrimination.

Stigma and stereotypes

Here are some of the responses we heard when we asked, “What does stigma mean to you?”

  • Negative judgement

  • Judgement based on one aspect of a person’s life

  • Long-lasting labels

  • Disgrace

  • Embarrassment and shame

  • Something you are not proud of and want to hide

  • Being treated differently from the rest of society

  • Hating yourself

Who is stigmatized most?

When we asked which group of people with substance use problems are stigmatized the most, answers fell into the following categories:

  • People who use illegal drugs (especially injectable drugs; crack and heroin)

  • People who take methadone

  • People who use any drug a lot

  • Women (especially if they are pregnant or have kids)

  • People of lower socio-economic status

  • Older adults or younger people

  • Aboriginal people

How does stigma affect people?

Stigma affects every aspect of a person’s life, in ways that are impossible to measure. The following impacts on life were mentioned most often:



  • Violation of human rights (e.g., being treated with less consideration and respect when seeking medical care and housing)

  • Lack of employment (losing jobs and difficulty getting jobs if substance use problems are known)

  • Negative feelings about themselves (internalizing the negative beliefs of others

  • Avoiding services (e.g., fear of disrespectful treatment)

  • Continuing substance use (to cope with other people’s negative attitudes and their own feelings

Suggestions for reducing stigma

Three themes emerged about ways to reduce stigma:

  1. Educate people (including students, health care and other professionals, as well as the general public)

    • Highlight the reasons people develop problems with substance use

    • Address media biases and inaccuracies

    • Portray people with substance use problems as human beings

  2. Personalize substance use problems

    • Have people who have experienced substance use problems and the related prejudice and discrimination speak about it

    • Use well-known spokespeople to raise awareness that substance use problems can affect anyone

    • Show that people with substance use problems come from a variety of backgrounds

  3. Tell positive stories

    • Show the positive face of people with substance use problems rather than the negative (e.g., ways in which individuals contribute to society)

Taking what we learned into the community

sults of our research to the community. Examples of some of our awareness-raising events included presentations at conferences, community coalitions, and to addiction and mental health agencies; and a forum for the general public.

As an immediate response to the suggestions for reducing stigma, we made an effort to have someone who has been affected by the stigma related to substance use problems participate as a co-presenter at the events. These were golden opportunities to “educate,” “personalize” and “tell positive stories.”

A toolkit for action

The collective voice of the community led to another project, resulting in a practical resource to actively address the stigma related to co-occurring substance use and mental health problems. Beyond the Label: An Educational Kit to Promote Awareness and Understanding of the Impact of Stigma on People Living with Concurrent Mental Health and Substance Use Problems is a free resource, offering activities that emphasize the impact of attitudes and beliefs on people with concurrent mental health and substance use problems; highlight facts and dispel myths; present positive stories and solution-focused approaches; and support addiction and mental health workers in their efforts to reduce stigma, prejudice and discrimination.

Beyond the Label focuses on hurtful language which leads to prejudice and discrimination. How people are labelled can actually affect the way we feel about them and how they feel about themselves. Negative stereotypes often associated with terms like “junkie,” “drunk” or “psycho” eclipse other stories of a person’s life—their strengths, successes and possibilities.

The last word

Stigma is not just about hurting someone’s feelings. Stigma is about prejudice, discrimination and violating a person’s human rights.

About the Authorss

Margaret works in Education and Publishing at the Centre for Addiction and Mental Health (CAMH) in Ontario. She transfers research and clinical knowledge into practical print and Web resources

Ellie works in Education and Health Promotion at CAMH, conducting workshops in the community to raise awareness of the impact stigma has on individuals with co-occurring substance use and mental health problems

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