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Saturday, Aug. 31 is international overdose awareness day, the world’s largest campaign to end overdose, to remember those who have died, and to acknowledge the grief of family and friends left behind. The theme for 2024 is Together We Can, highlighting the power of community when we take collective action.
We are facing one of the most devastating public health crises of our time, and it is only with all of us working together that we can take steps to change course. We must start with addressing the pervasive stigma that stands between people who use substances and the care and service they need. In 2022 alone, 124 people in our community lost their lives to opioid drug toxicity. These individuals, along with their families, friends, neighbours, first responders, and health care workers who are all connected to the communal grief and trauma of addiction, deserve this from us.
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Stigma is all our negative assumptions about a person based upon one characteristic that we see. The stories that we, sometimes subconsciously, believe about who someone is and the value we assign them, that is stigma. Stigma leads to shame and division. Stigma lies to us when it tells us that there is an “us” and a “them.”
Stigma about substance use, and its associated shame, seriously affects the well being of those who experience it. If we feel shame about our substance use, we may not reach out for help, or accept the help offered to us. When trying to support or help individuals, if we understand substance use as something shameful, we may not provide accessible, dignified, and respectful health and social services.
According to the Canadian Centre on Substance Use and Addiction, one in 10 Canadians are experiencing substance use problems. This is not their issue, it is our issue. Further, eight in 10 people with substance use disorder report experiencing barriers to recovery, including stigma. This is our issue, and we can do something about it.
The complexity of substance use disorder is indisputable. Genetics, education, income, trauma, mental health, physical health, and social support all contribute in some way. Yet, for decades we have treated substance use disorder as a personal failing or a choice, rather than a complicated health issue. Individuals struggling with addiction often have one or more chronic health conditions, including lung or heart disease, stroke, or cancer. The connection between substance use disorder and mental illness is complex. In some cases, drug use may trigger mental health conditions, while in other cases, individuals with mental health disorders, including anxiety, depression, or schizophrenia, may turn to substances to ease their symptoms. Individuals with a substance use disorder have a treatable medical condition, and they deserve care and empathy.
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At the community level, we require a robust, well-funded and coordinated response in the areas of prevention, harm reduction, treatment and enforcement related to substance use. These are the four pillars of an evidence-based, comprehensive strategy to address substance use in our community. Each pillar is essential.
At the individual level we must examine our own thinking about substances and the people who take them. How did widespread campaigns such as “Just say no to drugs,” influence our thinking? What is fact about harm reduction and what is fiction or speculation? How can we support people and ensure they feel dignified and respected? How does the language we use (such as addict, junkie, user) contribute to stigma? How can we call out stigmatizing language and behaviour?
Nearly 10 Ontarians die each day because of drug toxicity. Most of these deaths are between the ages of 25 and 44, in what should be the prime of their lives. This is an astounding loss of human life that causes ripples across communities and across generations. Together, we can lift the stigma that acts as a barrier between people who use substances and the care, service, and supports they need. Together we can: we can connect, we can understand, we can thrive.
Joanne Kearon is the acting medical officer of health at the Middlesex-London Health Unit
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