Courtney O'Brien
N8841349
Abbey Diaz

The Artefact

drug-addiction.jpg

This artefact shows the word “help” written in what can be assumed as cocaine. The picture represents the struggle that people have to go through to get the help they need. Whilst there are many options available for treatment for addiction these may not be so obvious to someone who is desperate for help. They may feel that no one cares and therefore don’t know who to speak to. With the ever-growing moral panic about drug addiction, the public have begun to discriminate against people with addictions which add to the fear of seeking help. The purpose of the wiki is to highlight the options available whilst looking at the barriers that will be faced with someone seeking treatment.


The Public Health Issue
Drug addiction, according to Best in 2012, is defined by a condition of chronic relapse over an extended period of time. Best (2012) recognises that treatments available to the addicted are only a short term solution and results in relapse for most patients. Drug addiction has been seen as a public health issue as the consequences can lead to homelessness and damage to family structures to name a few and has also left a burden on the health care system with the increase in overdoses and secondary illnesses as a result of participating in drug use and abuse (Best, 2012). The underlying purpose of this wiki is to highlight the help and treatment options available to people suffering from an addiction to drugs by looking at the current studies.

Literature Review
According to the Australian Institute of Health and Welfare (2010) approximately 8% of people aged 16-85 have had a drug disorder in their lifetime with 1 in 10 people having used ecstasy or hallucinogens and less than 1 in 10 using amphetamines, cocaine or heroin. From the same study performed by the AIHW (2010) 1.8% of drug users have injected in their lifetime increasing the risk of the spread of blood borne viruses such as HIV and Hepatitis C. As can be seen in the graph below, the highest age bracket for illicit drug use is between 15-29 years (AIHW, 2010). This is worrying because this age bracket is seen to be the time in which people make decisions to participate in risky behaviours (Australian Bureau of Statistics, 2009). Such risk factors have been defined and studied by the AIHW (2010) to include activities such as driving whilst under the influence (13.2%), going swimming (11.4%), abusing other people (5.3%) and committing a crime (4.8%) not to mention needle sharing.
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Since the beginnings of the moral panic of drug addiction, the public has discriminated against people who are addicted. Count the Costs is a global project run by organisations influenced by drugs, crime, human rights and discrimination (Count the Costs, 2013). Count the Costs (2013) has hypothesised that using the criminal justice system to treat addiction promotes discrimination. As there is much speculation as to whether or not addiction is a disease or a crime, more emphasis should be placed on the treatment opportunities available. Man (2011) states that preventing and treating addiction will save money and reduce the risk of more than 120 000 deaths due to drugs each year. There are many options available including harm minimisation strategies, needle syringe programs and counselling but these options are not often sought for many reasons.

The barriers to following through with treatment are very common, with The Department of Health and Ageing (2007) noting that some barriers can include:
  • The associated stigma of addiction instilling fear of judgement upon the person seeking help
  • Health, family and relationship breakdowns, crime, debt and homelessness
  • Lack of resources
  • Strict entry requirements.
Man (2011) highlights that another barrier toward treatment is that many treatment sites focus on advertising revenue and may be prejudiced toward a particular product or method.

Stigma is one of the biggest issues faced by people addicted to drugs and/or seeking help for their addiction. The study performed by Earnshaw, Smith and Copenhaver (2013) found that the biggest forms of stigma came from family members (31.1%) and health care professionals (28.4%). The study found that participant’s family members doubted that they could change and participants said this has or could have been a trigger for them to keep using (Earnshaw, Smith & Copenhaver, 2013).

With barriers as extreme as these, it is no surprise that government and non-government organisations feel they are not “winning the battle” of the drug war. The Queensland Health department (2013) estimates that the annual cost of drugs to society is in excess of $55.5 billion with the majority being attributed to health care alone. Drug addiction has been likened to asthma and diabetes but as Bernstein (2013) states, “If a person acquired diabetes from eating too much sugar and not getting enough exercise, should we deny them basic healthcare?” Health care professionals help pave the way for policy changes to the public health system however perhaps these policies are not aiming to treat and change addiction but to prevent it based on the stigma that people don’t want help.

Miller (2007) has found that the outcomes of treatment evaluations are problematic as there is a poor understanding as to what addiction really is, what treatment is required and how to measure success and therefore treatments should be based upon the best evidence-based practice outcomes. The National Institute on Drug Abuse (2009) has thus formed a set of principles to guide professionals with their client’s treatment routine. Some of these principles include:
  1. Addiction is complex and affects brain function
  2. No single treatment is appropriate for the entire population
  3. Treatment should not only address the individual’s addiction but also factors such as socio-economic status, family and environment.
  4. Treatment must be monitored and evaluated regularly to adapt to the individual.
The limitations to such research is that there a very few studies that have investigated stigma in terms of the social groups that discriminate the most and just how it effects people with addictions. The study performed by Earnshaw, Smith and Copenhaver (2013) had a small sample size which does not provide the opportunity for data that can be generalised to the entire population.


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Cultural and Social Analysis
The moral panic of drugs as Young (2009) described, is not due to the drugs themselves but the people who take the drugs. From Young’s research in 2009, it was found that deviance from societies norms is portrayed to show a lack of culture however the moral panic itself is being blamed on a need for social control using a disproportionality of reactions. It is such beliefs that create discrimination and stigma toward the people involved. Earnshaw, Smith and Copenhaver (2013) have found that a large part of the stigma and stereotyping has come from health care professionals who believe that drug addicts are non-compliant, using safe equipment to get “high” and are out of control and lack the will to change. With such stigma, there is no doubt that people seeking help will feel that health care professionals are not interested. It is not just health care professionals however who stigmatise against drug addicts. Earnshaw, Smith and Copenhaver (2013) reported that among drug users, 75.2% had reported to experiencing stigma from family members. Such a stigma has been associated with the breakdown of families and as Earnshaw, Smith and Copenhaver (2013) suggest, “threatens social support” which (depending on the individual’s needs) may be vital toward their recovery.

Lawson (2007) states that when the media is so powerful as to shape the thoughts of society with distorted information, policies are built around them without being completed evaluated thus exacerbating the problem of drug addiction plus creating more problems to discriminate its victims. After a 39% increase in overdoses from drug users, policy has been made based on the stigma that doesn’t see addiction as anything more than a moral failure (Bernstein, 2013).

Whilst there is the stigma that people who abuse drugs are deviants and criminals, there is also a socio-economic stigma existing as well. Ahern, Stuber and Galea (2006) argue that when someone of a low socio-economic status uses heroin or crack cocaine the stigmatism is stronger, displaying such people as “feral” and explaining their lack of social skills. Ahern, Stuber and Galea (2006) also argue on the other hand that when someone of a high socio-economic status uses powder cocaine, it is seen as a display of status. Such stigmatism is said to cause chronic stress and may lead to the person withdrawing from society and causing harm to their well-being (Ahern, Stuber and Galea, 2006).

The focus of public health policy should therefore be aimed at removing the stigma and understanding that addiction is not a choice but a “condition of chronic relapse.” Ahern, Stuber and Galea (2006) mention that not only does stigma exist whilst addicted to drugs but it continues after the person has sought treatment including the difficulty in finding employment. Denying people of such a right to not “get back on their feet” after seeking help would be denying basic human rights.
Upon researching this wiki, it was difficult to find information of evidence based practice and it would thus be beneficial to trial treatments, understand that each individual is different and responds to treatments differently. By understanding that everyone is different will help to recognise addiction as a disease and not a crime, remove the stigma and would help form many different treatment options for the people in need.
Analysis of the Artefact
The above artefact represents the trouble that people who suffer from addiction face upon realising that they need help. Whilst researching into this wiki, I have a greater appreciation for their struggle and understand that it’s not just something that can be turned on and off like a switch. The stigma alone can sometimes be enough to deter people from getting the help they need and it is therefore a matter of stopping the stigma and understanding that addiction is not a choice but a disease that requires serious long term treatment.

I found this artefact while researching drug addiction and was surprised to see how many other images were offering to help with support services such as Kids Help Hotline and Beyond Blue. There are so many government and non-government organisations trying to help treat people with addiction and reduce the risk of secondary illnesses/death but they are not often taken because of the stigma and fear. The artefact I chose is an appropriate representation of the public health issue of drug addiction as it shows that addiction is not something that can be controlled by the individual and as Best (2012) defined it, a condition of chronic relapse.

Overall, I learned that with approximately 120 000 deaths per year (National Institute of Drug Abuse, 2009), more evidence based research is needed for stronger treatment plans that suit a range of people with an addiction to a range of different drugs.

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Reflection
Afton
Asking for It

References
  1. Ahern, J., Stuber, J., & Galea, S., (2006). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2), 188-196. doi: 10.1016/j.drugalcdep.2006.10.014
  2. Australian Bureau of Statistics, (2001). Illicit Drug Use. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4808.0
  3. Australian Bureau of Statistics, (2009). Risk taking by young people. Retrieved from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Chapter5002008
  4. Australian Institute of Health and Welfare, (2010). Drugs in Australia 2010: Tobacco, alcohol and other drugs. Retrieved from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737420455
  5. Bernstein, S., (2013). Stigma kills drug users in Abbotsford and elsewhere. Retrieved from http://www.pivotlegal.org/stigma_kills
  6. Best, D. W., (2012). The recovery paradigm: A model of hope and change for alcohol and drug addiction. Australian Family Physician, 41(8), 593-597.
  7. Count the Costs, (2013). The war on drugs: Promoting stigma and discrimination. Retrieved from http://www.countthecosts.org/sites/default/files/Stigma-briefing.pdf
  8. Department of Health and Ageing, (2007). Barriers and incentives to treatment for illicit drug users with mental health comorbidities and complex vulnerabilities. Retrieved from http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/87388A80B499F44BCA25739B000A2DF2/$File/mono61.pdf
  9. Earnshaw, V., Smith, L., & Copenhaver, M., (2013). Drug addiction stigma in the context of methadone maintenance therapy: An investigation into understudied sources of stigma. International Journal of Mental Health Addiction, 11(1), 110-122. doi: 10.1007/s11469-012-9402-5
  10. Lawson, L., (2007). Why moral panic is dangerous. Journal of Forensic Nursing, 3(2), 57-59.
  11. Man, D., (2011). Addiction and treatment. Journal of Consumer Health on the Internet, 15(1), 87-99. doi: 10.1080/15398285.2011.547100
  12. Miller, M. M., (2007). Evaluating addiction treatment outcomes. Addictive Disorders and Their Treatment, 6(3), 101-106.
  13. National Institute on Drug Abuse, (2009). Drug Facts: Treatment approaches for drug addiction. Retrieved from http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
  14. National Institute on Drug Abuse, (2012). Trends and Statistics. Retrieved from http://www.drugabuse.gov/related-topics/trends-statistics
  15. Queensland Department of Health, (2013). Drug Statistics. Retrieved from http://www.health.qld.gov.au/atod/drug_statistics.asp
  16. Young, J., (2009). Moral panic: Its origins in resistance, ressentiment and the translation of fantasy into reality. The British Journal of Criminology, 49(1), 4-16. doi: 10.1093/bjc/azn074