Cycled+Out+of+Proportion!+The+Drug+Scandal!!+STIGMA+EXPOSED!!

Name: Jongsil Adamedes Student Number: n6818285 Tutor: Michelle Newcomb **CULT ****U ****RAL ARTEFACT ** Picture reference: []

This is a picture of a woman addicted to illicit drugs; it is part of a You Tube video clip of a rehab group who are telling their story about how addiction has affected their lives and the stigma surrounding their addiction. The picture illustrates the labels people are branded with, the experiences they had while they were using drugs and the feelings in which they are situated in and are confront by. This of course poses the question, what is stigma? How has it come to this? Should the social norm be to shun those who are addicts and/or illicit drug users? Regardless, people are still faced with this dilemma everyday of their lives under the crux of this stigma.

As a society, we have come to associate illicit drug users with many different perceptions, be it good or bad. However, this instigates a burning question, why is there a stigma on illegal drug addicts? What can be done to fix it? This negative stigma is the public issue, denying self-worth and deflating self-esteem. Whereby stereotyping people in our societies who are addicts with undermining nicknames such as “Drugo” and “Junkie”. How did this come about? Even more so, what about the possible health outcome illicit drug users might experience? How are they coping? All of which are important to address this public issue.
 * PUBLIC HEALTH ISSUE **


 * LITERATURE REVIEW **

According to The War on Drug: Promoting stigma and discrimination, (2012), the globe has been in a struggle for over 50 years, to combat the “war on drugs “. With no luck preventing the long-term effect and trend of increasing drug supply and use, the “unintended consequences” of this war has infected ranges of populations in our global communities promoting stigma and discrimination. According to Room et al., (2001) drug addiction is the most strongly marked with stigma among a range of health and social conditions including homelessness, leprosy, being unhygienic or unkempt and possessing a criminal record. This further marginalises drug users and marks them as social deviants.

To comprehend what is happening with illicit drug users and their stigma, first there is a need to clearly clarify what is stigma. White, (2009) describes stigma at its core, “involves processes of labeling, stereotyping, social rejection, exclusion, and extrusion as well as the internalization of community attitudes in the form of shame by the person/family being discredited.” Although stigma can be identified, it is quite hard to decipher the cause to one particular thing as it combines many interacting factors which goes without saying, as it too resembles how complex and multifaceted our society is today.

Palamar, Halkitis, and Kiang, (2013) describes that there is a debate that stigma has a potential to be a protective tool in public health to deter non-users away from illicit drugs, for example the stigma of tobacco and the decline in its use. The War on Drugs: Promoting stigma and discrimination, (2012) explains that by in large these legal and social controls are desirable and helpful to establish healthy norms.

According to United Nations Office on Drugs and Crime (2008), legal legislation in Australia has been incremental to illicit drug related issues. The Australian government implemented a series of control strategies in providing preventive measures to safe guard the population and its borders. In the early development through the 1960-90’s they didn’t foresee large amounts of drug abuse while it succeed in reducing the drug related diseases such as AIDs/HIV. Further implementation using the “National Strategy, Tough on Drug” in 1997 allowed for empirical research from experts to evaluate and relook at the situation and allow harm minimisation, treatment and prevention activates to become an important part of their policy. However, the government still sees the level of drug use as high, and further explanation and research is required to continue to control in regards to Australian legislation.

Social controls in school are educating preventative means to crack down on illicit drug use, thus stigmatising through a comprehensive strategy involving the community prevention. Found in a longitudinal study, those who receive education and support were a lot less likely to use. (Botvin, Griffin, Diaz, Scheier, Williams, & Epstein, 2000).

However, most studies (Link, Struening, Rahav, Phelan, & Nuttbrock, 1997; Luoma et al., 2007; Young, Stuber, Ahern, & Galea, 2005) sampled suggest illicit drug users were “socially disgraced” obviously becoming socially disadvantaged from stigmatisation. Furthermore it’s needed to be supported by empirical data of the effect on illicit drug stigma and how it’s affecting people for both illicit drug users and non users, thus there is yet more to be accounted for and considered. It is important not to undermine the complexity of the situation, which requires involvement of public policy, social change and individual education to ensure the improvement of both physical and mental outcomes for drug users. (The War on Drug: Promoting stigma and discrimination, 2012.) (Palamar et al., 2013) and (White, 2009)

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">Illicit drug stigma is multilayered, and as for those who are subjected to stigmatisation are generally the ones who aren't able or have limited access to resources to cope with drug stigma. This in turn isolates them from society, reduces them from seeking help, compromising long term physical and mental health outcomes (White, 2009).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Users confined with the perception of stigma result in psychological consequences which in turn is brought by the guilt of social disapproval, thereby developing: secrecy, shame, low self-esteem, a preoccupation with non-disclosure and social withdrawal (Palamar et al., 2013). While stigmatized they are also faced with possible unjust incarceration which furthers their experience of rejection and unequal treatment attributed to drug use.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> According to Ahern et al., (2007) illicit drug stigma exacerbates not just mental but also contributes to physical effects with those who are chronically stressed, psychologically impeding them to seek help from health care and as a result it can lower their quality of health as a consequence. This also creates complications and higher stressors for those seen as ethnic minorities. In which the stigmatization of drug use is associated with their characteristic on their ethnic group. Drug related criminalizations of Aboriginals in particular are subject to this (Australian Institute of Criminology, 2011)

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">According to Major and O'Brien (2005) as time proceeds while illicit drug users avoid receiving health care they are at greater risk of mental and physical health problems, such as: depression, hypertension, coronary heart disease and stroke. Discrimination, marginalised the stigmatised by exposing then to more toxic environments and limits their access of medical care and nutrition. As a result because there are many different events of how stigma can arise, it can affect many domains in people’s lives: impacting on their earning, housing, criminal involvement, heath, and life itself. (Link & Phelan, 2001)

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">Poverty is another alarming revelation that explains the damage and stigma drugs have placed onto the lives of many living in the slums and low socio-economic areas. However it is a misconception that illicit drug use is marginalized in these places, which isn't the case, poor does not amount to those more likely to use drugs (The War on Drug: Promoting stigma and discrimination, 2012 ). For the poor who are involved in the drug supply or drug trade in these areas it is a means of survival, and even so they unfortunately received only 1% of earning, while most goes to the traffickers themselves. If there were intervention to stop the production of drugs, the consequences will force people into greater levels of poverty, restricting the access of health services and education. (The War on Drug: Promoting stigma and discrimination, 2012)

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Media has been significant in shaping what drug’s stigma means to people. According to Hughes, Lancaster, and Spicer, (2011), media has heavily distorted preconceptions of crime and deviance framings and is capable of controlling social issues which can change the perception of the actual report incident or severity of the problem. Harm Reduction International, (2012) demonstrate words such as “junkie” or “clean/dirty” does imply that to the public that these are a part of a person’s character.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">**CULTURAL AND SOCIAL ANALYSIS**

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Goffman’s theory of stigma is crucial to define and explain what is stigma. Goffman (1990) defines stigma as “a ‘mark’ of social disgrace, arising with social relations and disqualifying those who bear it from full social acceptance,” defining each “mark takes various forms: ‘abominations of the body such as physical deformities, alleged ‘blemishes of individual character’ such as mental illness or unemployment and ‘tribal identities’, such as religion or ethnicity” and “a shared belief that person ought to behave in certain ways at a certain time” (Ahern et al., 2007) (Campbell & Deacon, 2006).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Goffman describes a divide of what is deemed to be fine, desirable or morally right by social agreement, but what does not fit is given a “stigma” a distaste to something which the majority don’t particularly find appealing or healthy. This in turn creates a negative effect on particular societies and minority groups who slip into these stigmas. Link, Struening, Rahav, Phelan, and Nuttbrock (1997) describes that once it is perceived the users believe these stereotypes, then devaluation becomes most damaging and thus alienation occurs and once internalised they begin to marginalise themselves. (Boyd Ritsher, Otilingam, & Grajales, 2003).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">Additionally compounding effects for those who are also stigmatised from vulnerable population such as minority ethnic groups and those living in a low socio-economic class who are more likely to receive stigma from multiple sides of the spectrum mentioned before.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">It is fundamentally important to acknowledge the importance of stigma that is carried but illicit drug users. Awareness needs to be highlighted that it goes against several articles from the Universal Declaration of Human Rights. The mistreatment of person equality, dignity and rights has disappeared in the mists on this stigma. It hides the fact they are entitled even when they are discriminated and marginalised. (United Nations. n.d.) To preserve our human right it is vital to continue to discuss and address stigma, as in the past it has been generally dealt as a criminal problem rather than a health problem which could be prevented and treated (Ahern et al., 2007).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Campbell and Deacon (2006) explains the importance of understanding stigma as a social psychology topic, whereby it primarily dwells within the individual psyche but is constantly mediated by material, politic institutions and symbolic context. As a result, it does involve the majority it is society whose framework determines what stigma is. However it is a multi-faceted intervention and requires health education and improved service delivery, along with self help and social support for stigma to be reduced.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Public health offices should focus their efforts to deglamorize and discourage use while aiming to reduce stigma toward users by treating use as health behaviour and not a deviant or moral behaviour. (Palamar et al., 2013) Public health officers can focus on improving awareness for the community; provide education for service understanding and attitude towards drug dependency (Australian Government, 2011).


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">ANALYSIS OF THE ARTEFACT AND LEARNING REFLECTION **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">The woman in the picture is the result of the effect stigma can impact on a person. Stripping their pride and isolating them from society because they feel demoralised by what is perceived to be true, causing mental and physical repercussion. There is a need to understand the situation and in the process remain unbiased and informed and not conform because of the stigma. Not only drug stigma, it is imperative to understand the purposes and the effects of all stigmas which can heavily affect lives, because after all “to ere is human” especially in tough circumstances. The woman in the picture would be in a different circumstance if she wasn’t stigmatised and treated with like a human, with equality and dignity, however she still has to bear the addiction.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> I would like to conclude by saying that an unbiased, informed empathy is the key! Although it’s necessary to accept the consequences, it would be gratifying to know that the world has sympathy and has moved on, preventing more stressful and tortuous outcomes. I believe, by instilling integrity, equality, and the capacity to forgive, as a global tradition, which is also mitigating and adapting to the times, is a world I would personally like to live in.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> In saying so, based off what I have researched. Firstly, I am more consciously aware to what it means to recognize another person, and secondly, as a human right and of ethical importance to help others see it in themselves too, drug addict or not.


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">REFERENCE **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Ahern, J., Stuber, J., & Galea, S. (2007). 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

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Australian Government. (2011). National Drug Strategy 2010-2015 A framework for action on alcohol, tobacco and other drugs. Retrieved from the Australian Government website []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Australian Institute of Criminology. (2011). Australian crime: Facts and figures. Retrieved from Australian Institute of Criminology website[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Botvin, G. J., Griffin, K. W., Diaz, T., Scheier, L. M., Williams, C., & Epstein, J. A. (2000). Preventing illicit drug use in adolescents. Addictive Behaviors, 25(5), 769-774. doi:10.1016/S0306-4603(99)00050-7

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Boyd Ritsher, J., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121(1), 31-49. doi:10.1016/j.psychres.2003.08.008

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Campbell, C., & Deacon, H. (2006). Unravelling the contexts of stigma: From internalisation to resistance to change. Journal of Community & Applied Social Psychology, 16(6), 411-417. doi:10.1002/casp.901

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Goffman, E. (1990). Stigma: Notes on the management of spoiled identity. Harmondsworth: Penguin

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Harm Reduction International. (2012). Cause for Alarm: The Incarceration of Women for Drug Offences in Eurpoe and Central Asia, and the need for Legislative and Sentencing Reform. Retrieved from the Harm Reduction International website []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Hughes, C. E., Lancaster, K., & Spicer, B. (2011). How do Australian news media depict illicit drug issues? an analysis of print media reporting across and between illicit drugs, 2003-2008. The International Journal on Drug Policy, 22(4), 285.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Human Rights Watch. (2003). Fanning The Flames How Human Rights Abuses are Fuelling the Aids Epidemic in Kazakhstan. Retrieved fom Human Rights Watch webstie []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Human Rights Watch. (2009). Decades of Disparity Drug Arrests and Race in the United States. Retreved from Human Rights Watch website []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Koutsoyannis, S. (n.d.) Femicide in Ciudad Juarez: Ever-Present and Worsening. Retrieved from the Peace Build website[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363-385. doi:10.1146/annurev.soc.27.1.363

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Link, B. G., Struening, E. L., Rahav, M., Phelan, J. C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38(2), 177-190

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Luoma, J. B., Twohig, M. P., Waltz, T., Hayes, S. C., Roget, N., Padilla, M., & Fisher, G. (2007). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviors, 32(7), 1331-1346. doi:10.1016/j.addbeh.2006.09.008

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Major, B., & O'Brien, L. T. (2005). The social psychology of stigma. Annual Review of Psychology, 56(1), 393-421. doi:10.1146/annurev.psych.56.091103.070137

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Palamar, J. J., Halkitis, P. N., & Kiang, M. V. (2013). Perceived public stigma and stigmatization in explaining lifetime illicit drug use among emerging adults. Addiction Research & Theory, 1-10. doi:10.3109/16066359.2012.762508

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Room, R., Rehm, J., Trotter II, R. T., Paglia, A., & U¨stu¨ n, T. B. (2001). Cross-cultural views on stigma, valuation,parity, and societal values towards disability. In T. B. U¨stu¨ n, S. Chatterji, J. E.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Bickenbach, R. T. Trotter II, R. Room, J. Rehm, et al. (Eds.), Disability and culture: Universalism and diversity (pp. 247 – 292). Seattle, WA: Hogrefe & Huber Publishers

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">The Justice Policy Institute. (2007). The Vortex: The Concentrated Racial Impact of Drug Imprisonment and the Characteristics of Punitive Counties. Retrieved from Justice policy website []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">The War on Drug: Promoting stigma and discrimination, (2012). The War on Drug: Promoting stigma and discrimination. Retrieved from []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;"> United Nations. (n.d.) The Universal Declaration of Human Rights. Retrieved November 3. 2013, from [|http://www.un.org/en/documents/udhr/#atop]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">United Nations Office on Drugs and Crime (2008), Drug Policy and Results in Australia. Retrieved from United Nations Office on Drugs and Crime website []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">White, W. (2009). Long-term strategies to reduce the stigma attached to addiction, treatment, and recovery within the City of Philadelphia (with particular reference to medication-assisted treatment/recovery). Paper presented at faces and voices of recovery. Retrieved from[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%; line-height: 1.5;">Young, M., Stuber, J., Ahern, J., & Galea, S. (2005). Interpersonal discrimination and the health of illicit drug users.The American Journal of Drug and Alcohol Abuse, 31(3), 371-391. doi:10.1081/ADA-200056772


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">LEARNING ENGAGEMENT AND REFLECTION **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">[] []