Stigma around drugs and weight in health care

Drug use is a phenomenon analyzed in various fields: political, legal, social, historical, medical, educational, psychological, psychiatric, anthropological, etc.

Each of these fields of knowledge has attempted to explain the causes and consequences of the use of various drugs, as well as to answer the question of why their expansion. In this sense, it is important to adopt a broad approach that includes social variables to understand one of the most addictive experiences: stigma.

    Drug addiction as a social problem

    While it is true that the history of drugs and their uses is as old as that of mankind, it was from the twentieth century that drug use was identified as a social problem, an identification that involves significant obstacles.

    What is said about drugs and their users is surrounded by a network of ideological discourses that associated the figure of the consumer with crime, social deviation and pure vice, which is read from a strictly moral point of view.

    This vision has influenced the way in which drug users are perceived as problematic or not, whether they are treated both in social and family spaces, but also in political and public terms.

    Until less than a decade ago, there was no public healthcare network in Ecuador for troubled consumers and drug addicts. Most of the supply of care services was provided from the private sphere and only with a standardized and universal type of intervention.

    This involved forced internment in so-called drug addiction clinics, governed, for the most part, by “rehabilitated” ex-consumers, without any professional experience or any serious approval to deal with this problem, and with minimal regulation of. the State, offering services of apparent rehabilitation which had little or nothing to do with the psychological, medico-psychiatric, professional, social, educational attention that this problem requires.

    It’s like that during For decades, drug addicts and drug addicts have been exposed to inhumane treatment and constant violations of their rights. ranging from involuntary confinement with capture practices to physical and psychological abuse as “reductive” measures to reverse addiction.

      The political dimension of the problem

      However, all of this could not have been done for so long without a policy that supports and condones these practices. Since the 1990s, in Ecuador and, thanks to the so-called war on drugs (orchestrated in the 1970s by the United States of America, forcibly arrived in Latin America in the 1980s and 1990s) one of the most draconian drug laws in the region has been drafted, Bill 108, who located the drug and its users in the criminal justice system.

      Added to this is the influence of religious discourse, which places drug use in the order of sin, has given way to the construction of strong stigmas that have guided prevention and treatment policies and, consequently, clinical practices.

        The stigma of addiction

        Although, since 2008, the Constitution of the Republic considers drug addiction as a public health problem and there are professional residential treatment centers for residential and outpatient care, social stigmas still prevail in certain health practices and, above all, in the social imagination.

        It is enough to listen to a few familiar speeches about drug addicts to understand how these stigmas work. This is how drug users fall into identities such as sinners, criminals, vicious, deviant., etc. What is common to all these identities is that subjectivity, that is to say vis-à-vis the human being who uses drugs or has an addiction, is put aside.

        With regard to health care, these stigmas mean, on the one hand, that problematic users do not seek care, because they and their families do not consider that they should be treated or cared for at a professional level. . , and, on the other hand, that the health professionals themselves base their interventions on stigma.

        Then we find biased interventions, poorly indicated treatments, people who have been hospitalized without needing it, little interest in building other devices such as risk and damage reduction; dogmatic and universal institutions and treatments, which indicate the same treatment both for those who use marijuana once a month and for someone who is chronically addicted to various drugs; little professional training in this area, and exclusion of certain services such as hospitals, for detoxification or in the event of relapse.

        There is a long way to go and a huge debt owed to drug addicts, drug addicts and their families. while restoring their rights, developing appropriate policies and establishing sufficient treatment alternatives in accordance with the complexity of the issue and ethical principles.

        Author: Lorena Villacís, clinical psychologist and member of Con-Dicción, Ambulatory device for problematic alcohol and other drug use, of the Superar Center Integral de Psicologia.

        Leave a Comment