According to a 2014 study published in the Canadian Journal of Psychology, stigmatization is the key predictor of substance dependence. That is, because people with substance dependence are often seen as morally inferior, they are discriminated against and treated as second class citizens. The authors of the study stated that “stigmatization inflicts greater psychological pain than the addiction itself.” It seems that stigmatization sends a message that increases an addict’s negative self-perception.

This study also found that new those who are newly dependent upon substances carry negative perceptions of their quality of life, their health, and even their neighborhoods. These negative perceptions are then reinforced through the stigmatization placed upon them. That is, if a person sees himself as less than others, and then others treat him as less than themselves, then it becomes quite clear to that person that he is in fact less than others. This diminishing of self carries consequences far greater than substance dependence; it can lie at the root of a cycle of bad juju that can lead to depression and even, potentially, suicidality.

As these results indicate, clinicians and educators need to be aware of the impact stigmatization has on those who are dependent upon substances. We need to develop and implement programs that will reduce stigmatization and increase social participation. Isolation is a key feature of an addiction and stigmatization only increases tendencies for social isolation. Also, clinicians and educators must make treatment and health care more accessible; the study found that those who believed themselves to be stigmatized had a far lower chance of seeking health care services of any kind. The bottom line is that, unless safety is a real concern, we need to find ways of including people with substance dependence issues within our social activities. While it can be all too easy to judge those who struggle with substances, there’s a good chance that they really do want an opportunity to be a part of a group, even if their behavior suggest otherwise.