There is still a great deal of stigma surrounding the issue of substance use disorder. A better understanding of what causes an issue, and how to work through them, can help destigmatize the issue and encourage people to get the help they need.
Substance use disorder often is genetic
“I think the genetic component of substance use gets missed a lot,” said Paula Hensel, a nurse practitioner with Alcohol & Drug Recovery Center, Family Health Center (FHC) of Marshfield, Inc., a member of Marshfield Clinic Health System. “Some people are just going to be more likely to go down the path of substance use.”
The stigma surrounding a substance use disorder can prevent families from talking about their past history, added Laure Ann Blanchard, a substance use and mental health therapist with FHC Alcohol & Drug Recovery Center.
“No parent hesitates to tell their child about a family history of heart disease or cancer,” Blanchard said. “Yet as parents we are much more hesitant to sit our kids down and talk about any history of addiction in our families.”
Relapse is part of recovery
Blanchard said people often do not seek treatment for substance use disorder until they experience serious consequences from their use, like legal problems, relationship losses or losing a job.
“Many times I hear patients say ‘this has to stop. I need my life back,’” Blanchard said. “For the patient to want to get better is really important. And I always let them know, they can work through a relapse with honesty and accountability.”
“If a person returns to use, we are still here to help,” Hensel added.
Stages of making a change
Blanchard described five main stages in the process of dealing with a substance use issue:
- Pre-contemplation – In this stage the person denies he/she has a problem with substance use and may be defensive.
- Contemplation – The person admits he/she has a problem, but they are not ready to make a change.
- Determination – The person acknowledges the issue and decides to make a change.
- Action – The person has committed the necessary time and resources and is actively making a change in his/her behavior.
- Maintenance – At this stage, the person is working to maintain the changes he/she has made and avoid return to use.
Because of the stigma surrounding substance use disorder, and the general reluctance people feel about seeking help, the language we all use is important.
We should say someone is a ‘person with a substance use disorder’ instead of calling them an addict, substance abuser or alcoholic,” said Tammera Neumann, a registered nurse and clinical coordinator with FHC Alcohol & Drug Recovery Center. “You really want to avoid language that blames or labels people. It continues the stigma.”
Treatment is confidential
Hensel emphasized that the treatment the team provides at FHC Alcohol & Drug Recovery Center is confidential.
“Federal law mandates that we keep things confidential for our patients,” Hensel said. “Even a patient’s primary care doctor won’t be able to see our notes on him or her unless the patient consents to it.”