Drug and alcohol stigma in relationships

Women reported experiencing stigma in their personal relationship. Often friends and family regarded behaviour related to drug and alcohol use as problematic that created challenging dynamics in the relationship. This leads to women feeling isolated which ultimately increased their vulnerability as they were pushed into spending more time with others who are experiencing drug and alcohol use, making recovery more difficult. Women who made the choice to move away from these relationships struggled with loneliness.

‘… you can be isolated when you move away from your circle of drinking or drugs because it’s all you ever knew and then when you isolate, it’s not a good start to your recovery, to isolate.’

Often these challenges are compounded by women’s experiences of multiple disadvantages combining homelessness, domestic abuse, mental health conditions and contact with the criminal justice system which each carry stigmatisation. In particular, drug and alcohol use was cited as a barrier to accessing support for poor mental health, despite evidence that often the reason for the drug and alcohol use is mental health issues.

‘… basically that I’m no good… especially having mental health as well, it’s a double whammy, erm, it’s like a stigma really, er, around, um, mental health and alcohol addiction because it does actually come together… to be honest with you, err, people weren’t nice to me at all, even my friends.’

Discriminatory practice

Both women and professionals reported instances where healthcare staff declined to offer services to women judged to be under the influence of drugs and/or alcohol, or deliberately delayed access to treatment. They encountered ‘silence,’ ‘lengthy waits,’ and ‘inadequate notetaking’ instead of supportive measures was essentially perceived as a passive-aggressive response. Additionally, women shared their experiences of the discomfort of overhearing professionals making judgmental comments.

‘…when you’ve been in and out of the hospitals, they know you… (P3—They get sick and tired of you don’t they?)… they stand at the bottom with the curtains closed and they’re talking about you, “oh she’s an alcoholic, she’s been in here”… You hear it so many times and then they treat you like that (P3—yeah)’

Frequent interactions with services while intoxicated or during drug or alcohol withdrawal appeared to result in heightened levels of stigma from professionals. Women reported enduring emotional and verbal mistreatment from professionals, and, disturbingly, some experienced physical abuse at the hands of police officers.

‘…I’ve been beat up by police officers plenty of times… they think they can do whatever they want… they’re meant to have… some kind of trauma training… I got arrested so many times before I went to prison and all I needed was someone to care a bit more and actually help me… I had mental health, bad mental health that had been undiagnosed since I was a child… And they’re there just tarnishing me, thinking I’m just a criminal, when really, I was just a mum that needed help…’

Recommendations

Our research underscores the crucial importance of implementing recommendations to significantly reduce social harms to women grappling with addictions. Timely, authentic, honest, gender-informed, and trauma-informed practices must be prioritized for girls and women employing drugs and alcohol as a means of self-medication for traumatic experiences.

To achieve this, we advocate for mandatory training, accompanied by regular updates, for professionals across all relevant services. This training should encompass key areas such as trauma, gender discrimination, harassment, ethical professional practice, non-judgmental approaches, and effective responses to service user complaints. It is imperative that professionals are equipped with the necessary skills to identify and respond appropriately to trauma, recognizing and addressing intersectional vulnerabilities. This assumption should transition from expectation to reality.

Incorporating lived experience accounts into training programs is of paramount importance. This approach will not only enhance professional understanding but also foster empathy among professionals, ultimately contributing to a more compassionate and effective support system.

In conclusion, this work sheds light on some critical issues faced by women using drugs and alcohol in the West Midlands. The collaborative effort between academic researchers, peer-researchers, and the Center for Justice Innovation has produced a comprehensive exploration of women’s experiences, particularly the impact of stigma on identifying treatment needs and accessing timely services. The narratives presented underscore the detrimental effects of isolation, difficult relationship dynamics, and discriminatory practices within service settings.

The call for mandatory training with regular updates for professionals, emphasizing trauma-informed and gender-informed practices, resonates strongly. To truly address the challenges faced by women with addiction, it is imperative to bridge the gap between policy and practice, ensuring authenticity, honesty, and empathy are at the forefront of service delivery. The experiences of women must be integrated into training programs, fostering a more profound understanding and compassion within the professional landscape.

Thanks to Katherine Hanlon for kind permission to use the header image in this post which was previously published on Unsplash.