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Substance Use Disorders - Stigma and Harm Reduction

A substance use disorder (SUD) is a disease that affects an individual’s brain and behaviour, leading to an inability to control the use of legal or illegal drugs and medications (Mayo Clinic, 2019). According to the U.S. Department of Health and Human Services, substance use disorders are considered both a complex brain disorder and a mental illness (2019). Contrary to some individuals’ belief that SUDs are not a problem in Canada, the United Nations claims that Canada is the largest producer of methamphetamine. Approximately six million individuals in Canada are suffering from a substance use disorder, which equates to 1 in 5 (Statistics Canada, 2015).

Harm reduction practice involves using programs and plans that encourage people to reduce harm to themselves and their communities. Through the sharing of information and practical tools, it can help empower individuals to make informed decisions. Examples of harm reduction strategies may include distributing clean needles and placing condoms in public places for easy access.

A common public misconception is that harm reduction supply distribution increases drug use, and used needles on community streets. However, there is no evidence that this public health practise increases drug use among non-drug users; needle exchange programs and safety containers have decreased the number of needles discarded in the community (British Columbia Ministry of Health, 2005). Another objection to harm reduction is that we are draining resources and publicly funded dollars on harm reduction services, when they could be spent on other treatment options and save healthcare funding. In reality, an unused syringe costs seventy-nine cents, compared to treating an individual for a blood-borne disease such as human immunodeficiency virus (HIV), costing our healthcare system $250,000 over their lifetime (Kingston-Riechers, 2012). Studies have shown that needle exchange programs can decrease an individual’s risk of contracting HIV by as much as 50-80% (British Columbia Ministry of Health, 2005).

Addressing Stigma:

Stigma is negative and unfair beliefs that society or groups of people have about something. A stigma is often attached to compromised populations. Research has shown stigma to have a negative effect on individuals with substance use disorders in a number of ways. Stigma can affect the individual in seeking help and could lead to decreased self-esteem. Stigma also includes public bias, which leads to discrimination against people with substance use disorders. (Livingstone, Milne, Fang, & Amari, 2012)

Reducing the stigma surrounding substance use disorder and harm reduction is everyone’s responsibility. Even changing the daily language that an individual or the public uses makes a positive impact. We have stopped referring to an individual with schizophrenia as schizophrenic, so it is time to stop referring to those with substance use disorders as junkies and meth-heads. Offering compassion and kindness to someone who is struggling with substance misuse is an easy thing to do. Educate yourself and replace negative attitudes with evidence-based facts.

Here is something to think about; addictions are not only related to illegal substances. Many individuals are addicted to their cell phones. We challenge you to leave your cell phone at home during your workday and see how addicted you really are. This exercise doesn’t even compare to how someone with a substance use disorder would feel.



British Columbia Ministry of Health. (2005). Harm reduction a British Columbia community guide. Victoria, British Columbia: British Columbia Ministry of Health.

Government of Manitoba. (2019). Harm reduction. Winnipeg, Manitoba: Government of Manitoba.

Kingston-Riechers, J. (2012). The economic cost of HIV/AIDS in Canada. Canadian AIDS Society.

Livingston, J. D., Milne, T., Fang, M. L., & Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction107(1), 39-50.

Mayo Clinic. (2019). Drug addiction (substance use disorder). Rochester, Minnesota: Mayo Clinic.

Statistics Canada. (2015). Mental and substance use disorders in Canada. Ottawa, Ontario:  Pearson, C., Janz, T., & Ali, J.

U.S. Department of Health & Human Services. (2019). Mental health and substance use disorders. Washington, D.C.: U.S. Department of Health & Human Services.

Written by: Morgan Johnson, Hailey Lockhart, Steven Champagne – Brandon University Year 4 Nursing Students.