The Truth About Kids, Alcohol and Other Drugs

Excerpted from
Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs- How to Recognize the Problem and What to Do About It
By Katherine Ketcham

Adolescents who regularly use drugs-and who cannot seem to quit no matter how many problems they experience-are inevitably judged from the outside. Labeled drug abusers, juvenile delinquents, and threats to the community, they are kicked out of schools, bounced around from one helping agency to another, cycled through the juvenile justice system, and, in many cases, incarcerated in juvenile institutions for months, even years.

Because they keep drinking and using, they are considered irresponsible, careless, self-centered, and immature. The labels "drug abusers" and "addicts" isolate them from the rest of normal society and undermine their identity as people of merit and worth. They are branded with the stigma of a disorder that is not recognized as a true medical condition but as a symptom of moral degeneration, a character defect or personality flaw.

This one word-stigma-is extremely important in understanding substance-use disorders and the reasons why they have been so difficult to diagnose and treat. The Oxford English Dictionary defines stigma as "a mark of infamy or subjection, a sign of public abhorrence," and cites the stigma inflicted on African-American slaves as an example. Hundreds of years ago, slave owners branded their slaves with the "stigma" of scars and cuts, making it easier for their owners to catch them if they ran away. Slaves carried these visible signs of shame and debasement for life.

The stigma of drag addiction, like all stigmas, creates a permanent if invisible stain on a person's character and reputation. Branded by censure and condemnation, the addict's identity is spoiled, scarred, and disgraced, as he or she is "reduced in our minds from a whole and usual person to a tainted, discounted one," as Canadian sociologist Erving Goffman wrote several decades ago.

The stigma associated with drug problems and drug addiction has existed from the beginning of recorded time. The Bible warns that whoever is led astray by strong drink is "not wise" (Proverbs 20:1). Good men and women are advised to "not associate" with drunkards. "With such a man do not even eat" (Corinthians 5:11). Heaven's doors are closed to drunkards; for, as the Bible reminds us, those who engage in drunkenness, debauchery, and the like "shall not inherit the Kingdom of God" (Galatians 5:19-21).

Thousands of years later-despite the scientific research demonstrating that drug addiction is a genetically influenced, physiological disease-we continue to view drunkenness and drug disorders as signs of moral weakness, character defects, or personality disorders. In a 1979 survey, 67 percent of 2,187 respondents expressed the belief that alcoholism is a sign of "personal emotional weakness." Only 19 percent of people surveyed believed alcoholism is solely a health problem.

A survey conducted nearly twenty years later reveals that our attitudes toward alcoholics have not changed significantly over the years. Based on telephone and one-on-one interviews with more than two thousand people, the survey concludes:

Most people see alcoholism as having elements of both disease and weakness. Fewer than one in four say alcoholism is 100 percent disease. In fact, the majority of every group surveyed, except psychiatrists and counselors, said alcoholism is at least 25 percent due to moral or personal weakness.

Counselors are most likely to accept alcoholism as a physical or mental illness, attributing an average 70 percent to disease and 20 percent to weakness. Doctors see alcoholism as 64 percent disease and 31 percent weakness, and family members view it as 56 percent disease and 39 percent weakness.

Even people who have been clean and sober for years feel the sting of stigma. A 2001 survey reveals that one in four people in recovery have experienced discrimination in the workplace or in seeking health care, and one in five fear being fired if their employer finds out they are recovering alcoholics or addicts.

For family members, it is guilt by association. Helping professionals often focus exclusively on family dynamics, implicitly or explicitly blaming parents for the child's misbehaviors. Parents also blame themselves, fearing that their parenting style contributed to their children's emotional and behavioral problems. Self-blame and feelings of anger, guilt, and fear that the family as a whole will be judged as abnormal isolate parents and other family members and prevent them from seeking help for their children.

In a comprehensive 1999 review of the literature on the stigma of drug use and drug users, researchers describe the painful paradox confronting family members:

The family member is part of the "normal" social world of the non-stigmatized. Yet, on the other hand, the family member shares the stigma of his/her loved one and also has membership in the social world of the stigmatized... families of stigmatized people are seen as "normal" yet "different."

Parents and other family members generally respond to this "normal yet different" label in one of two ways, according to the researchers. They either accept their drug-dependent family member "in the hopes of showing the world how to treat their loved one with compassion," or they distance themselves from the addicted person "in order to shield themselves against stigma."

Family members appear to suffer the most stigma when dealing with professionals, including teachers, school administrators, police officers, lawyers, judges, and employees of the criminal justice system. Researchers report that parents often feel "ignored, blamed and de-valued when dealing with people in these agencies," and frequently experience difficulty getting professionals "to respond appropriately to their child's drug abuse."

Most frustrating of all, many parents feel that bureaucratic agencies and helping professionals blame them for their children's drug problems and hold them responsible for finding solutions. University of Colorado researcher Judith A. Barton discusses the gap between what parents want from helping agencies and what they receive:

The parents wanted these supposedly impersonal bureaucratic organizations to enforce the rules and laws, to charge the child with wrongdoing so that the child could be socialized about the consequences of drug abuse. Instead, the bureaucrats appeared to be reacting personally against the parents. The message parents received was that it was their responsibility to control the child, with minimal support from community institutions.

When researchers at the Centre for Addiction and Mental Health in Canada asked family members to respond to the question, "What is it that you would really like other people to know or think about someone who has (or has had) a problem with substance use?" they received some fascinating answers.