Americans View Drug Addiction Far More Negatively Than Mental Illness, Study Shows

Kim Stalcup embraces many roles in her busy California life.  She’s a respected mental health counselor in Fresno, a volunteer at the local Anglican Church, a proud grandmother, homeowner and full-time graduate student — working on her second master’s degree.

There’s one more aspect to Stalcup’s identity:  she’s in recovery from heroin and cocaine addiction.

“It’s not ‘once an addict, always an addict.’  We do recover,” says Stalcup, who has been drug-free for 15 years.  “People in recovery are above average IQ, typically, and have many skills that can transfer to employment and volunteering.  Our life experiences translate into helping others.”

That’s the message that Stalcup — and many people in recovery — want others to know about addiction.  But a new study indicates a deep stigma remains.

The study, from Johns Hopkins Bloomberg School of Public Health, shows that Americans have far more negative perceptions of drug addiction than mental illness (“Discrimination, Treatment Effectiveness and Policy: Public Views About Drug Addiction and Mental Illness,” published October 2014 in the journal Psychiatric Services).

“As a society we still think about drug addiction as a moral failing as opposed to a chronic medical condition that can be very responsive to effective treatments,” says Dr. Colleen L. Barry, who led the study and is an associate professor in the Department of Health Policy and Management at Johns Hopkins.

Job Bias, Desire for Social Distance

Barry and her colleagues surveyed 709 Americans about their opinions toward drug addiction or mental illness.  They were asked questions such as “Would you work with someone with a mental illness?” and “Are you willing to marry into a family with history of drug addiction?”  (the questions did not specify whether the person had sought treatment for addiction).

Since mental illness and addiction are both treatable conditions that often occur together, Barry said it made sense to study perceptions of both.

“Our hypothesis was that the public actually thinks about these conditions quite differently and that was borne out,” she says.

According to the survey results:

• 64% of respondents said companies should be able to deny employment to people with a drug addiction (only 25% of respondents said people with a mental illness should be denied employment)
• 43% of respondents said people with a drug addiction should be denied health insurance benefits (only 21% of respondents said people with a mental illness should be denied health insurance benefits)
• Only 22% of respondents said they would be willing to work closely on a job with a person with drug addiction (62% said they would be willing to work closely with someone who had a mental illness)
• An estimated 3 in 10 respondents said recovery from either drug addiction or mental illness is impossible.

“We see very negative attitudes, a strong desire for social distance, high levels of discrimination and low support for policies that could improve access to treatment,” Barry says of the poll results on drug addiction.

The Real Face of Addiction

Currently, drug and alcohol addiction affects an estimated 23.2 million Americans, but only about 10 percent get the treatment they need, according to the National Institute on Drug Abuse (NIDA).  To change the stigma surrounding addiction — and encourage more people to seek help — experts say widespread education is key.

“In reality, we know that drug addiction can touch anyone — my neighbor, grandparents, mothers, people from all walks of life,” Barry says.  “I think that it is critical to put more of a human face on the struggles with drug addiction.”

Neuroscientific evidence reveals that addiction is a chronic but treatable brain disease .  Like diabetes, hypertension and other chronic conditions, drug addiction carries a high risk of relapse.  Typically, several episodes of drug relapse and treatment will occur before long-term recovery is achieved.

“I was homeless, I lived in shelters and on the street, and I got my meals out of the garbage bin,” Stalcup recalls of her hellish addiction and drug relapses.  “It was miserable.  It’s harder to be an addict on the street than it is to be a reliable employee.  It’s a lot more work.”

Stalcup says the realization that anyone else “would be a better parent than me” prompted her to spend a year in residential treatment — and make profound life changes.

“The inspiring stories of individuals and families have the greatest impact on public perception.  Recovery is everywhere,” says Patty McCarthy Metcalf, Executive Director of Faces & Voices of Recovery, a non-profit advocacy group.

“Whether you’re a person in recovery or a family member, sharing your story demonstrates that recovery works,” McCarthy Metcalf says.  “As a society, we must work together in an organized movement to eliminate the stigma associated with addiction.  We envision a day when the public and policymakers will accord individuals and families affected by addiction dignity, and that they will receive respectful, nondiscriminatory care on the same basis as people with other health conditions.”

Positive Role Models in Recovery

Scandalous media portrayals of drug users — and scant coverage of people who overcome addiction — fuels the stigma, advocates say.  But there are many societal benefits demonstrated by people in recovery.

Faces & Voices of Recovery conducted a national online survey of 3,228 people in long-term recovery from drug and alcohol addiction (on average, participants had been in active addiction for 18 years and over half had been in recovery for at least 10 years).

The survey results, published by Faces & Voices in 2013, reveal:

• A ten-fold decrease in illegal activities and involvement with the criminal justice system (DWIs, arrest, incarceration, etc.), compared to when there was an active addiction
• A 50 percent increase in steady employment
• A ten-fold decrease in Emergency Room visits
• A doubling of paying back personal debt and paying bills on time
• A nearly three-fold increase in volunteering/civic engagement and in planning for the future (i.e., saving for retirement
• A four-fold decrease in reports of untreated emotional/mental health problems

The Life in Recovery Survey also revealed that a greater number of people in long-term recovery pay taxes, have good credit, participate in family activities, further their education, vote and maintain steady employment.

Stalcup says she is grateful to be a contributing member of her community.
I am not the disease of addiction to heroin and cocaine.  You have to separate those,”Stalcup says. “I can’t live a daily life of guilt and shame.”

“The stigma that others would put on me, made me feel like I could never participate and be successful again,” Stalcup recalls.  “Because I thought, ‘Oh, I’ll never have another career, I’ll never have a house.’  That was coming from outside, and I bought into it until I was strong enough and said, ‘That doesn’t have to be true.’”