Brain disease does not equal stigma reduction

Yesterday, I posted about The Anonymous People and Dawn Farm’s co-sponsorship of an upcoming screening of the film.

So…why is this message of recovery so important to stigma reduction?

We’ve spent 20 years trying to convince the public that addiction is a brain disease without too much attention to the potential for this message to backfire. Bill White outlines the potential pitfalls:

 My fears are captured in the following three propositions.  First, communicating the neuroscience of addiction without simultaneously communicating the neuroscience of recovery and the prevalence of long-term recovery will increase the stigma facing individuals and families experiencing severe alcohol and other drug problems.  Second, the longer the neurobiology of addiction is communicated to the public without conveying the corresponding recovery science, the greater the burden of stigma will be.  Third, the brain disease paradigm could create new obstacles for social inclusion of people in recovery and provide a rational for coercive, invasive and harmful interventions.

As I noted in my earlier paper, the vivid brain scans of the addicted person may make that person’s behavior more understandable, but they do not make this person more desirable as a friend, lover, spouse, neighbor, employee, or candidate for college entrance, military enrollment, or a car or home loan.  In fact, in the public’s eye, there is a very short distance between the diseased brain and the perception of a deranged and dangerous person. We should not forget that less than a century ago biological models of addiction provided the policy rationale for prolonged sequestration of addicted persons, their inclusion in mandatory sterilization laws and a host of other harmful interventions, including prefrontal lobotomies and chem- and electroconvulsive “therapies.” Further, christening addiction a CHRONIC brain disease without accompanying recovery messages, inadvertently risks further contributing to social stigma from a public that interprets “chronic” in terms of “forever and hopeless” (“once an addict, always an addict”)(See Brown, 1998 for an extended discussion of this danger).

Conveying that persons addicted to alcohol and drugs have a brain disease that alters emotional affect, compromises judgment, impairs memory, inhibits one’s capacity for new learning, and erodes behavioral impulse control are not communications likely to reduce the stigma attached to alcohol and other drug problems, UNLESS there are two companion communications: 1) With abstinence and proper care, addiction-induced brain impairments rapidly reverse themselves, and 2) millions of individuals have achieved complete long-term recovery from addiction and have gone on to experience healthy, meaningful, and productive lives.

5 thoughts on “Brain disease does not equal stigma reduction

  1. Sound words of wisdom from Bill white… as always. A proper diagnosis is necessary and should inform, but does not guarantee a proper response. Good post.

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