Substance Use Disorder: Myths and Facts

“If she just put her mind to it, she could stop using.” “Drug addicts are hopeless criminals. The world would be better off without them.”

Substance use disorder is fraught with stigma. Based on negative stereotypes and false assumptions, stigmas promote shame and discrimination, and they make us think less of the person they’re attached to.

When you shift out of negative attitudes around substance use disorder, you can begin to treat those affected by it with empathy and respect. Listen to what the experts have to say, and think about how you can check your assumptions and shift your thinking.

• What does a drug user look like?
• Is substance use disorder a choice?
• Do my words and attitudes matter?
• What about relapse?

Harm reduction means reducing the chance something bad will happen. We use harm reduction tactics every day. Installing smoke detectors, keeping passwords private, and storing medications out of children’s reach are just a few ways we keep ourselves and the people we care about safe.

When it comes to substance use disorders, harm reduction is the same. The goal is to keep people who use drugs and their families, friends, and communities as safe as possible. Harm reduction reduces death from overdose. It also connects people to healthcare, treatment, and social support.

There are many examples of evidence-based, public health interventions for harm reduction:

• Clean needles prevent the spread of HIV and hepatitis. When a syringe exchange program was introduced in New York City in the early 1990s, it reduced the incidence of HIV infection in people who use injected drugs from 54% in 1990 to 3% in 2012.
• Medically supervised, safer spaces for drug consumption keep people from injecting alone or in dangerous places. Research shows the sites do not increase crime in surrounding neighborhoods. But they do save lives. In 2017, one such location in Vancouver, Canada, responded to over 2,000 overdoses. Not one person died. The sites also connect people to basic medical treatment (like wound care) and social support. Many people who use the sites end up in treatment programs.
• Drug checking (also known as drug testing or adulterant screening) helps people who use drugs know they are free from dangerous additives like fentanyl.
• Good Samaritan Laws in many places protect people who call 911 when they witness an overdose, even if illegal drugs are involved.
• Drug courts that connect people to evidence-based treatment methods reduce rates of re-offending.
• Community access to naloxone, a medication that reverses an opioid overdose, saves lives. From 1996 to 2014, naloxone was used by people with no medical training to reverse more than 26,000 overdoses in the United States.