The Stigma About Drugs And Its Weight In Health Care
Drug consumption is a phenomenon that is analyzed from several areas: political, legal, social, historical, medical, educational, psychological, psychiatric, anthropological, etc.
Each of these fields of knowledge has attempted to explain the causes and consequences of the use of various drugs, as well as provide answers to the question of why they have expanded. In this sense, it is important to adopt a broad approach that includes social variables to understand one of the experiences most linked to addictions: stigma
While it is true that the history of drugs and their uses is as old as that of humanity, It is from the 20th century onwards that drug use is identified as a social problem an identification that brings with it important obstacles.
What is said about drugs and their users is shrouded in a network of ideological discourses that has made the figure of the consumer associated with crime, social deviation and pure vice which is read from a strictly moral perspective.
This view has influenced the way in which drug users are seen as problematic or not, whether they are treated both in social and family spaces, but also with regard to politics and the public.
Until less than a decade ago, in Ecuador there was no public care network for problem consumers and those suffering from addiction. Most of the care services offered were provided from the private sphere and only with a type of intervention that was normalized and universalized.
It was about forced confinement in the so-called addiction clinics, run, for the most part, by “rehabilitated” ex-consumers, without any professional experience or any serious endorsement to deal with this problem, and with minimal regulations from the State, offering services of apparent rehabilitation that had little or nothing to do with the psychological, medical-psychiatric, occupational, social, and educational care that this problem requires.
It is so that during For decades, drug users and those suffering from addiction were exposed to inhumane treatment and constant violations of their rights which ranged from hospitalization against their will with capture practices to physical and psychological abuse as “reductive” measures to reverse the addiction.
The political dimension of the problem
Now, all of this could not have been carried out for so long without a policy that supports and tolerates these practices. Since the nineties, in Ecuador and, thanks to the so-called war on drugs (orchestrated in the seventies by the United States of America, which arrived in Latin America with force in the eighties and nineties) one of the most draconian drug laws in the region was built, the so-called law 108, which placed drugs and its consumers in the criminal field.
Added to this we find the influence of religious discourse which places drug consumption in the order of sin, gave way to the construction of strong stigmas that guided prevention and treatment policies and, consequently, clinical practices.
The stigma of addiction
Despite the fact that since 2008, the Constitution of the Republic considers addictions as a public health problem, and that there are public treatment centers, both residential and professionalized outpatients, Social stigmas still prevail in certain health practices and, above all, in the social imagination
It is enough to listen to some colloquial speeches about drug users to understand how these stigmas operate. Thus, drug users are given identities as sinners, criminals, vices, deviants, etc. What is common in all these identities is that subjectivity is left aside, that is, the human being who consumes drugs or has an addiction.
In terms of health care, these stigmas cause, on the one hand, that problematic users do not demand care, since they themselves and their families do not consider that they should be treated or cared for professionally, and, on the other, that the same health professionals make their interventions based on stigma.
So we find biased interventions, poorly indicated treatments, people who have been hospitalized without needing it, little interest in the construction of other devices such as risk and damage reduction ; dogmatic and universal institutions and treatments, which indicate the same treatment for someone who uses marijuana once a month as for someone who has a chronic dependence on several drugs; little professional training in this field, and exclusion from some services such as, for example, hospital services, for detoxification or in cases of relapse.
There is a long road ahead and an immense debt with drug users, with people suffering from addiction and with their families as long as the restitution of their rights, the construction of appropriate policies and the establishment of sufficient treatment alternatives in accordance with the complexity of the problem and with ethical principles.
Author: Lorena Villacís, clinical psychologist and member of Con-Dicción, Outpatient Device for Problematic Consumption of Alcohol and other Drugs, of Superar Centro Integral de Psicología.
