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Just How Caring Are We?

Addressing the Stigma of Addictions in Older Adults



Jennifer Barr,  Canadian Centre for Mental Health

Canadian Association on Gerontology Conference

Montreal, October 2002


Roundtable Discussion: Just How Caring Are We? Addressing the Stigma of Addictions in Older Adults


One definition of ageism is "a process of systematic stereotyping or discrimination against people because they are old, just as racism and sexism accomplish this with skin colour and gender” (Butler, Lewis, 1973). The stereotypical view of the elderly person is somebody who



The common belief is that seniors benefit less from health care resources than younger patients. Another form of ageism involves a tendency to structure society based on an assumption that everyone is young, thereby failing to respond appropriately to the real needs of older persons.


Now, add the stigma of addiction to this stigma of old age!


A qualitative research project was conducted under the leadership of Margaret Kittel Canale on the Stigma of Addiction at the Centre for Addiction and Mental Health (CAMH) in 2000 – 2001. Through interviews and focus groups, 87 people with experience using drugs, 18 family members and 36 service providers from across Ontario were asked about stigma.


By far the predominant message given by the people interviewed was that “Stigma Hurts!” People who have problems with substance use are judged and labelled in a negative way by society and often come to think of themselves in the same way.


The substance users who are stigmatized most are:


-     those who use illegal drugs (especially those who inject drugs, use crack or heroin or take methadone) or those who use any drug a lot

-      women (especially if they are pregnant and/or are mothers already)

-       people of lower socioeconomic status

-      younger people and older adults, and

-      aboriginal people.


The main ways in which stigma affects people with experience using drugs are:


-       violations of human rights

-       lack of employment

-       development of negative feelings about themselves

-       adoption of certain behaviours (e.g., avoiding needed services, becoming secretive, continued substance use).


It is important to acknowledge that behaviour can exacerbate society’s disdain:  if the person is acting erratic, abusive, manipulative, dishonest, blaming, impulsive, etc.




Solutions to Stigma


Some of these suggestions have been gleaned from learnings in the mental health field. Others were suggested in the CAMH Project:


-       Personalize the issue — by having people who have experienced substance use and stigma speak about it; arrange face-to-face presentations, and portray people with addictions as human beings.


-       Positive stories — which show people who have experienced problems with substance use contributing to society; address media biases and inaccuracies; recruit well-known people as spokespersons to raise awareness that addiction can affect anyone; show the face of substance use on a variety of people in society.


-       Educational initiatives — which highlight the reasons people develop problems with substance use; seek to promote understanding of this as a health condition rather than individual moral failure; promote human rights protection.


-       For example in Peterborough, Ontario several training events for senior service providers (2000 and 2001) included stages of change theory, harm reduction philosophy, information and support regarding personal views of substance use and abuse, and promoted the value of improving the quality of life for older adults, and promoted services. A concrete result was the increase in referrals of older adults to the local addiction service.


-       Promote understanding of reasons behind negative behaviour for example the social environment, dis-inhibiting factors, brain damage, and so on


-       Promote the value of treatment and dismantle barriers to treatment – after all older adults have a higher success rate in treatment!



Stigma is discrimination! We as a society are obliged to address this and effect positive change.




Some References and Resources


Ontario Human Rights Commission, (2001). Time for Action, Advancing the Rights of Older Persons in Ontario. Online at: http://www.ohrc.on.ca/english/consultations/age-consultation-report.shtml


Nelson, T.D.  (ed.) (2002). Ageism : stereotyping and prejudice against older persons. Cambridge, Mass.: MIT Press.

Butler, R.N. (1975). Why survive? : being old in America. New York : Harper & Row.

Butler, R.N.  (1989). Dispelling ageism: the cross cutting intervention. Annals of American Academy of Political and Social Science, 503, 138-147 at 138.

Butler, R.N. (1980). Ageism: a foreword, Journal of Social Issues. Vol. 36 (No. 2): p. 8-11.



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