Matt Begg works for the Umbrella Society, which is an organization supporting those who use substances, and he has generously shared important insights and information about addressing stigma and supporting those with substance use challenges.
Can you describe your role with the Umbrella Society and your passion behind this work?
I work in Umbrella Society’s housing team as an outreach and support worker for clients who live with addiction. In this role, I develop ongoing relationships with clients in order to help them navigate the various systems and organisations in place to get the help they might need. This looks like referring people to treatment centres or helping clients with basic tasks, like getting their ID or paying taxes. Someone might need a doctor’s appointment or a counsellor, so I’ll help them with that as well. Of course, we also work thoroughly with overdose prevention, both in terms of providing it ourselves as well as teaching clients how to use the tools and contact the authorities when necessary. I also try to support clients with positive reinforcement, and through my past as a client of Umbrella myself, exemplify that people can overcome addiction if that’s something that they want. In short, we’re trying to bring care and much needed support to these communities.
What kind of harmful assumptions and stigma still exist around substance use? Can you break down some of these myths for us?
I think things are getting better to a degree, but absolutely, our clients still face tremendous stigma at all levels of society. They’re often assumed to be dangerous criminals, diseased and dirty. Perhaps the most common thing I hear is that they’re lazy, don’t want to be productive and would rather leech off the system. The truth is that all sorts of people can suffer from addiction, regardless of their behaviour, how they look, class, cultural heritage, or how they live their lives. That said, I would say that often people who suffer from addiction are dealing with some kind of pain. It can be physical, emotional or it could be an ongoing mental health issue. For them, drugs are often like a self-prescribed medicine (or an attempt at it) that allows them to manage living day-to-day.
Are there particular challenges in rural communities when it comes to substance use and the stigma that often surrounds people who use substances?
Absolutely. Drugs are often used as a cure for pain. So, the further removed clients are from resources to deal with their pain in a healthy way, the more likely it is for addiction to continue and worsen with those clients. In the case of clients who have emotional trauma and unresolved emotional pain from their past, the isolation caused by stigma can often amplify the problem. If they already have unresolved trauma, dealing with the implications of addiction, feeling isolated and rejected by their community is only going to make matters worse. In rural places where isolation is more exacerbated and addiction services are minimal, this is even more of a problem. A common phrase in this line of work is “the opposite of addiction is connection,” and that really is true. What people suffering with addiction require is community support and being treated with dignity, care and love.
In more populated places like cities, people in addiction have a lot of community and social options. They can find anonymity when that is valuable, and they can find large communities of people in similar situations and are surrounded by considerably more support. Unfortunately, when we look at rural communities, it’s really hard for people in addiction to feel anonymous or to find large-scale community support. When you couple that with the stigma that most addicts are aware of, it can be difficult for somebody in addiction to even justify walking into a grocery store or a coffee shop. Feeling judged or degraded by one’s own community will only serve to create further anxiety and shame in that person, which of course will be worse for their addiction.
If any community, rural or otherwise, wishes to address addiction seriously, then love, care and empathy need to be forefront, using a non-judgmental approach.
How does this stigma discourage people from reaching out for help and accessing needed support?
It is a huge deterrent for clients accessing services. Like I was saying about someone in addiction not wanting to go to a grocery store for fear of being treated poorly or judged, those same feelings of shame can prevent somebody from accessing the services that they need. If you feel like being labelled a drug addict comes with all these other negative stigmas, then why would you go access services that are for drug addicts in any kind of a public way? This is amplified considerably in rural areas where somebody is trying to maintain their own dignity in a closely knit and transparent community.
Alternatively, if addiction was always met with empathy and care, people would be far more likely to access services. It all comes down to care and dignity.
What kind of support exists for people using substances (especially in rural communities)?
If somebody is coping with addiction and looking for supports, there are all kinds out there. A person could reach out for counselling or access a 12-step group such as Alcoholics Anonymous. From a medical perspective, a person could also speak with their doctor about various pharmaceutical solutions. If a person is hoping to overcome their addiction, they can usually find a local medical detox, and if more is needed there are treatment centres and sober living solutions in most places. A lot of these facilities accept people from abroad, making them ideal for people in rural areas. For people who are just trying to maintain an addiction in a healthier way, there are harm reduction organizations and doctors that can offer safe supply (in some places), and even supervised locations where you can use drugs in order to help prevent and treat overdoses. Of course, if somebody wants an outreach worker to help them navigate this sometimes complicated network of options, they can always contact an organization such as Umbrella.
Thankfully, more and more organizations such as these are becoming available. Community and healthcare professionals and governments are starting to realize that treating addiction as part of a greater mental health solution works very well and can save lives. That said, there’s still a lot of social stigma that gets in the way of programs like these being implemented. As we continue to replace stigma with actual education about addiction, I’m sure programs like these will become better funded and more accessible.
Can you explain what a harm-reduction approach is?
Harm Reduction is a strategy for approaching addiction that seeks to reduce harm within the practices of that addiction, be that physical or emotional harm. This approach is opposed to strategies like criminalization or abstinence, where people aren’t given care if they’re still involved in drugs. In a harm reduction approach, people are given care and solutions that fit their needs. Of course, if somebody wants to get sober, services would certainly be provided to achieve that, but for people still in active addiction, a harm reduction approach aims to support them as best as possible despite their continued use. This can take the form of outreach services, safe supply of non-street drugs, clean and unused drug paraphernalia, safe sex supplies and education, safe drug use sites, elevated medical and clinical support, and an overall practice of treating people with care and love.
A common misunderstanding about harm reduction is that it causes elevated drug use in communities, the misconception being that if it’s easier to get drugs and easier to get the tools to get drugs, then more people will do drugs. But repeated studies have shown this is not the case. Ultimately, living a life entrenched in addiction isn’t glamorous or fun, so providing adequate support for people doesn’t make it any more appealing.
How can family, friends and community members best support someone who is struggling with substance use?
“The opposite of addiction is connection” is a pretty good baseline for making decisions around helping people with addiction in our lives. For people hoping to help members of their communities and their loved ones, I would definitely say first and foremost to let the person know they are loved and they are valued. Beyond that, helping to connect them to an outreach worker or a social worker who can tackle some of the more complex systemic stuff would be really helpful. Oftentimes, people in addiction know they need help but struggle to know exactly what they should do and in what order. Trying to navigate complex intake forms and treatment applications while also trying to manage an active addiction is pretty difficult. Also, making sure to consult a medical professional before trying to quit drugs is very important. Some addictions require constant medical supervision due to the dangers of such considerable chemical changes in a person’s body. And lastly, I would say familiarize yourself with how to access and use harm reduction supplies. Naloxone kits save lives everyday, so get your hands on one and learn how to use it.
For people in addiction, simply showing them that you love them and you’re going to be there is enough to help them start making healthier decisions. Many people in addiction struggle with shame and guilt and depression, so whatever you can do to not be a part of that cycle in terms of the way you talk to and treat them will be of tremendous value. It all comes back to care and dignity.