The impact of addiction globally cannot be underestimated. Addiction in many forms touches the life of large sections of our communities.

From the individual, to the family and loved ones, children and whole community’s addiction cuts across all sectors of society.

The infrastructure created to combat the damage from addiction is immense and immeasurable. From the NHS, Health and Social Care Partnerships, Alcohol and Drug Recovery Services, Residential and Community Rehabs, Third Sector Charities and other Statutory Services.

Researchers and Strategists, Justice Services (Police and courts), Department of Works and Pensions, Housing and Homelessness, Mental Health Services and the emergence of Recovery Communities.

The list of services, professionals and volunteers working towards supporting those affected is endless.

But still the negative impact and effects continue to affect and devastate whole families and communities.

The media impression of addiction being exclusive to the most vulnerable of our societies attached to low income, job losses, food poverty and deprivation. Has created a false representation of where addiction can be found.

As addiction is the most notorious foe and regards itself to be non-discriminatory. Addiction is not interested in wealth, job status or family lifestyles. Rich or poor dependence can and does affect anybody.

However, the tide is turning slowly in the UK to appreciate a whole population approach is required to reduce the harms and death rate attached to problematic alcohol and drug use.

And regard this greatest of adversaries as a Public Health Problem. And not an area where a person can be punished into improvement or wellness by the statutory services created to ‘support’ those with addiction problems.

No other health problem is approached this way.

The Impact of Addiction

Language and re-framing the terminology

The article title The Impact of Addiction can be reconsidered to encompass a more compassionate view.

Language attached to addiction is important as the use of negative language particularly in literature and the media rarely looks at the person with a substance use disorder as a ‘normal’ human being.

Each person encountering problems with drugs and alcohol is a loved one and dehumanising and ostracising those with a dependence to substances is unhelpful and serves as a barrier to seeking the appropriate support.

This also drives the problem underground as families struggle to deal with the devastating effects of a loved ones condition in secret.

This can affect the individual as they begin to view their own self in a negative light as they are led to believe the problems they are encountering with drugs and alcohol are because they lack socially acceptable morals and values.

Many problems may begin to occur due to the secretive nature that begins to unfold as fear of the ‘secret’ being uncovered drives the person into a lonely and detracted lifestyle.

Parents, partners and children are affected by the now secretive nature of a loved one’s substance use as they are unsure how to help or who to turn to in order to protect their own emotions and happiness.

Reframing the language used to describe those with an addiction problem into those with a substance use disorder can improve society’s view on those struggling to control their own use.

A more compassionate view towards those with a substance problem will bring around positive changes as humans are supported and encouraged to seek help without negative consequences attached to the process of admitting they need/want help.

Positive examples of language change can be changing ‘misuse’ to ‘use’ and ‘addiction’ to ‘substance use’ as negative connotations are attached to both the terms i.e. the words conjure up negative images in the reader's head as soon as they read them.

Stigma

Negative outcomes can occur under the influence of alcohol and drugs such as: drink driving, job losses, arguments, relationship break ups, accidents, physical and mental health problems. Nobody wants the consequences attached to dependence.

Due to these negative consequences areas such as the media may sensationalise these issues and promote a real sense of negativity, deprivation and shame attached to substance use (previously known as addiction).

With this negativity comes discrimination and stigma.

Stigma is a large part of society. Stigma creates unhelpful barriers to accessing support sooner rather than later and has been shown to promote feelings of low self-esteem and self-worth.

Stigma can be organisational and attached to systems and the professionals who work for these systems. This is a fundamental issue. If the services that are working to support those with substance use disorders create barriers to accessing treatment and enforce penalties i.e. benefit sanctions or withdrawing their access to medically assisted treatment the most vulnerable of society will be affected.

Self-stigma is where the individual has a negative self-belief due to the narrative used to describe those with a substance use disorder by members of the public, the media or their own loved ones. Again this relates to the almost dehumanising representations of those who are dependent on alcohol and or drugs.

The impact of a substance use disorder on how the individual views their self can have long reaching consequences to the individual – an individual is part of society therefore the whole of society is affected.

There are many other areas to be considered such as the underground nature attached to selling drugs, the decriminalisation debate and long-term effects of alcohol and drugs on an individual’s health.

A move away from stigmatising substance use disorders and using negative language and images to represent those struggling with dependence will improve society’s view of dependence on alcohol or drugs.

Mental Health Problems

There are two areas to consider here: did the individual self-medicate their mental health problem with alcohol and drugs or did the use of alcohol and drugs create a mental health problem.

This then creates the problem should the mental health problem be considered before the substance use disorder or vice versa.

Most therapists prefer their clients to be drug and alcohol free before commencement of therapy such as:  Cognitive Behavioural Therapy (CBT). 

However other therapies such as MI Motivational Interviewing can be undertaken between client and therapist to promote an internal desire to stop or reduce intake.

It can be argued that until an individual is ‘abstinence’ from substances then a true representation of the condition can’t be reached. However, ‘abstinence’ may not be possible. And other forms of therapy such as community support may help.

As the stigma attached to substance use disorders can promote loneliness and isolation for the sufferer as they feel ashamed of their use. This in turn can create feelings of depression, anxiety, and stress.

Endorsing the importance of community support for all affected.

Physical Health Problems

The physical health problems attached to substance use disorders are many and varied.

The conditions can be dependent on type of drug used, duration, amount, way in which it is consumed and if used in combination with other substances i.e. alcohol with diazepam, Cocaine with alcohol, cigarettes and alcohol. To name but a few.

Here are some areas or problems that may arise:

  • Stomach; alcohol gastritis, ulcers
  • Bowel problems
  • Lungs disease
  • Heart conditions
  • Liver cirrhosis
  • Skin disorders; eczema or psoriasis
  • Pancreatitis
  • Gallbladder; gallstones
  • Hepatitis B & C
  • Blood clots
  • Mobility issues
  • Gum disease; tooth loss
  • Weight gain/loss
  • Alcohol related brain damage
  • Stroke
  • Digestive Problems
  • Increased risk of cancer
  • Weakening of the immune system

Known as comorbidity the presence of one of more diseases or medical conditions may mean the individual becomes quite unwell.

Age and comorbidity may also increase poor health.

Physical and Mental Health problems may occur over time and may not in some cases be directly attached to length of time a substance has been consumed.

Some alcohol and drugs can have negative effects to the body right away. 

Also some drug use can be extremely dangerous and overdose or other irreversible complications may occur.

Trauma 

Trauma has similarities to mental health and substance use. As individuals may use alcohol and/or drugs to self-medicate the thoughts and feelings that arise after experiencing trauma.

And in some cases those who use alcohol or drugs problematically may experience trauma directly related to their use of these substances.

Trauma may go unrecognised for many years and if having experienced trauma as well as having a substance use disorder, residential rehab may be suitable as clients can detox and access professional Psychotherapists at the same time. 

What does it mean to have a substance use disorder? 

The individual has a problem with substances (drugs and/or alcohol) and struggles to control or limit their use, has cravings for, needs to use more in order to feel better or experiences withdrawals from. Social functioning can also be inhibited and a change in mood or personality can occur.

If experiencing a substance use disorder all areas of life may begin to become affected. Such as:

  • Mood
  • Motivation
  • Outlook on life
  • Productivity
  • Personality
  • Personal relationships
  • Self-care
  • Self-worth
  • Employment
  • Social functioning

If experiencing any of the above in relation to drug/alcohol use it is important to realise there is help available.

Sometimes taking the first step and admitting there is a problem is the hardest step of all. In order to continue using alcohol or drugs in a problematic manner a level of denial is always active.

Denial supports the continued use and minimises the extent of the problem at hand.

Many statements like:

  • Just one more
  • I will stop tomorrow
  • I can’t stop now I have this thing I need to do
  • I am not as bad as……..
  • I am only hurting myself
  • Nobody cares anyway

Are common denial statements. A stay at a long-term residential rehab may be the catalyst that promotes real and sustainable lifestyle changes.

Fear also blocks the person using substances from stopping which has been seen to change. They can develop a healthier fear - a fear of recommencing their substance use. As their time in rehab has helped them identify reasons and triggers to use.

Knowledge of self can be the powerful tool required to stay stopped. That and a positive support network in the community.

Having considered the impact of addiction and the language used a more compassionate term such as those with a substance use disorder may be used.

The harms from substance use can be far reaching and nobody escapes unharmed from their own or loved ones problem with alcohol and/or drugs.

As a society that realises the impact of addiction on whole families and communities a more supportive role would support the reduction in harms to the whole population.

As the incidence of trauma, stigma, mental and physical health problems on those caught in the negative cycle of dependence is surely worthy of support.


About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.