Pathways to Addiction: Stigma and Substance Abuse

Substance abuse develops for a range of reasons. Three common experiences can contribute to the development of addiction: trauma, stigma, and poverty. Over the next few months, I want to explore the role that each of these factors plays in the pathways to developing and maintaining addiction.

Pathways To Addiction: Trauma and Substance Abuse

Pathways To Addiction: Poverty and Substance Abuse

Substance abuse claims the lives of hundreds of thousands of people every year. Between drug overdoses, medical conditions caused by substance use, substance-related suicide, and more, substances are involved in too many deaths each year. If you include alcohol-related fatalities, the numbers skyrocket even further.

According to the Centers for Disease Control and Prevention, 91,799 people lost their lives to a drug overdose in 2020.1 Additionally, data from the National Institute of Health reveals that about 95,000 people lose their lives to alcohol-related causes each year.2

In other words, an estimated 500 people die of substance-related causes every day, every year.

The Substance Use and Mental Health Services Administration found that an estimated 41.1 million people needed substance use treatment in the last year alone.3 And while there is a wide range of addiction treatment programs and recovery solutions available, only 4.0 million people received help.

Thousands of staggering statistics reveal that alcohol and substance abuse is one of the leading preventable causes of death in the United States. Why are so many people losing their lives to drug and alcohol abuse? What brings them to substances in the first place and what keeps them from receiving the life-saving care they need?


Trauma and poverty are two primary pathways to addiction, and stigma is a driving force that keeps people from seeking help. Providing care for the more than 40 million people living with a substance use disorder is crucial for reducing fatality rates. But the dangerous effects of stigma place barriers between people struggling with addiction and the vital care they need.

What is Stigma?

“Stigma” is a word that comes from both Greek and Latin. It originally referred to a tattoo, burn, or other distinguishing mark inflicted on a person that identified them as a disgrace. Today, stigma refers to the assumptions, labels, stereotypes, and discrimination applied to misunderstood conditions like diseases, mental health disorders, or substance abuse.

Stigma contributes to the ongoing misconceptions of many different disorders. Perpetuating these harmful misunderstandings keeps people separated from one another. The fear of judgment-fueled ridicule limits the ability and willingness of those struggling to reach out and ask for help.

The Relationship Between Stigma and Substance Abuse

Stigma and substance abuse are closely intertwined. The primary problem that keeps people trapped in the cycle of addiction is a false idea that addiction is not a disease but a personal choice. Too many people still believe that those who struggle with substance abuse lack willpower, personal responsibility, or morality. 

One study attempted to model the impact of stigma on addiction using rodents.4 Heroin- and methamphetamine-dependent rats were offered a choice between social interaction or drugs. The rats consistently chose social interaction over substances unless that socialization came with a punishment, similar to stigma.

Although this is only one study, humans are just as socially-motivated. They are far less likely to seek help when their attempts are met with blame and shame. Still, despite extensive medical proof to the contrary, people are frequently seen as the cause for their continued struggles with substances.

Reducing Stigma Reduces Barriers to Addiction Treatment

Any attempt to address the rampant problems of substance abuse and addiction must also consider the ways that stigma limits opportunities to heal. Reducing harmful assumptions and judgments is vital before any lasting change can occur. The longer people view addiction as an issue of moral failing or weak character, the longer it will take for those struggling to find help.

Dr. Nora Volkow, Director of the National Institute on Drug Abuse, shared a story of a man she met while on a trip to Puerto Rico a few years ago.5 He was injecting heroin into his already-severely-infected leg at a makeshift injection site in San Juan. The researcher urged the man to seek immediate medical help but he refused; all of his previous attempts to seek help were met with harsh judgment and terrible treatment. To Dr. Volkow’s alarm, the man preferred to continue using heroin and risk further infection than ask for help again.

This is only one story of the likely hundreds of thousands of untold stories of those battling addiction in the United States, as well as the world as a whole. Drug and alcohol use disorders are now attributed to declines in U.S. life expectancy rates.6 The problem is not slowing down, and ongoing research reveals how drastic it has become.

Stigma and substance abuse still go hand-in-hand to this day but Emerge Recovery is a program that exists to break down that connection. We understand that compassionate treatment and a truly individualized approach are the only way to help those who are suffering. 

Judgment and condemnation have brought the problem to the point it’s at now; the dire need for a new approach is undeniable. We know how it feels to face criticism when asking for help. And we understand how terrifying it can be to try again, but that’s what we’re here to do: strip away all judgment and meet you where you are.

To learn more about how Emerge is doing rehab differently, please reach out today. We can’t wait to hear from you and find out how we can help.


1. Centers for Disease Control and Prevention. (2022). Drug Overdose Deaths.

2. National Institute on Alcohol Abuse and Alcoholism. (2022). Alcohol Facts and Statistics.

3. Substance Abuse and Mental Health Services Administration. (2021). 2020 National Survey on Drug Use and Health.

4. Nature Neuroscience. (2018). Volitional social interaction prevents drug addiction in rat models.

5. National Institute on Drug Abuse. (2020. Addressing the Stigma that Surrounds Addiction

6. The New England Journal of Medicine. (2020). Stigma and the Toll of Addiction.

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I’m here to help you get sober and stay sober. We’ll uncover what’s keeping you sick and why you’re stuck in the same cycle. Parts of you are begging to be healed but you can’t do it alone. Emerge Recovery is the first step toward learning to navigate and thrive in a life free from substances.

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