Opioid dependence: a serious, chronic, and relapsing disease.1,2
Harms associated with opioid use
Long-term use of opioids have significant health consequences, including:5
Help stop the stigma
Stigma is a barrier to treatment.18
The experience of stigma is associated with delays in seeking treatment, increased rates of treatment withdrawal, withholding information in an effort to avoid sub-standard care, as well as increased engagement in risky behaviour such as needle sharing.18
Fear of being stigmatised is also a key barrier for carrying naloxone, and can lead to injecting drug users distancing themselves from harm reduction services such as syringe exchanges.18
The following are tips for reducing stigma in everyday conversations:19
- use person-centred language that focuses on the person, not their substance use
- correct others who may have misconceptions about alcohol and other drug use or people who use alcohol and other drugs (AOD)
- show support by treating people with dignity and respect
- use non-stigmatising language that encourages people to seek help
- don’t use stigmatising words like ‘addict’ that can hurt, damaging self- image and stand in the way of recovery. Instead talk about a person with dependence
- focus on hope. When you empathise, you begin to see how words like ‘abuse’, ‘relapse’, ‘non-compliant’, and ‘dependent’ may come across like a prison sentence: hurtful, demeaning, pessimistic and hopeless
- be aware of negative stereotyping – many people who use AOD feel threatened by the prejudice that results from misconceptions about AOD use
- be an active listener. Acknowledge what the person is saying – don’t brush it off
- use body language that shows you are there for them, let them know they are not alone, and their issue is important.
Treatment goals: minimising harm10
Treatment for opioid dependence in Australia is based on the principles of harm minimisation.
Goals of treatment include reducing demand and by extension the harms associated with use and improving quality of life.
Treating the person2
- Kosten TR, George TP. The neurobiology of opioid dependence: implications for treatment. Sci Pract Perspect. 2002;1(1):13-20. doi:10.1151/spp021113.
- National Guidelines for Medication-Assisted Treatment of Opioid Dependence, 2014. Accessed October 2022 <https://www.health.gov.au/resources/publications/national-guidelines-for-medication-assisted-treatment-of-opioid-dependence>
- Australian Institute of Health and Welfare (2021) Alcohol, tobacco & other drugs in Australia., AIHW, Australian Government. Accessed October 2022 <https://www.aihw.gov.au/reports/illicit-use-of-drugs/illicit-drug-use>
- Australian Institute of Health and Welfare 2018. Australia's health 2018. Australia's health series no. 16. AUS 221. Canberra: AIHW.
- National Drug and Alcohol Research Centre. Heroine, What You Need To know, 2018.
- Australian Institute of Health and Welfare (2021) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government. Accessed October 2022. <https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-otherdrugs-australia/contents/priority-populations/people-incontact-with-the-criminal-justice-system#illicitdruguse>
- Australian Institute of Health and Welfare (2021) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government. Accessed October 2022 https://www.aihw.gov.au/reports/phe/221/alcohol-tobacco-other-drugs-australia/contents/population-groups-ofinterest/homeless-people
- Penington Institute (2021). Australia's Annual Overdose Report 2021. Melbourne: Penington Institute.
- Australian Road Deaths database. Accessed October 2022 <https://www.bitre.gov.au/statistics/safety/fatal_road_crash_database>
- Commonwealth of Australia Department of Health 2017. National Drug Strategy 2017-2026. Publications Number: 11814. Accessed October 2022 <https://www.health.gov.au/sites/default/files/national-drug-strategy-2017-2026.pdf>
- NSW Health. About alcohol and other drugs. Accessed October 2022 <https://www.health.nsw.gov.au/aod/Pages/about-treatment.aspx>
- NSW Health. Withdrawal management and residential rehabilitation services. Accessed October 2022 <https://www.health.nsw.gov.au/aod/Pages/wmrs-contact.aspx>
- NSW Clinical Guidelines: Treatment of Opioid Dependence, 2018. Accessed October 2022 <https://www.health.nsw.gov.au/aod/Publications/nsw-clinical-guidelines-opioid.pdf>
- Benyamina A. Heroin Addict Relat Clin Probl. 2012; 14(4): 65-80.
- Tompkins CNE, Neale J and Strang J. Substance Abuse Treatment. 2019; 104: 64-71.
- Dunlop AJ, White B, Roberts J, et al. Addiction 2021.
- Barnett A, Savic M, Lintzeris N, et al. Drug and Alcohol Dependence (2021), doi: https://doi.org/10.1016/j.drugalcdep.2021.108959.
- Cheetham A, Picco L, Barnett A, Lubman DI, Nielsen S. Subst Abuse Rehabil. 2022;13:1-12.
- Alcohol and Drug Foundation, Stigma - why words matter, April 2021. Accessed October 2022 <https://adf.org.au/insights/stigma-why-words-matter/>