Stigma from the inside out: how internalized stigma can trap you

The drug I used, alcohol, is a legal substance, so some of my experiences may be different than those who use illicit substances. I could go to the store and buy my drug and, because it is regulated, I knew that the substance I was consuming was the same as what I purchased. There were no uncertainties or dangers.

I used alcohol in my early teens and throughout my twenties, but it became problematic in my early thirties. At that time, I was attending university, working part-time and raising my child as a single parent. I was poor and beyond busy.

That time of my life was extremely stressful, and I experienced debilitating anxiety. I had ongoing intrusive thoughts that something bad might happen to me or my child. If I were to try and convey this experience of chronic fear and panic, it would be akin to being in a car accident or experiencing some other kind of trauma. My nervous system was elevated, I was afraid, and my reality felt perilous and surreal. I consumed alcohol to quiet the terrifying thoughts and relax my body. Despite intellectually knowing alcohol worsened the situation, it helped me cope, and no matter how hard I tried, I could not stop.

Internalized stigma a barrier to recovery 

Compounding the anxiety and stress was the internalized stigma I felt about my alcohol use. Internalized stigma is the negative beliefs you have about yourself, and they often reflect the negative beliefs society has. I felt immoral, tainted and a failure.

In addition, I had ideas of what other people would think about me, which is called perceived stigma. I believed if people found out about my out-of-control drinking, I would lose my credibility as an employee, student and parent, and even my value as a human being would be reduced. So, while contending with life stresses, poverty, addiction and stigma, I was trying hard to seem normal and together.

There were many factors that helped with my recovery, but having more time and finances were key: I completed university and no longer had the stress of classes, I finally had enough money to pay bills, and I had a bit more time to parent my child.

These had to fall in place first to stabilize my mental health. Next, I joined group therapy. Hearing other people’s experiences and realizing there was nothing wrong with me was a gamechanger. It helped me exponentially in reducing my internalized stigma and shame. I recognized that going to university, working and raising my child were not doable and something had to give. I learned methods to regulate my anxiety. Today, I pay attention to my self-care so that I can be mentally well or, at least, better than before.

Helping others shift their internalized stigma

When I think about the thousands of people who have died from an overdose or from toxic drugs while using their substance alone, I think of the deep internal and perceived stigma they must have been experiencing. I would imagine that, like I did, they didn't feel safe letting anyone know about their substance use and worried about the stigma of even reaching out for help.

To me, International Overdose Awareness Day is an opportunity to show up and help others shift their internalized stigma by reframing substance use as the health issue that it is. It’s also an opportunity to show compassion and understanding that, for many people, substance use is just a symptom, and underneath that symptom are complex and multilayered issues they are struggling with, including mental health.

A key message from International Overdose Awareness Day is that overdose is preventable and must be prevented. Prevention starts with connection, and supporting people where they are at with no judgment. I plan to attend an International Overdose Awareness Day event and stand together as a community, remember the loved ones I’ve lost, be an ally, and connect in caring and compassionate ways with people using substances. I hope to see you there!

Alison Houweling is a regional harm reduction coordinator with the Interior Health Harm Reduction team. When she’s not living and breathing social justice advocacy, she’s "loving up" her family (especially her grandchildren), working on renovations, practising yoga and meditation, hiking in the woods and swimming in the lake.

Call 310-MHSU (6478) to reach your local Mental Health and Substance Use Centre for support in your community. You can also explore these provincial resources:

• Help Starts Here
• Toward the Heart (BCCDC)

If you’re experiencing feelings of hopelessness or thoughts of self-harm, you can call one of these numbers. These services are available 24 hours a day, seven days a week, including holidays:

• Interior Crisis Line Network - 1-888-353-2273
• Suicide Crisis Helpline - 988
• KUU-US (Indigenous) Crisis Line - 1-800-588-8717
• Métis Crisis Line - 1-833-638-4722

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