If you’ve been fortunate enough to never develop a substance use problem or struggle with a mental health condition, it can be difficult to understand that these are chronic health conditions, just the same as someone diagnosed with Diabetes or Cancer. It’s normal to want to place blame when it comes to addition. We want to believe that making bad choices lead to bad things and making good choices lead to good things…but it’s not that simple.

Behavioral health disorders such as substance abuse are diagnosable medical conditions. behavioral health is a blanket term that includes mental health. Behavioral health looks at how behaviors impact someone’s health — physical and mental. While we would never tell someone diagnosed with cancer that they, ” brought it on themselves” those sentiments are frequently used with people who have a substance abuse disorder.

The use of such devise language creates a stigma for people who have a behavioral health disorder. The fear of being seen as a “drunk” or “crackhead” stops many people from seeking out treatment for their condition. Consider the different language we use when someone with a chronic condition such as cancer experience a reoccurrence of their illness. We say their cancer has “returned” and individuals who have successfully complete treatment are deemed a “survivor” who won the “battle” against cancer.


In comparison, someone with a chronic condition such as a substance use disorder may have a reoccurrence of their illness deemed as, “falling off the wagon”. When the individual has successfully completed treatment they are now, “clean and sober”.

It does not matter that the person with cancer chose to smoke cigarettes or work at a job that exposed them to dangerous chemicals- they are still a survivor. It does not matter that the person with  a substance use disorder took their first drink at age 11 to deal with being assaulted, they are still a drunk.

It is this misunderstanding of what behavioral health disorders are and the impact they have on people’s lives that leads to stigma. No matter what an “addict” does, they will never be a “survivor”, because we don’t identify them as one.

Understanding Addiction

We need to understand that people use drugs for various reasons, including low self-esteem, being reared in an addictive or dysfunctional family, lack of decision-making and problem-solving skills, inability to cope with stress, lack of positive alternatives to drug use, and lack of information.

Self-Esteem. To build self-esteem, discussion exercises and activities that help children feel good about themselves can be developed. Since children with low self-esteem often come from troubled, dysfunctional, or addictive families, early intervention for preventive treatment within the family system needs to be instituted.

Decision-Making. Many children are not taught decision-making skills at home. These skills include identifying the problem, examining solutions to the problem, examining solutions for positive and negative consequences, choosing a solution, taking action, taking responsibility for consequences of the action (positive or negative), and evaluating the choice. Teaching children the process of making choices about a variety of issues can help in many areas of life including alcohol and other drugs.

Assertion Skills. If “no” is the choice for a decision, assertion skills and teaching strategies which show how and why to say “no” can be taught. Assertion training skills include various techniques to resist peer pressure.

Stress Reduction. Adults, and sometimes children, become chronic drug users to reduce life stress. Teaching young people to apply stress reduction techniques to high-stress situations can be a positive alternative to using drugs.

Recreational Activities. Various recreational activities that provide excitement and interest such as spelunking, rock climbing, and white water canoeing also can be encouraged. Youth involved in these types of risky activities are thought to be less likely to become involved in alcohol and other drug abuse problems.

Factual Information. Since a good knowledge base for decision-making is necessary, information about the action and effects of various substances needs to be presented to young people as part of a well-defined curriculum of health education, not as an isolated subject or a one-time presentation.

If any education and prevention programs are to succeed, we must involve young people in all stages of program development, including determination of philosophy and content. If we do not include them, our efforts are likely to be ignored. Experts say the key to successful campaigns are approaches that produce changes in behavior, not just an emotional reaction.

Above all, avoid scare tactics.

“Substance abuse is much more complicated than a simple choice of yes or no,” ~Lori Criss, chief executive officer of the Ohio Council of Behavioral Health & Family Services Providers.

“The evidence is clear that the D.A.R.E. programs, fear-based advertising, and Just Say No campaigns of the 1980s had no benefits at all,” ~Keith Humphreys, a psychiatrist at Stanford University who served as a drug policy adviser under President Barack Obama.