Why some people who use substances become addicted

The experience of substance use is different for each person and how it affects people depends on a variety of factors. Addiction and substance use are often connected to a person’s lived experience, mental health and behavior patterns. Addiction is caused by dependence, resulting from physical changes in the brain that cause cravings and withdrawal symptoms. As a result, using substances may be a choice for some people but for those with addiction issues, it really isn’t a choice and quitting may be extremely difficult even with support.

Continuum of Substance Use The continuum of substance use ranges from abstinence to dependence. People start and continue to use drugs for a multitude of reasons. Those reasons can change over time. People do not necessarily move along the continuum, but rather can stay at one point for extended periods of time or cycle through difference points along the continuum. People who are polysubstance users can be at different points along the continuum for different substances.

Information adapted from the Ontario HIV & Substance Use Training Program No Use (abstinence)

The person does not use a substance. Experimental Use

The person tries a substance and may or may not use it again. Social or Occasional Use

The person uses the substance infrequently. Medication (prescribed)

The person is prescribed and uses a medication as directed by a medical practitioner; medical supervision is provided minimizing risk of adverse outcomes Problematic Use

The person experiences negative consequences from using a substance (e.g., health, family, school, work, financial, legal problems). Dependence

The person is dependent on a substance and continues using, despite experiencing serious problems. Withdrawal symptoms may exhibit if use stops.

See The Person. Stop Stigma.

No one chooses addiction. People who use drugs come from all walks of life - they are parents, children, friends, co-workers, and neighbours. Many people with substance use disorders face barriers in getting the support and services they need because of the stigma that surrounds addiction.

Stigma is negative attitudes and beliefs about a group of people due to their behaviours or circumstances in life. It includes discrimination, prejudice, judging, labelling, excluding and stereotyping. Fear and misunderstanding often lead to stigma against people who use drugs, who are regularly blamed for their inability to stop using. This further contributes to feelings of hopelessness, shame and isolation. Stigma increases the likelihood that a person will hide their substance use from others, use alone or in an unsafe way, and avoid seeking help from others, even when they want to.

Stigma can destroy self-esteem and relationships, make it harder to access treatment, jobs and housing, and leads to discrimination and isolation. Health Canada, 2018

Stigma impacts people with substance use disorders, as well as their family members, peers, service providers and our entire community. By working to stop stigma, we can build a healthier, more caring Hamilton.

Local Stories

Listen to the stories of local Hamiltonians who have been affected by substance use disorders and what impact stigma had on them, their loved ones, their friends and their patients, and learn what actions you can take to stop stigma. Everyone has a unique story to tell.

The following stories shared as part of this project may trigger distressing feelings. If you need to talk to someone for support, please contact the 24-hour crisis line for COAST Hamilton at 1-844-972-8338. If you are interested in seeking treatment for a drug or alcohol problem, contact ConnexOntario at 1-866-531-2600.

“We need to take the time to say ‘Are you okay?’”

Rebecca

“All they want a lot of the time is somebody to care.”

Joseph

“Be kind - that is someone’s son, daughter, mother, or father.”

Lesa

“Stigma prevents my clients from being able to recover.”

Dr. Lori

“Ask us how we want help, ask us what our barriers are.”

Tyler

“I was really fortunate to find people that met me where I was at.”

Lisa

“Anyone from any walk of life… can be affected.”

Faisal

“The antidote to [addiction] is connection.”

The Filcs

No One Chooses Addiction: Take Time to See the Person

There is no typical path to addiction. There are many reasons why people develop substance use disorders. Some are genetic or biological. Some stem from childhood trauma, violence or overwhelming stress at school, work or home. Some come from feeling alone, excluded or powerless. Some result from prescription medicine used to deal with chronic pain. Sometimes the cause is unknown.

Addiction is a health issue, not a character flaw. It is simply not a matter of will power or having a desire to stop. A substance use disorder is a medical condition diagnosed under the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 (CAMH). It causes changes in the brain and body that make it very hard to stop using a substance, regardless of the harm it causes to the person or to others around them. People with substance use disorders deserve to be treated with the same dignity, care and respect that is given to others living with a health condition or disorder such as cancer, heart disease or diabetes.

Substance use is only a part of a person’s larger picture. It is important for everyone in our community that we choose to see the person and not simply their addiction.

Take Action to Stop Stigma

There are actions you can take to stop stigma. Learn what you can do to make a difference to someone and help build a healthier, more caring Hamilton.

Choose compassion

Acknowledge a person as a human being who should be treated with dignity, care and respect.

See a person for who they are and what they can be, and not by what drugs they use.

Recognize that your own experiences, or lack of experiences, should not be used to make assumptions or judgements about another person’s life.

Give support to the person and remember to extend support to their family members and loved ones. Listen to their stories, be there for them when they need you, and acknowledge how hard the situation may be for them.

Choose your words carefully

Use person-first language. Avoid using hurtful labels such as drug abuse or drug user; replace with the terms substance use and a person with a substance use disorder.

Accept a person’s situation and avoid judgement. Acknowledge what the person is going through, the difficulty to disclose addiction, and avoid passing blame.

Replace negative assumptions with expressions of care and concern.

Listen and avoid lecturing. Allow space and time for a person to share their story. Give them your full attention and stop yourself from jumping in. Never force someone to share their story if they aren’t ready or willing.

Ask how you can support a person instead of coming to your own conclusions and solutions. It could be a glass of water, company to sit with, or helping them get the support they need at that moment.

Choose to get involved

Like, retweet and share ‘See the Person’ posts on social media, videos and the link to this webpage.

Educate yourself about addiction, harm reduction and substance use disorders.

Get trained to use Naloxone which can reverse an opioid overdose and save a life. Call the City of Hamilton Public Health Services’ Harm Reduction program at 905-546-4276 or the Drug and Alcohol Helpline at 1-800-565-8603.

Help others become more aware by passing on facts and challenge stereotypes.

Volunteer at a local agency that supports harm reduction or people with substance use disorders.

Know what resources are available for people with substance use disorders. Offer this information to others if asked or when they are ready.

Learn what the Hamilton Drug Strategy is doing to help reduce the harms associated with drug use in Hamilton. Agencies and residents interested in joining one of our workgroups can email [email protected]