My name is Lashandra, and I work for an addiction treatment charity inside a prison. Working in this setting I often witness stigma against people who use substances – it’s so commonplace that you could easily become resigned to it. I often hear people who use drugs being referred to in demeaning, labelling, and dehumanising terms. Words can hurt and they can poison, or they can empower and build people up.
‘I was in the meds queue one morning to get my methadone,’ says a member of the prison stigma forum. ‘An officer was manning the queue and as “banter” said to me, “yeah, but you’re just a crackhead”. He laughed, and I laughed along with him. This really hurt me, and I went back to my cell and it went round and round in my mind. In that moment I felt like I wasn’t worth anything. The officer thought he was being funny, and he didn’t realise how it made me feel. Since being part of the Stigma committee and attending our meetings, I feel like I would be able to challenge him in an appropriate way.’
The people we support generally tend to agree that it’s ok for them to self-identify as something – an ‘addict’, for example – but that doesn’t mean it’s okay for someone else to use that term to describe them. In order to create behaviour change, stigmatising language needs to be called out and challenged. Many people who use substances, however, don’t challenge it because they’ve internalised these labels throughout their lives, and their confidence and self-esteem are so low that they start to believe that is all they are.
Whether I’m talking to someone using our services, a prison officer, another colleague, a family member, or the public, I’ll educate them as to why the terminology used isn’t respectful or inclusive. I explain the impact of stigma, offer insight into how it makes people feel, and suggest alternative terms.
I started to have conversations in the prison with the people that we support to better understand how stigma impacts them, and through these I understood there was a definite need to act. We created a stigma committee made up of people with lived experience, and it meets regularly to discuss ideas and feedback. We’ve also implemented stigma forums which are used as safe spaces to discuss issues relating to stigma and substance use – it’s a place where people can come and talk about their issues openly. Through these forums we’ve found that many people have been in denial about their substance use, or kept it a secret because they don’t want to be treated differently. We’ve also learnt that some people on scripts will collect their meds late because they don’t want others to look down on them for being on medication.
We’ve seen a great response to the stigma forums from both people who use substances and the wider prison population. It’s been impactful to see the benefits for those who are gaining support, self-esteem and confidence, and I’ve also noticed a move away from the acceptance of certain words and behaviours. The committee is currently working on co-producing our own anti-stigma campaign, and we’re also developing awareness-raising leaflets, posters and an educational video that shares lived experience.
We’re also delivering training to staff and the wider prison community. To make anti-stigma education as accessible and inclusive as possible, the committee has developed an approach that suits different learning styles – as part of that we’re putting on a play for the prison staff and governors. It will then be put onto a digital platform for the wider prison community to watch.
Reaching out far and wide, breaking down barriers to accessing support, and offering education to those who don’t fully understand stigma are important tools in facilitating change. We must speak up on behalf of the people we support. Even when they have the confidence and self-belief to advocate for change themselves, it’s all of our responsibilities to find innovative and inclusive ways of amplifying their voices and making sure they get heard.
Lashandra works for a treatment charity in a UK prison. Join the Anti Stigma Network at www.antistigmanetwork.org.uk