Rachel Winograd is the Director of Addiction Science at the Missouri Institute of Mental Health.
She spoke about how the dominant perception of people who use drugs can impact their ability to seek care and recover.
Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words.
Rachel Winograd: A lot of people in this country view drug use as a pursuit of sinful pleasure, and that conflicts with our largely puritanical values: what we deem important, and what we reward - you know - hard work, sacrifice, productivity, being a contributing member of society, etc. And a lot of that does not seem to go hand in hand with pleasure. And so whether it's about drugs or about sex, you know, we do not reward those types of behaviors if they're not aiming to achieve a goal, like have kids or treat our very acute pain. So that is just like a big, broad umbrella of how I approach some of this.
The idea that people can use drugs recreationally and still live quality, meaningful lives, I think, is just an idea that a lot of people cannot wrap their heads around - let alone the idea that people who become addicted or develop a substance use disorder - that it is something that they may need and deserve high quality medical care for, and also that it can be addressed and people can get better and they can lead meaningful lives. I think that's a big source of disconnect as well.
There's this common belief that, you know, quote: once an addict, always an addict. And that carries a very negative perception and stereotype of that person, too - that they're a bad person, that they're morally weak, that they chose to be where they are, that this is all a result of all their own bad choices and therefore they don't deserve our help. Certainly not our compassion, and certainly not our tax dollars. So I think that's kind of an old school way of thinking about it. But it's still probably a pretty dominant narrative.
The more recent or emerging understanding of drug use and addiction is, first of all, that not all drug use is bad. That people use drugs for all sorts of reasons. Most people who use drugs don't develop a substance use disorder or addiction to them, but for those who do, that it is a potentially a long term condition that they need support and addressing. And every case is going to look different and the type of support they might need might look different. But that this is something that we should address compassionately, as a society through an approach of public health and understanding rather than punishment and judgment.
