Douglas Todd: Anti-stigma campaigns need a complete rethink

Social norms often change through stigma as the smoking example illustrates. For the most part, the same phenomenon with overt racism, sexism and the like but as we see south of the border, limits to its effectiveness:

…More importantly, slavish commitment to anti-stigma theory is also out of place when we realize we live in a society, if you think about it for more than a few seconds, that is quite adept at stigmatizing certain behaviours.

Like cigarette smoking.

In the past 50 years North America’s public-health community has used the power of stigma to great effect. It launched anti-smoking advertising campaigns, complete with grisly death data, that eventually rendered smoking uncommon. Something similar happened with drunk driving. And it’s widely agreed that’s been a good thing.

So there is much to learn from the professor whom Bonnie Henry hired as a consultant. In their article in The Atlantic, Caulkins and Humphreys actually highlight B.C.’s policies, because this province has gone further than just about any place in North America in making harm reduction, and anti-stigma, the centre of its drug-response strategy.

B.C. “has decriminalized drugs, offers universal health care, and provides a range of health services to drug users, including clinic-provided heroin and legal provision of powerful opioids for unsupervised use,” write Caulkins and Humphreys.

“And yet its rate of drug-overdose fatalities is nearly identical to that of South Carolina, which relies on criminal punishments to deter use, and provides little in the way of harm-reduction services.”

Caulkins and Humphreys are not trying to suggest there is no place for empathy for those in the clutches of illicit drugs. As they say, when it comes to people who are addicted, it’s worth remembering the teaching, “Love the sinner, hate the sin.” The problem is the behaviour, not the person.

And to be clear, no single strategy will end today’s scourge of drug deaths. That means there is a role for safer supply and harm reduction. And there is huge space for compassion.

But there is also a time for social deterrence, as there has been with cigarette smoking. There is a time to reinforce the message that “one pill can kill.”

To put it directly, fentanyl and its ilk should be shunned.

Source: Douglas Todd: Anti-stigma campaigns need a complete rethink