Discrimination against drug addicts
In the process of stigmatization, people with substance use disorders are stereotyped as having a particular set of undesirable traits, in turn causing other individuals to act in a fearful or prejudicial manner toward them.
[4] People who use or have used illicit drugs may face discrimination in employment, welfare, housing, child custody, and travel,[5][6][7][8] in addition to imprisonment, asset forfeiture, and in some cases forced labor, torture, and execution.
Due to this gap in educational curricula, and competency, healthcare professionals may be unaware of how much of what they assume to be true about treatment and people with substance use disorders is neither evidence-based nor factual.
Healthcare professionals may hold biases similar to those of the general US population, who often see substance use disorders as a moral failure rather than a chronic brain disease that has significant contributory racial and psychosocial factors, with 40-60% heritability.
SAMHSA and ASAM have clinical guidelines for things such as medications for addiction treatment, withdrawal management, and non-pharmacological therapeutic interventions as well.
If symptoms persist for longer following discontinuation, providers may consider a mental health disorder as primary, or as stemming from a different etiology, rather than as substance-induced.
People may be exposed to substances in utero, or involuntarily initially in childhood (especially if parents use or manufacture drugs) or in adulthood (e.g. GHB, rophynol, etc.).
[26] The limited presence and access to comprehensive care for addiction poses a barrier for recovery for many, particularly those hailing from lower socioeconomic backgrounds.
[28] How language regarding SUD is framed plays an important role in mediating stigma experienced by those with the condition, which can consequently shape critical outcomes for this population such as treatment contact, social isolation, and attitudes towards healthcare providers.
[29][30][31] The NIDA additionally applies a similar framework to terminology such as "clean" or "dirty" to denote whether or not someone is actively using as they cite the former vocabulary holds punitive connotations.
[36] Treatment centers and harm reduction efforts in Tanzania have come into conflict with recent discourse from politicians, such as President John Magufuli, who established the nation's war on drugs in early 2017.
[37] Calling for the arrest of anyone involved in narcotics, Magufuli's stance is distinct from growing harm reduction pathways established in sub-Saharan Africa in the early decades of 2000.
[37] This wave of criminalization policy aims to redress the issue of those who use being primarily being targeted by law enforcement, rather than other individuals involved in the trafficking schema.
[39] Populations that exist at this intersection, for instance, Tanzanian women sex workers who engage in injection drug use, are alienated from utilizing risk reduction interventions due to fear of arrest.
[40] Low-income, urban, young men which are the most likely populace to be recruited to illicit substance trafficking due to lack of economic opportunity otherwise, have been highly scrutinized under recent waves of drug criminalization.
[41] Substance use ranging from marijuana to heroin is prohibited and a record denoting arrest for such use highly influences subsequent employment outcomes after time served for these individuals, which can ultimately be deleterious to expanding economic mobility within the communities they hail from.
Certain crimes outlined by the Narcotic Drugs and Psychotropic Substances Bill are also eligible for the death penalty, and while cases involving marijuana have been charged with capital punishment in the past, they tend to be successfully appealed in higher courts.
[45] This legislation is heavily influenced by a coordinated United Nations effort throughout the latter twentieth century to stymie international drug trafficking.
[51] This has led the United Nations Human Rights Council to adopt a resolution urging the Philippine government to set up an investigation into mass killings during the war on drugs.
[52] Drug control strategy in modern Vietnam was first formally introduced in 1990 around the cause of eradicating "social evils," in reference to substance use.
[54] Ordinances and violation measures were propositioned by the Vietnamese National Assembly in this legislation to mandate compulsory treatment for substance users, rather than subject them to prison.
[56] Harm reduction measures such as clean needles and condom access have been introduced throughout the 2000s at a national level to address the prevalence of HIV and HCV among drug users.
[55] Consequently, at a local level, substance users remain eligible to be charged by law enforcement and subjected to forced labor treatment centers that are comparable to detention.
[59] To apprehend people who use, law enforcement is permitted to conduct urine testing based on suspicion, rather than wholly requiring a public disturbance.
[60] Such protocol is justified by lawmakers as a way to expand early intervention for people who use substances to be referred to rehabilitation channels, but legal advocates have challenged such practices for infringing upon personal freedoms.
[61] Moreover, while those who use drugs can apply to their local welfare administrator for rehabilitative services, this process is selective despite being less costly than long-term imprisonment for an associated drug-related crime.
[61] Many cite this for why Sweden has rising substance-related mortality in the 21st century, for instance, having 157 overdose deaths in 2006 compared to the Netherlands which had a little over a hundred despite having a population close to double the size.
An article published by the Canadian Medical Association Journal discusses new efforts to create safe injection sites for people struggling with opioid addiction.
[67] Substantial punitive measures exist for illicit possession, whether that be in the context of use, trafficking, or selling, with length of incarceration scaling up with repeat offenses.
[69] Three-quarters of those imprisoned for fentanyl today are people of color, which directly corresponds to Black and Latin populations being disproportionately policed for drug-related crimes.
