Bursting the stigma that mental illness and substance abuse are unrelated, the language used to describe or talk to an individual who is dependent on illicit substances does affect that person’s psyche and behavior, according to one professional in the field.
“I never ask someone ‘What did you do?’ I ask, ‘What happened to you?”
That was the assessment offered by addiction specialist Jennifer Gasparino-DeGennaro, who said it has been reported that 70 percent of individuals who use drugs have experienced or witnessed traumatic events.
Contrary to that statistic, Gasparino-DeGennaro said that in her 20 years as a specialist, “Everyone I worked with who used drugs had some kind of trauma.”
On Nov. 12, Gasparino-DeGennaro was invited by students in the Phi Theta Kappa honor society (PTK) to speak at Brookdale Community College in Lincroft.
Students in PTK have devoted the fall semester to examining and researching what they have called an opioid crisis.
Gasparino-DeGennaro, who said substance abuse disorders fall under the category of mental illness, said the disorders should be treated like other ailments that have been diagnosed by medical professionals.
Individuals who have substance abuse disorders are often associated with connotations, she said, including junkie, addict and “dirty” that can negatively reinforce a person’s thinking and behavior.
“We shape minds based on what we tell people,” Gasparino-DeGennaro said.
Labels placed on these individuals, she said, have become societal norms. Demeaning labels can impair the way an individual who is suffering from a substance abuse disorder views themselves and their situation, further damaging a person mentally, she said.
Gasparino-DeGennaro said mental illness is at the root of drug dependence.
Society, she said, has become accustomed to the stigma that is associated with the types of people who use illicit substances to feel better, often labeling sufferers as outcasts. She noted that people who are addicted to alcohol are referenced and spoken to differently than those who use drugs.
Referencing a urine sample an individual may need to take during a routine drug test, Gasparino-DeGennaro said medical professionals use “dirty” and “clean” to classify positive and negative test results, respectively.
She said a person battling a substance abuse disorder who receives a positive result that is classified as “dirty” may reinforce an assumption the individual is unclean. Something that is unclean can be thought of as “bad,” she said.
“It is like we are saying they are dirty if they used drugs,” Gasparino-DeGennaro said. “… We get very crazy that society is calling us crazy things. Then, the person with the substance abuse disorder labels himself because that is what he has been taught. The idea is that we have to change the language from both angles.
“When I work with clients and they tell me, ‘Ah, I’m going to have a dirty urine,’ I say, ‘Why, did you put dirt in it before you peed in the cup?’ I say, ‘If your result is positive for some type of drug, we will talk about it. Dirty only means you rolled around in the mud.
“When you talk with someone who is struggling with a substance abuse disorder, from that lens, it helps them to change their thinking. That is what we want to do. We want to change thinking so we can change behaviors so we can change action. We can change the way we decide to take care of ourselves,” she said.
Gasparino-DeGennaro said there is a direct correlation between substance abuse and trauma.
People who use and have become addicted to illicit substances such as heroin and cocaine, she said, could have been exposed to something in their past that was traumatizing to them.
Trauma, she said, is temporarily suppressed by the use of opioid narcotics and other illicit substances. When individuals use drugs, she said, opiates mimic endorphins – the brain’s “natural painkillers.”
When people use drugs, neurotransmitters in the brain cease production of endorphins and let the substance an individual could be using produce “mimic endorphins.”
Once a drug has served its purpose and the high is over, Gasparino-DeGennaro said, an individual’s brain, one that has become accustomed to substance abuse, will fail to produce natural endorphins.
Withdrawal, which is a period of sickness, follows, she said.
“Drugs work,” Gasparino-DeGennaro said. “If you have ever been drunk, if you have ever been high, you know it feels good, until it doesn’t … Many people who have experienced trauma lend themselves very nicely to opiates because it kills pain. They do their job. They make you forget.”
To change the language individuals use to describe or speak with people who have a substance abuse disorder, she said members of society need to practice using and implementing different terminology.
“If you knew something traumatic happened, would you still call someone a junkie?” Gasparino-DeGennaro said. “Probably not … but we have this image, and what we focus on is the result. We focus on the person who uses the drug and we don’t focus on how the person got there.
“That is really important. That’s why we ask the question, ‘What happened to you?’ as opposed to ‘What did you do?’ The person who could be standing in front of the judge because they have been caught using, selling or distributing … We are talking about the ‘bad kid’ who is standing in front of the judge who is now going to be punished.
“We are talking about the ‘junkie.’ We are not looking at what happened to (that person). We need to change that and we are never going to change the language if we don’t change the way we look at them,” she said.
Gasparino-DeGennaro suggested using phrases such as “person in recovery” and “person with a substance abuse disorder” rather than phrases that have become mainstream in society such as “ex-addict,” “abuser” or druggie.”
“Watch what you say moving forward,” she told those at the presentation. “If it ever comes up, I want you to think about this; do you call a person a heroin addict or do you call them a person who has been diagnosed with opioid use disorder?”