2.4 Race, Stigma and Substance Use

One example of an agency ensuring the intersectionality of health is addressed is the North End Community Health Centre in Halifax, NS⁽⁷⁾.

One step we can take as Social workers is to actively talk about racism and how it exists in our lives.  Addressing the language we use is an important part of addressing racism, reducing stigma, and supporting the health of minorities in Canada.  For example, the intersectionality of black people’s lives in Canada includes “age, gender, sexual orientation, ability, religion, immigration status, country of origin, socioeconomic status, and racialized identity” ⁽⁸⁾. For Indigenous Canadians intersectionality also exists between colonialism, residential schools, and trauma.  “While the experiences of First Nations, Métis and Inuit in Canada are unique, they have all endured and pushed back against hundreds of years of colonization, persecution and on-going structural violence that was intended to push them to the margins of society” ⁽⁹⁾.

The knowledge of these overlapping factors and identities are critical when providing service as this can reduce barriers and stigma.  Service provision can be more comprehensive, for example, and programming must be culturally and trauma sensitive when working with people who have a racialized identity.  Due to their identity, we can assume that they have experienced racism.  Racism can lead to further stigma, which in turn creates barriers to treatment and support.  This racism has led to perceptions of substance use among Indigenous communities.

When you read stories or reflect on these situations like this and others, it may cause you to feel emotional.  This emotional reaction may result in feeling uncomfortable or unsafe.  It is important to understand where these feelings begin.  As you explore your thoughts, feelings, and emotions, this is an opportunity to also explore your understanding of racism in Canada. This could lead to further education about slavery in Canada, or of residential schools.  Perhaps you may wish to learn more about traditional or cultural ways of knowing; exploring the concept of two-eyed seeing, developed by Elder Marshall, Mi’kmaq Indigenous Leader from the Eskasoni First Nation who suggests making change as “one conversation at a time” (personal communication, February 9, 2021).   You may reflect on your identity and begin to examine privilege, “an invisible package of unearned assets” ⁽¹⁰⁾.

As Social workers, it is your responsibility to understand systemic issues that create barriers to service so you may work with empathy, compassion, and knowledge.  This will contribute to reducing racism and stigma.

Promoting the importance of traditional knowledge and traditional treatment is another step in the reduction of stigma.  It is through the resilience of Indigenous communities that “Indigenous peoples, languages, cultures, and traditions have not only survived, but they have also been revived, reclaimed, and revitalized” ⁽¹¹⁾.  Watch the video below and reflect on the importance of Indigenous culture, practices, and treatment in healthcare.

Royal College of Physicians and Surgeons of Canada. Bridging the gap between traditional and western medicine: The remarkable work of Dr. Karen Hill.    Dr. Karen Hill is the inaugural recipient of the Royal College’s Dr. Thomas Dignan Indigenous Health Award, which celebrates Canadian doctors who epitomize a zeal and devotion to Indigenous rights and the dogged pursuit of justice for Canada’s Indigenous people.

We know “substance use disorders are one of the most stigmatized mental health issues”.⁽¹²⁾ From the language we use, to the communities we engage with, we must be aware how language plays a role in racism and stigma for people who use substances and have substance use disorders. While we must be prepared to have difficult conversations and be prepared to talk about intersectionality, race, racism, and stigma in our work, it will require further training; seek out training that can support your understanding of language, racism, and stigma.We know “substance use disorders are one of the most stigmatized mental health issues” ⁽¹³⁾.  From the language we use, to the communities we engage with, we must be aware how language plays a role in racism and stigma for people who use substances and have substance use disorders. While we must be prepared to have difficult conversations and be prepared to talk about intersectionality, race, racism, and stigma in our work, it will require further training; seek out training that can support your understanding of language, racism, and stigma.

Attribution

Exploring Substance Use in Canada by Julie Crouse is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, with minor revisions for clarity and ease of use.