1.4 Race, Stigma and Substance Use

Numerous studies have documented relationships between self-reports of discriminatory experiences and reports of distress, which can lead to substance use ⁽⁶⁾.  While further research must be done to determine the causal relationship, the relationship exists.  This means that if a person experiences racism they may use substances as a form of coping.  Rather than using substances to cope, we can help promote healthier choices through access to healthcare that addresses the social determinants of health, including racism.

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

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 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.