Activity 1: Stigma—The broader context

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Topic Progress:


The aim of this activity is to expand our perspective on health-related stigma and discrimination and the potential impacts on the kind of care we provide. This is an important area for advocacy in our agencies, organizations, communities, and beyond. Dr. Volkow talks eloquently about the need to replace negative stigmatizing practices with skills that generate empathy and caring for people with substance use disorders. Her (short) interview is targeted towards physicians but has relevance to everyone in the substance use workforce. Room (2005) expands the micro discussion about empathy to understand how social stigma towards substance use is embedded in structural social inequity/class issues in society.

For a slightly irreverent perspective (and a bit of a break) on the stigma of mental illness, the Ted Talk by Ruby Wax—Ruby Wax: What’s so Funny About Mental Illness—is fun to watch (ensure you bring your sense of humour to this).


  1. Review CAMH’s Mental Health and Addictions 101 Stigma tutorial Stigma at:
  2. Read pages 26 and 27 in A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy.
  3. View: Global Medical News Network’s Addiction Stigma Still Exists Among Physicians in which Dr. Volkow speaks about NIDAs efforts to dispel stigma and the role of primary care providers in helping their patients to address their addiction sooner.
  4. Read: Livingston et al. ( 2012) “The Effectiveness of Interventions for Reducing Stigma Related to Substance Use Disorders: A Systematic Review”
  5. Read: Room (2005) “Stigma, Social Inequality and Alcohol and Drug Use”
  6. What do you think of Room’s discussion of stigma as social control? What are the merits of this perspective? Drawbacks? What was surprising to you? Take the time to post your thoughts to the discussion area entitled “Stigma as Social Control.” You may want to read what others have posted, making comments or asking questions.
  7. Once again, challenge your self-awareness. At an individual level, are you have more difficulty having empathy for some of your clients compared to your other clients? What is it about these clients that cause you difficulty? Is your perception affected by broader societal prejudices?
  8. In your community/region what sub-populations of the substance using population experience differing caring approaches? Think about perceptions of gender, age, race, disability, and LGBTTQ. Which groups are confronted by more stigma in society?