How stigma perpetuates substance use
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In 2022, 54.6 million people 12 and older in the United States needed substance use disorder (SUD) treatment. Of those, only 24 percent received treatment, according to the most recent National Survey on Drug Use and Health.
SUD is a treatable, chronic medical condition that causes people to have difficulty controlling their use of legal or illegal substances, such as alcohol, tobacco, prescription opioids, heroin, methamphetamine, or cocaine. Using these substances may impact people’s health and ability to function in their daily life.
While help is available for people with SUD, the stigma they face—negative attitudes, stereotypes, and discrimination—often leads to shame, worsens their condition, and keeps them from seeking help.
Read on to find out more about how stigma perpetuates substance use.
Stigma can keep people from seeking treatment
Suzan M. Walters, assistant professor at New York University’s Grossman School of Medicine, has seen this firsthand in her research on stigma and health disparities.
She explains that people with SUD may be treated differently at a hospital or another health care setting because of their drug use, appearance (including track marks on their arms), or housing situation, which may discourage them from seeking care.
“And this is not just one case; this is a trend that I’m seeing with people who use drugs,” Walters tells PGN. “Someone said, ‘If I overdose, I’m not even going to the [emergency room] to get help because of this, because of the way I’m treated. Because I know I’m going to be treated differently.’”
People experience stigma not only because of their addiction, but also because of other aspects of their identities, Walters says, including “immigration or race and ethnicity. Hispanic folks, brown folks, Black folks [are] being treated differently and experiencing different outcomes.”
And despite the effective harm reduction tools and treatment options available for SUD, research has shown that stigma creates barriers to access.
Syringe services programs, for example, provide infectious disease testing, Narcan, and fentanyl test strips. These programs have been proven to save lives and reduce the spread of HIV and hepatitis C. SSPs don’t increase crime, but they’re often mistakenly “viewed by communities as potential settings of drug-related crime;” this myth persists despite decades of research proving that SSPs make communities safer.
To improve this bias, Walters says it’s helpful for people to take a step back and recognize how we use substances, like alcohol, in our own lives, while also humanizing those with addiction. She says, “There’s a lack of understanding that these are human beings and people … [who] are living lives, and many times very functional lives.”
Misconceptions lead to stigma
SUD results from changes in the brain that make it difficult for a person to stop using a substance. But research has shown that a big misconception that leads to stigma is that addiction is a choice and reflects a person’s willpower.
Michelle Maloney, executive clinical director of mental health and addiction recovery services for Rogers Behavioral Health, tells PGN that statements such as “you should be able to stop” can keep a patient from seeking treatment. This belief goes back to the 1980s and the War on Drugs, she adds.
“We think about public service announcements that occurred during that time: ‘Just say no to drugs,’” Maloney says. “People who have struggled, whether that be with nicotine, alcohol, or opioids, [know] it’s not as easy as just saying no.”
Stigma can worsen addiction
Stigma can also lead people with SUD to feel guilt and shame and blame themselves for their medical condition. These feelings, according to the National Institute on Drug Abuse, may “reinforce drug-seeking behavior.”
In a 2020 article, Dr. Nora D. Volkow, the director of NIDA, said that “when internalized, stigma and the painful isolation it produces encourage further drug taking, directly exacerbating the disease.”
Overall, research agrees that stigma harms people experiencing addiction and can make the condition worse. Experts also agree that debunking myths about the condition and using non-stigmatizing language (like saying someone is a person with a substance use disorder, not an addict) can go a long way toward reducing stigma.
Resources to mitigate stigma:
- CDC: Stigma Reduction
- National Harm Reduction Coalition: Respect To Connect: Undoing Stigma
- NIDA:
- Shatterproof: Addiction language guide (Disclosure: The Public Good Projects, PGN’s parent company, is a Shatterproof partner)
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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How to Find Happiness In Yourself – by Michelle Mann
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A lot of books about happiness tell you what to pursue, generally. What things to focus on, and that’s good, but incomplete. This book does cover those things too (complete with academic sources to back up what really works), but also goes further:
Michelle Mann gives 25 key habits that will cumulatively build happiness, which is what it’s really about. After all:
- If you watch your favourite movie, you’ll be happy for 90 minutes (or 9 hours if it’s The Lord of the Rings).
- If you build daily habits that add happiness to you, your surroundings, and those around you, you’ll be happy for life.
They do also cover happiness while going through difficult times, such as divorce, job loss, illness, or bereavement.
Sometimes, knowing what we “should” do in theory is the easy part. Where Mann excels here is in providing explanations of each habit. This means that rather than it being some platitude, the principles underlying it are truly understood… and thus motivate us to actually apply the advice and build the habits into our life.
While the explanations are therefore the greatest value of the book, we do recommend copying out the 25 habits (which are effectively subchapter headings) and putting them somewhere to read often.
Bottom line: we recommend getting yourself (and/or your loved ones!) a copy of this book. You (and/or they) will be happy you did!
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Red Lentils vs Green Lentils – Which is Healthier?
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Our Verdict
When comparing red lentils to green lentils, we picked the green.
Why?
Yes, they’re both great. But there are some clear distinctions!
First, know: red lentils are, secretly, hulled brown lentils. Brown lentils are similar to green lentils, just a little less popular and with (very) slightly lower nutritional values, as a rule.
By hulling the lentils, the first thing that needs mentioning is that they lose some of their fiber, since this is what was removed. While we’re talking macros, this does mean that red lentils have proportionally more protein, because of the fiber weight lost. However, because green lentils are still a good source of protein, we think the fat that green lentils have much more fiber is a point in their favor.
In terms of micronutrients, they’re quite similar in vitamins (mostly B-vitamins, of which, mostly folate / vitamin B9), and when it comes to minerals, they’re similarly good sources of iron, but green lentils contain more magnesium and potassium.
Green lentils also contain more antixoidants.
All in all, they both continue to be very respectable parts of anyone’s diet—but in a head-to-head, green lentils do come out on top (unless you want to prioritize slightly higher protein above everything else, in which case, red).
Want to get some in? Here are the specific products we featured today:
Enjoy!
Want to learn more?
You might like to read:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Eat More (Of This) For Lower Blood Pressure ← incidentally, the potassium content of green lentils also helps minimize the harm done by sodium in one’s diet
Take care!
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Why You Should Diversify Your Nuts!
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Time to go nuts for nuts!
Nuts, in popular perception, range from “basically the healthiest food anyone can eat” to “basically high calorie salty snacks”. And, they can be either!
Some notes, then:
- Raw is generally better that not
- Dry roasted is generally better than the kind with added oils
- Added salt is neither necessary nor good
Quick tip: if “roasted salted” are the cheapest or most convenient to buy, you can at least mitigate that by soaking them in warm water for 5 minutes, before rinsing and (if you don’t want wet nuts) drying.
You may be wondering: who does want wet nuts? And the answer is, if for example you’re making a delicious cashew and chickpea balti, the fact you didn’t dry them before throwing them in won’t make a difference.
Now, let’s do a quick run-down; we don’t usually do “listicles” but it seemed a good format here, so we’ve picked a top 5 for nutritional potency:
Almonds
We may have a bias. We accept it. But almonds are also one of the healthiest nuts around, and generally considered by most popular metrics the healthiest.
Not only are they high in protein, healthy fat, fiber, vitamins, and minerals, but they’re even a natural prebiotic that increases the populations of healthy gut bacteria, while simultaneously keeping down the populations of gut pathogens—what more can we ask of a nut?
Read more: Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans
Pistachios
Not only are these super tasty and fun to eat (and mindful eating is all but guaranteed, as shelling them by hand slows us down and makes us more likely to eat them one at a time rather than by the handful), but also they contain lots of nutrients and are lower in calories than most nuts, so they’re a great option for anyone who’d like to eat more nuts but is doing a calorie-controlled diet and doesn’t want to have half a day’s calories in a tiny dish of nuts.
Walnuts
Popularly associated with brain health (perhaps easy to remember because of their appearance), they really are good for the brain:
Check it out: Beneficial Effects of Walnuts on Cognition and Brain Health
Cashews
A personal favorite of this writer for their versatility in cooking, food prep, or just as a snack, they also do wonders for metabolic health:
Brazil nuts
The most exciting thing about these nuts is that they’re an incredibly potent source of selenium, which is important not just for hair/skin/nails as popularly marketed, but also for thyroid hormone production and DNA synthesis.
But don’t eat too many, because selenium is definitely one of those “you can have too much of a good thing” nutrients, and selenium poisoning can make your hair (however beautiful and shiny it got because of the selenium) fall out if you take too much.
Know the numbers: Brazil nuts and selenium—health benefits and risks
Bottom line on nuts:
- Nuts are a great and healthful part of almost anyone’s diet
- Obviously, if you have a nut allergy, then we’re sorry; this one won’t have helped you so much
- Almonds are one of the most healthful nuts out there
- Brazil nuts are incredibly potent, to the point where moderation is recommended
- A handful of mixed nuts per day is a very respectable option—when it comes to food and health, diversity is almost always good!
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Give Your Adrenal Glands A Chance
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The Hats Of Wrath
Your adrenal glands are two little hat-shaped glands that sit on top of your kidneys (like your kidneys are wearing them as hats, in fact).
They produce adrenaline, as you might have guessed, and also cortisol and aldosterone, which you might or might not have known, as well as some miscellaneous corticosteroids that are beyond the scope of today’s article.
Fun fact! For a long time, doctors thought adrenal glands were much larger than they usually are, because of learning anatomy from corpses that were dissected, but invariably the corpses were those of poor people, especially criminals, whose adrenal glands were almost always overworked and swollen.
You don’t want yours to be like that.
What goes wrong
Assuming you don’t have a rare disorder like Addison’s disease (in which the adrenal glands don’t produce enough of the hormones they’re supposed to), your adrenal glands will usually not have trouble producing enough adrenaline et al.
However, as we learned from the Victorian vagabonds, they can also have no problems producing too much—much like any organ that gets overworked, however, this has consequences.
Hopefully you’re not living a life of stressful crime on the streets, but maybe you have other reasons your adrenal glands are working overtime, such as any source of chronic stress, bad sleep (can’t recharge without this downtime), overuse of stimulants (including caffeine and/or nicotine), and, counterintuitively, alcohol. All these things can tax the adrenal glands considerably.
When this happens, in the extreme we can get Cushing’s syndrome, characterized by the symptoms: hypertension, cortisol-based fat distribution i.e. especially face and abdomen, weakness, fragile easily irritable skin, hair loss and/or hirsutism, paradoxically, and of course general fatigue.
In the non-extreme, we get all the same symptoms just to a lower level, and experience what the medical profession is begging us not to call “Adrenal Fatigue Syndrome” because that’s not an official diagnosis, whereas if it gets a name then they’ll be expected to treat it.
What keeps things going right
Obviously, the opposite of the above, for a start. Which means:
Manage chronic stress; see: How To Manage Chronic Stress
Get good sleep; see: Why You Probably Need More Sleep
Go easy on the caffeine; see: Caffeine Mythbusting
Skip the nicotine; see: Nicotine Benefits (That We Don’t Recommend)!
Avoid alcohol; see: How To Reduce Or Quit Alcohol
There are specific vitamins and minerals that support adrenal health too; they are: vitamins B5, B6, B12, C, & D, and also magnesium and zinc.
Good dietary sources of the above include green leafy things, cruciferous vegetables*, nuts and seeds, avocados, olive oil, and if you eat fish, then also fatty fish.
In contrast, it is good to cut down (or avoid entirely) red meat and unfermented dairy.
*Unsure how to get cruciferous vegetables in more often? Try today’s featured recipe, superfood broccoli pesto
Want to know more?
A large part of adrenal health is about keeping cortisol levels down generally (except: for most of us, we can have a little hormesis, as a treat), so for the rest of that you might like to read:
Lower Your Cortisol! (Here’s Why & How)
Take care!
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Green Tea Allergies and Capsules
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Hey Sheila – As always, your articles are superb !! So, I have a topic that I’d love you guys to discuss: green tea. I used to try + drink it years ago but I always got an allergic reaction to it. So the question I’d like answered is: Will I still get the same allergic reaction if I take the capsules ? Also, because it’s caffeinated, will taking it interfere with iron pills, other vitamins + meds ? I read that the health benefits of the decaffeinated tea/capsules are not as great as the caffeinated. Any info would be greatly appreciated !! Thanks much !!❞
Hi! I’m not Sheila, but I’ll answer this one in the first person as I’ve had a similar issue:
I found long ago that taking any kind of tea (not herbal infusions, but true teas, e.g. green tea, black tea, red tea, etc) on an empty stomach made me want to throw up. The feeling would subside within about half an hour, but I learned it was far better to circumvent it by just not taking tea on an empty stomach.
However! I take an l-theanine supplement when I wake up, to complement my morning coffee, and have never had a problem with that. Of course, my physiology is not your physiology, and this “shouldn’t” be happening to either of us in the first place, so it’s not something there’s a lot of scientific literature about, and we just have to figure out what works for us.
This last Monday I wrote (inspired in part by your query) about l-theanine supplementation, and how it doesn’t require caffeine to unlock its benefits after all, by the way. So that’s that part in order.
I can’t speak for interactions with your other supplements or medications without knowing what they are, but I’m not aware of any known issue, beyond that l-theanine will tend to give a gentler curve to the expression of some neurotransmitters. So, if for example you’re talking anything that affects that (e.g. antidepressants, antipsychotics, ADHD meds, sleepy/wakefulness meds, etc) then checking with your doctor is best.
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Are You Stuck Playing These Three Roles in Love?
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The psychology of Transactional Analysis holds that our interpersonal dynamics can be modelled in the following fashion:
The roles
- Child: vulnerable, trusting, weak, and support-seeking
- Parent: strong, dominant, responsible—but also often exhausted and critical
- Adult: balanced, thoughtful, creative, and kind
Ideally we’d be able to spend most of our time in “Adult” mode, and occasionally go into “Child” or “Parent” mode when required, e.g. child when circumstances have rendered us vulnerable and we need help; parent when we need to go “above and beyond” in the pursuit of looking after others. That’s all well and good and healthy.
However, in relationships, often it happens that partners polarize themselves and/or each other, with one shouldering all of the responsibility, and the other willfully losing their own agency.
The problem lies in that either role can be seductive—on the one hand, it’s nice to be admired and powerful and it’s a good feeling to look after one’s partner; on the other hand, it’s nice to have someone who will meet your every need. What love and trust!
Only, it becomes toxic when these roles stagnate, and each forgets how to step out of them. Each can become resentful of the other (for not pulling their weight, on one side, and for not being able to effortlessly solve all life problems unilaterally and provide endlessly in both time and substance, on the other), digging in to their own side and exacerbating the less healthy qualities.
As to the way out? It’s about self-exploration and mutual honesty—and mutual support:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
While we haven’t (before today) written about TA per se, we have previously written about AT (Attachment Theory), and on this matter, the two can overlap, where certain attachment styles can result in recreating parent/child/adult dynamics:
How To Leverage Attachment Theory In Your Relationship ← this is about understanding and recognizing attachment styles, and then making sure that both you and your partner(s) are armed with the necessary knowledge and understanding to meet each other’s needs.
Take care!
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