What We Don't Know About Substance Use Health Costs Us

What We Don't Know About Substance Use Health Costs Us

CAPSA spends a lot of time busting myths about substance use disorder (“addiction”). For one, we don’t use the term “addiction”—being labelled as an addict literally worsens health outcomes. Second, substance use disorder (SUD) is not a choice. Third, there is no such thing as hitting rock bottom—the suggestion that people have to get sicker before getting help has caused a lot of harm.

Perhaps the greatest myth is that if we don’t have SUD, substance use has little-to-no effect on our health. It is a curious belief given all substance use carries health risks, and 23.7 million of us use them—socially, medically, occasionally, and regularly. We scrutinize anything that comes close to our bodies, so why are substances any different?

Our general knowledge about Substance Use Health is surprisingly low in Canada. We recently surveyed 4,000 people from the general population and found that most people don’t talk about substance use in the context of health. Eighty-three per cent of us have never asked our healthcare providers about it, and 62 per cent of them have never asked us either.

When we asked why people were so hesitant, there were a few common responses: “The question doesn’t apply to me.” Or “my doctor didn’t ask, so I didn’t either.” And “I didn’t know if they were knowledgeable on the topic.” We assume that if you don’t have SUD, your substance use is healthy, and you need not worry.

This false belief is the product of stigma. It allows the separation of “us” (healthy) from “them” (people with SUD). It makes it ok to exclude, judge or discriminate—silently, in our thoughts, or overtly, in our actions. The problem with stigma is that we have done such a good job at “othering” substance use that we have removed ourselves from the picture altogether.

The costs of this ignorance are significant. Most of us don’t know that 57 per cent of people who drink are at moderate to high risk of developing one of 200 health conditions directly related to alcohol. We don’t know that sick days and underperformance resulting from “average” substance use costs our economy $22 billion annually.

Not knowing enough to make informed decisions about our personal health is rooted in stigma. Separating substance use from the healthcare system is stigma. Not asking about substance use, or being afraid to ask, is stigma. It results in harm for all of us.

CAPSA exists to dismantle this stigma. We are among the 76 per cent of people in Canada who use substances. Sometimes, we enjoy good health around our substance use, and sometimes, we experience a decline in our health—just like we do for our mental and physical health. There is no shame in that for us, nor is there for you.

CAPSA provides training on how to support anyone along the spectrum of substance use (including those who don’t use substances). We have even created a new term—“Substance Use Health”—a framework that centres on health, not only illness or disorder. You can start by talking this way, too.

Join CAPSA in our movement to promote the Substance Use Health of all people in Canada. Check out our website at capsa.ca