Reducing alcohol stigma in services

Stigma (strong feelings of disapproval) is a major issue for people who have problems with alcohol. It can:

• create feelings of guilt, shame and hopelessness
• harm relationships with friends, family and employers
• stop people from seeking help

Many people with alcohol problems experience stigma. They may also experience self-stigma, including feelings of shame and embarrassment.

Older adults also experience stigma due to their age, leading to even more stigma for those of them with alcohol problems.

According to Drink Wise, Age Well research, one common and harmful stereotype is that older adults are set in their ways or too old to change.

As a result, they are less likely to be referred for alcohol treatment than younger people. But in fact, there is substantial evidence that older people are more likely to be successfully treated.

Nobody should feel ashamed or stigmatised because of problems with alcohol. Reducing stigma in alcohol services leads to better engagement - and fewer people stopping treatment early.

Types of stigma in alcohol treatment

There are many negative stereotypes about people with alcohol problems, but these don’t reflect reality for most people.

There are many different reasons why people can develop problems with alcohol - and they affect people from all kinds of backgrounds.

People with alcohol problems, and those close to them, can experience:

• Public stigma: The reaction of the public towards people with alcohol problems, based on stigmatising attitudes. It doesn’t just mean the general public: it also includes practitioners and other professionals.
• Self stigma or felt stigma: The negative and judgmental feelings people with alcohol problems have about themselves.
• Stigma through association: The stigma experienced by people like partners or family members due to being associated with someone who has an alcohol problem.
• Structural stigma: When institutions create policies, procedures or practices that disadvantage or discriminate against people with alcohol problems.

Ways to reduce stigma

Whatever your role in alcohol treatment, you can help reduce stigma. Here are some things to consider:

Offer more support

Sometimes offering more support and information is all it takes to help someone feel less stigmatised.

• If someone expresses negative beliefs about themselves, like “I’ll never change”, gently challenge these ideas with relevant facts and success stories
• Promote peer support groups if they’re available in your area: these foster a sense of hope and help people feel less alone
• Encourage people to cope with stigma through support services and counselling

Challenge stigmatising language and behaviours

We can all combat stigma by recognising and challenging stigmatising language in ourselves and in colleagues.

• Avoid using labels like “alcoholic”, which suggest that people are defined by their relationship with alcohol
• Avoid phrases like “dropped out of treatment” or “non-compliant”, which can reinforce stereotypes and assumptions
• Normalise alcohol problems, for example by saying “anyone can develop a problem with alcohol at any time in their lives”.
• Challenge stigmatising attitudes or behaviours among staff, and consider delivering or arranging further training

Protect people’s dignity and privacy

You can help people feel more at ease and less vulnerable to stigma by taking simple steps to maintain their dignity and privacy.

• Let people choose appointments or treatment in their homes if possible
• If someone isn’t comfortable taking part in group work, reassure them that they won’t have to
• If someone isn’t comfortable talking face-to-face, consider offering anonymous interventions, like webchat services and helplines (consider We Are With You’s webchat service or Over 50s Alcohol Helpline)

Wider health and wellbeing

Beyond the immediate need for help with alcohol, you can take steps to support people’s wider health and wellbeing.

• Ask about other health and wellbeing problems people might experience - not just their problems with alcohol
• If somebody tells you they’re experiencing prejudice or discrimination, consider supporting them in an advocacy role
• Connect people with community groups and activities, to help them develop an identity beyond alcohol
• Provide opportunities for social connections and volunteering, which can increase self-esteem and self-worth