Hi Cathy,
That doesn't surprise me about the 6 months of alcohol abstinence for a liver transplant. It talks to the deemed worthiness for a liver transplant. If one is going to treat a liver transplant the same way they are treating the liver that they are born with, well then they are undeserving of a healthy liver. Holding a liver hostage in the hopes that it will be a motivator for someone struggle with a substance use disorder is not effective. It's not a black and white equation of 'stop choosing to use alcohol' then 'you get a liver transplant'. As a bigger community, we fail to see and accept the environmental causes of substance use disorders. It challenges the systems that have been built and those who benefit from the privileges of those systems.
When we look at trauma and the ways people cope, alcohol and other substances have been useful, as it gives people a sense of freedom from the pain. That they are able to have relief. Same with other situations that as a community we haven't deemed 'bad', i.e. I have a headache/migraine, I take Tylonel Migraine, I feel better from the pain. Similar process for other substances and the use they have for relieving pain from trauma, from the things that have happened to them. The fact that people are finding ways to cope with their pain, should be looked upon as a strength - that they can find something that works in the moment. It's more about finding other ways that have better long term consequences, so that they can live a less painful life.
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Kala Beers, MSW, RSW
AMH Education Consultant
CPCN
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Original Message:
Sent: 07-02-2021 10:10
From: Cathy Scrimshaw
Subject: Discussion of the Month (June) - Let's Talk About Stigma!
Kala and Janine,
I have always struggled with addiction as a term, but agree that substance use disorders leaves out other addictions like gambling, sex, as Kala points out. I struggle with the language and am constantly reminded how much it matters.
I have been looking into the stigma and health system issues particularly around liver transplantation in patients with alcohol use disorder. and the old standard of needing to be 6 months abstinent. I only realized n the last couple of years there is no evidence for that requirement. I think this is still a reflection of stigma around substance use disorders as being something people somehow chose. I am interested in your thoughts?
Cathy
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Cathy Scrimshaw
Pincher Creek AB
Original Message:
Sent: 07-02-2021 08:28
From: Kala Beers
Subject: Discussion of the Month (June) - Let's Talk About Stigma!
Hi Janine,
I agree with you, substance use disorder is definitely the direction to go. The one question I have though, is what is the language to include other 'addictions' such as process addictions, i.e. gambling, shopping, sex etc.? For this reason, I keep the word addictions as an umbrella term in my brain so it does include the process/behavioural addictions.
I'd love to hear your thoughts.
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Kala Beers, MSW, RSW
AMH Education Consultant
CPCN
Original Message:
Sent: 07-01-2021 09:06
From: Janine Karpakis
Subject: Discussion of the Month (June) - Let's Talk About Stigma!
very well said, Kala.
I am a strong supporter of changing our language around talking about substance use disorder and such. I wish for us to stop referring to ourselves as mental health and addictions and rather speak to mental health and substance use disorder groups. It's a small thing but goes towards destigmatizing the issues.
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Janine Karpakis
Lethbridge AB
Original Message:
Sent: 06-30-2021 10:24
From: Kala Beers
Subject: Discussion of the Month (June) - Let's Talk About Stigma!
Yes!
Stigma does perpetuate trauma as stigma promotes disconnection from others. Stigma is used to dehumanize others from which it is easier to hurt them. Take the NIMBY effect for example; this is telling other humans that they don't belong. Belonging is one of our basic needs and cannot occur in a community where a group of humans are consistently being told that they are wrong and are worthless.
We as healthcare professionals have a responsibility to engage in reflective practice to ensure that we are breaking down stigmas, on a personal practice level along with a team approach.
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Kala Beers, MSW, RSW
AMH Education Consultant
CPCN
Original Message:
Sent: 06-23-2021 12:30
From: Agatha Grochowski
Subject: Discussion of the Month (June) - Let's Talk About Stigma!
How does stigma perpetuate trauma?
Please comment your thoughts below.
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Agatha Grochowski
Alberta College of Family Physicians
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