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Cat Nelson* took her first shot of heroin when she was 13 years old. By 17, she was using drugs regularly. By 20, she was in and out of rehab, trying to get clean. Today she is 28. She has legal problems. She has been homeless. She does sex work to support her habit. She has hepatitis C. And she still uses drugs.

She wants to stop.

Cat's story is all too common, especially as addiction to opiates such as pain pills and heroin continues to skyrocket all over the country. Kids are starting young, getting hooked and spending years trying to get clean. Some will succeed. Some will not. All will be left with emotional and physical scars. But for many, the stigma of drug use, of being crushed under society's collective judgment and condemnation, is worse than anything.

"When you are a drug user, society tells you that you are worth nothing," says Cat, who lives in Charlotte, North Carolina. "It makes it harder to get help because you are so afraid of judgment and rejection."

Worse for Women

For female drug users, the stigma can be particularly acute. There are fewer treatment options available for women. Women are more likely than men to be asked for sex in exchange for drugs. Women with children are often condemned as bad mothers and under the constant threat that their children will be taken away.

Verna Gaines, a former drug user from Atlanta, Georgia who is now 20 years clean, did lose her children during the 12 years she struggled with crack addiction. "Women with children are stigmatized worse than anybody," she says. "When I was using drugs I was terrified to ask for help because I thought if I told someone, I would lose my kids."

Tracey Helton, a former drug user from San Francisco, says that even when she was buying her own drugs, other dealers or users often expected or demanded sex. She started using drugs at 17 years old after getting her wisdom teeth pulled. From popping doctor-prescribed opiates she went to street drugs and eventually to the street itself. She spent eight years trying to stay high so she wouldn't feel sick, before a residential treatment program helped her stop. Now 16 years clean, a happy mother with three children, Helton is a far cry from the tomboyish 25-year-old heroin user featured in the documentary, Black Tar Heroin: Dark End of the Street. But the stigma of drug use still haunts her, as she writes in her blog about parenting and recovery:
"I was so depressed at the time, sleeping in an alley. I just stayed like that for days crusted in my own blood. No one tried to help me. No one cared."
Killing Addiction with Kindness

Gaines and Helton lived for many years in what most people would call rock bottom before they recovered. They grappled with homelessness, prison, disease, loss of children, and loss of dignity. Yet what helped them climb out of it was not punishment, but kindness.

Verna Gaines recalls reaching out for help one night after selling her last possession, her car, for drugs. "I was walking down the street looking for crack and crying hysterically," she says. "I called a 1-800 hotline and they talked to me for hours. They were actually nice to me. Then I called my mom at 3am. 'I'm on my way,' she said. I went to the hospital, and then to NA meetings and with my family supporting me, I got clean."

Most people understand that constantly berating a person who is overweight can lead to psychological trauma that causes compulsive behaviors like overeating. Yet we think if we could just remind drug users one more time how weak and selfish they are, if we could inflict just a little more pain, they will stop. In reality, such tactics usually have the opposite effect.

"People think that if [drug users] get sick enough, if they punish us enough, if they hurt us enough, we'll get better, but it's the negative consequences that make us worse," says Louise, a 38-year-old drug user from Greensboro, North Carolina.
"When you take away all the good we have in our lives then all we have left is to say is fuck it, and use drugs. I'm now a felon. I don't have the opportunities I had before. I have court dates every other week. I've got police harassing me every time I walk out my door. Those aren't things that make people want to do better with their life....When I get upset, that is when I am most likely to want to use drugs."
People talk about tough love, but there is no love in denying drug users employment opportunities, locking them in jails and prisons, trampling their basic human rights and dignity, and hoping somehow (if they manage to live through all that) they will turn things around. Stigmatizing drug users can discourage people from seeking help because they are too ashamed. So why do we keep doing it?

"It's frustrating to watch someone with mental illness or addiction go through it," says Cat. "Sometimes I understand the anger towards people who use drugs. I get frustrated with them too and I know what they are going through."

It is understandable to feel frustration toward people living with addiction. Even the most compassionate among us feel frustrated from time to time. But that doesn't make it right or effective in helping people to control, reduce, or stop their drug use.

Verna Gaines now works for a harm reduction agency in Atlanta where people using drugs can go for help with anything from counseling to disease prevention to sobriety. No one forces them or pressures them to stop using drugs. But with kindness and trust, many of them do.

"I have a client who comes into our drop-in center who I thought would never get clean," Gaines says. "I think he had given up on himself. But we kept showing him love and one day he came in and said he was ready to stop using. I think if you show a person love and support, they will start to love themselves enough to get clean. The 12 steps program worked for me, but showing a person they matter, meeting them where they are at and allowing them to make that decision works too."

Combating Stigma

In her free time, Tracey Helton connects with drug users on the Internet through her blog and other social media. Many of them stopped using, at least for a time, after talking to her. "Some people tell me I am the first person they talked to about their addiction because they were so ashamed," she says. "Having that person who is not judgmental can make a huge difference."

Cat says she is open about her addiction as often as possible to show people that she is a decent human being, despite her struggle with drug use. "When people get to know me I tell them I am addicted to drugs so they see that we aren't all bad people," she says.

Stigma against drug users is still abundant, but there are signs of hope. Public opinion is shifting toward a more understanding position on drug use. Drug laws are loosening in some states, because people are beginning to recognize that these laws create a second-class society of people with criminal records who can't get jobs.

"People are realizing that the war on drugs is a failure," Helton says.
"They also are starting to see that drug use is a medical issue, not a character defect. Yes, people need to take personal responsibility for their behavior, but society also needs to create a system that treats addiction like we treat other health problems that are precipitated by poor choices, like diabetes, hypertension and asthma. Those poor choices need intervention. Thankfully we are starting to see changes with things like naloxone programs, states passing laws that help people call 911 for an overdose, and expanded services that include addiction treatment, suboxone and other opiate replacement medications."
More than anything, we need to understand that there is hope and value in every person who lives with addiction. No one is a lost cause. As addiction and drug use continue to creep into our communities, our families and ourselves, be kind. Love is much stronger than hate.

Tracey writes in her blog,
"I am not the sum of any guilty, shameful thing. I am not the sum of all the things that I have done, I have endured, I have witnessed, I have enjoyed. I will thrive despite my imperfections. I am a woman."

*Name has been changed.

About the author

Tessie Castillo is the advocacy and communications coordinator at the North Carolina Harm Reduction Coalition. She writes a regular column for the Huffington Post.