We are quite sure you have heard the phrase “drug addicts can’t be trusted” in the media, from someone you know as they talk about someone with a substance use problem, or maybe even your doctor or a treatment professional. Have you ever paused to consider the impact uttering that phrase could have on someone who struggles with their use of drugs or alcohol?

People struggling with substances live in a world of stigma, shame and shunning, and their interactions with most everyone, from family and friends to medical and treatment professionals is one that is fraught with fear, invisibility, and a sense they will not be listened to, understood, or believed. Gross generalizations like “drug addicts can’t be trusted” contribute to this problem. If you believed someone was going to approach you with those preconceptions about you (i.e. you are not to be believed, listened to, and on some fundamental level, seen as a person), how would you act? Would you feel comfortable acknowledging you have a problem? Would you have any faith that the person you are hoping can help you has any understanding of what you are experiencing?

Granted, people using substances in problematic ways often engage in behaviors that make them seem untrustworthy, like lying about their use, faking drug tests, saying they want to change and then engaging in the behavior again, etc. On the surface, you could say that this is proof that they simply cannot be trusted!

But if you step back and look at the context around them, there are likely all sorts of reasons why their behaviors actually make a lot of sense. Many people do not know how to change, but know everyone in their life needs or wants them to. They often lie about their use in an effort to prevent those around them from getting upset, angry, or scared. Knowing that being honest about their struggle would be met with fear and at times outright contempt can be a big reason to lie! Additionally, the motivation to change is impacted by lots of internal (e.g., emotional states) and external (e.g., a fight with a friend) experiences, and the pull to use can be both physical (I’m in withdrawal) and emotional (I don’t know how to deal with this feelings). Changing the way you use or learning not to use is hard for most people and requires making profound changes in almost all areas of your life and always involves setbacks. When the world around you reacts to those setbacks with contempt, suspicion or punishment, one can come up with all sorts of reasons to hide (and therefore lie about) the process.

By resisting the urge to make blanket statements such as “drug addicts can’t be trusted” we all can make it easier for people who struggle with their substance use to ask for help. As treatment providers, family, friends, members of law enforcement, clergy and teachers, we can help people actually consider their situation openly, feel safe to speak about their struggle realistically, and come to understand why change is important to them. People who misuse substances are engaged in motivated behavior (not crazy, sociopathic behavior) and by being more careful about how we talk about the problem we can create a place for them to tell us the truth.

Stigma and distrust have killed many people in our country. When we create environments in our homes, institutions and communities where people with problems are as a whole not trusted or treated equally, we can guarantee that they will go underground and the problem will go unaddressed. In the case of substance use, a person may die and their family engulfed in pain and loss.

People who use drugs and alcohol to cope are people struggling to escape pain, avoid a difficult life, deal with PTSD, chronic pain, a bad marriage etc etc etc. Hearing people out about how they got where they got is a huge and still rare conversation for most people struggling this way. By assuming they cannot be trusted: there could not be a more surefire way to never have this conversation, and to lose a chance to start a life-saving path of change.