Jen Gerson: Stigma is good, actually

It's a question of what we stigmatize, and why.

By: Jen Gerson

Sometimes writing columns about stuff that happens in this country is, if you’ll forgive the cliché, a little like shooting fish in a barrel. We’ve collectively normalized so much sincere and well-meaning insanity, that inevitably people in positions of power and authority are going to say things that sound indistinguishable from a carnival circus organ. And the only thing I have to do in response is to make note of how far out to sea on the tides of madness we’ve drifted.

Take B.C., for example; after years of experimentation with safer drug supply and decriminalization, even the NDP government has had to walk back its most liberal policies on this file. Initially, decriminalization was touted as a way to decrease “shame and stigma” around drug use. However, earlier this month, Premier David Eby admitted the attempt had resulted in utter failure. Decriminalization, for example, had created a “permissive structure” in which rampant and open drug use — and the attendant crime and social disorder — had become utterly normalized in sections of the province, and in particular, in Vancouver.

Of course, the usual progressive suspects are pushing back against Eby’s embrace of the patently obvious.

The province’s human rights watchdog, Kasari Govender, issued a statement last week accusing the province of the sin of stigmatization; the shift in focus toward involuntary care and criminal justice is a result of stigma — even to regard drug addiction as a “moral failing” is a violation of users’ human rights.

Personally, I think Eby is motivated by an electorate that would like the privilege of being able to walk through sections of Vancouver without the near certainty of having a knife waved in their face, but okay. Let’s go with Govender’s version. Let’s say an aversion to starting your day by picking up used needles from your front lawn, or a desire to avoid walking your kids through a heap of semi-conscious people, is best understood as “stigma.”

My response is: “Yeah, and?”

I don’t know why it so often falls to me to make the most obvious points here but, like, stigma is one of the chief tools human societies have used to police anti-social and harmful behaviours. Stigma and shame are among the most powerful weapons humans living in cooperative groups use to prevent destructive behaviour by both individuals and collectives. Stigma is core to how we function as social animals.

That’s not to say that “stigma” in and of itself is either good or bad. We have plenty of examples of humans stigmatizing the wrong things for the wrong reasons. We shouldn’t stigmatize people with HIV/AIDS, for example. That is bad. The work we’ve done to reduce and eliminate the stigma of homosexuality is a moral good.

But that doesn’t mean “stigma” can be eliminated from human society. Nor does it mean that we should try.

The people who drove cigarette smokers out of bars and insisted on printing packages with nasty images of blackened lungs ought to understand this. We’ve only recently undergone a generational project to use shame, stigma, and access barriers including consumption taxes to radically and successfully reduce the harmful behaviour of cigarette smoking.

This is good! We may never totally eliminate smoking, but we did a damn good job reducing the habit. It was a great victory for both individuals and society as a whole!

Yay us!

Yet, I’ll note, nobody is overdosing in a Vancouver Starbucks bathroom because he mainlined nicotine patches.

We stigmatize hard drug abuse because hard drug abuse is — wait for it — a bad thing that we should discourage people from doing. It deserves to be stigmatized. We should impose social penalties on drug abuse. We should punish people who flout laws, abuse drugs openly, threaten the general public, and behave in ways that are unequivocally regarded as scary and dickish.

We should also provide resources and offer compassion to help people get off drugs. Limitless grace ought to be extended to individuals trying to get clean, or to those attempting to manage their addictions in prosocial ways. Our moral duties cut in both directions.

But the stigma isn’t the problem here. The problem is meth. And fentanyl. It’s the drugs. The drugs are the problem.

Drug abuse is objectively harmful to both individuals who have lost control over their addictions, and to the communities and families around those individuals.

And, by the way, the people who advocate permissive harm reduction policies don’t have any problems using stigma or shame against the critics of those policies. They understand the use of stigma as a tool when it suits their preferred agenda. Stigma works, and they know it.

They’ve had no compunctions about shaming into silence those individuals, community associations, and businesses who objected to watching their neighbourhoods suffer the consequences of open drug trade, haphazardly discarded needles, and violence and public disorder — oftentimes openly accusing such critics of being indifferent to the very human suffering and death that their own permissive drug policies were actively normalizing and even abetting. All things that have absolutely occurred as a result of purportedly “evidence-based” agendas that supported the growth of Safe Consumption Sites and other similar harm reduction experiments.

These “evidence-based” studies — some of which are trumpeted and even written by activist groups like, say, the Drug User Liberation Front (DULF) — promised safer communities and reduced drug deaths. These claims have collapsed on first contact with reality, a fact made impossible to ignore thanks to recent moves in Ontario to close particularly problematic safe consumption sites. After closing several sites, opioid overdose deaths actually declined; although this has been attributed to a change in the potency of the drug supply, it is nonetheless the opposite of what we would have expected to occur if the sites were as central to preventing overdose deaths as their advocates have claimed. This will be a hard data point to reconcile if the positive trend continues over time.

Hell, even NDP Manitoba Premier Wab Kinew is not having it anymore. His province is passing a law to lock up intoxicated individuals for up to three days.

“The person who is too caught up in their addiction to be able to take care of themselves is no longer going to decide how safe the community is,” Kinew said. “Instead, the rest of the community is going to step up, get them the treatment they need.”

Wow. A commonsense statement. No doubt it will be treated as a profound violation of the rights of the differently intoxicated, brought down by the oppressive anti-euphoric elements of society. God help us when the Supreme Court weighs in.

That’s no joke. Remember, it was only 2011 when the Supreme Court ruled that the Vancouver Insite Safe Consumption Site had to be granted a criminal code exemption, paving the way for other sites across the country. It ruled that the exemption had to be granted to: “decrease the risk of death and disease, and [because] there is little or no evidence that it will have a negative impact on public safety.”

Lol. Real prescient, guys. Preach it to Karolina Huebner-Makurat.

Meanwhile, only 14 years have passed since that ruling, and we’ve now got a B.C. human rights commissioner essentially arguing that a shelter in which to shoot up or smoke meth without police attention or moral condemnation should be elevated to a “foundational human right.”

Hey, try this on, y’all: No, it shouldn’t.

Look, this isn’t a question about the use of “stigma.” It’s a question about who gets stigmatized and why. I’m not totally opposed to all harm reduction measures, in theory. I can empathize with the argument that subjecting an individual to shame in response to his or her personal addiction is likely to further that addiction. I want humane off-ramps for these people. But for society as a whole, there’s a line between harm reduction and drug normalization; between grounded compassion and naive enabling. And I’m just not seeing great evidence that normalization of drug abuse is giving better results.

Further, we can talk about the human rights of hard drug users, but we have to consider the human rights of those who want to live in safe communities alongside those users as well. Right now, those rights are out of balance. Everyone who hasn’t replaced their eyes for marbles can see it — which is why the democratic machine is asserting its inevitable weight back toward sanity, even and especially among progressive politicians.

And it’s not just Canada, either. Portland, Oregon recently voted to end its experiment with drug decriminalization. Similar rollbacks are in place in San Francisco and Philadelphia. Even Portugal, whose experiment in decriminalization and subsequent drop in heroin addiction has long been touted as a model for other Western nations — albeit one not successfully emulated — presents a much more complicated picture than what’s often publicized. That wasn’t just liberalization. It was a nose-to-tail effort to dry addicts out en masse, with the funding put in place to support the endeavour. Drugs are neither legal nor normal there; and drug addicts are incentivized via threat of fines to pursue comprehensive treatment and re-enter society as functioning members. I’m pretty sure even the Portuguese would blanch at the sight of DULF.

If drug liberalization were working as well here as its advocates promised it would — if it were demonstrably and convincingly saving lives and if there really were no negative impact on public safety for communities at large — then there would be no political incentive to change course. That’s not how this is panning out. Instead, reality is asserting itself, quickly, and right across the political spectrum. This tells us something about the real impact of more than a decade of these policies, and that something can’t be reduced to “mean NIMBY stigma.”

In a society that lost the will to speak openly and honestly about the real, obvious, and material consequences of its highly experimental drug policies amid an explosion of ever-more dangerous and pervasive drugs, we’ve shifted stigma away from open drug abuse and onto those who are opposed to open drug abuse. And in case anyone needs to hear this — she wrote, aiming a very large shotgun at a giant fish immobilized in a teeny, tiny barrel — that’s absolutely fucking insane.

Because, as we’ve seen, stigma works.

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