This is the beginning of a life-changing experience. A moment in my life.

My past revealed how structural stigma works and creates serious harm for people in need.

By Karen P.

structural stigma structural stigma

I was a young single mother. In 1989, with my 18-month-old daughter, we moved back to the Yukon to reunite with family so me and my child could have family supports. I was healthy, happy, and working. I had more children during this time and supported us the best I could.  

There were these two people I knew. After work, we hung around to have a few drinks. I was healthy, but they knew my family situation and didn’t care. They kept going in and out of the bathroom. Eventually I asked what they were doing and they showed me that they were using injection drugs. They both offered me some, and even though they knew they had hep C, they shared their works without my knowing. This was the only time I ever injected, but I knew something was wrong the next day. Thinking back, they also knew something was wrong, and it only took that one time. They didn’t care about my health, my wellbeing, my family. I was naive and they treated me like a dummy. They used me for my money and to use drugs with them. It was a bad situation.  

That was where my life with substance use and health issues began. I didn’t know I had hep C for almost 20 years before finally getting diagnosed. I don’t know how I didn’t know, and why doctors didn’t check for it. I don’t understand how my liver was allowed to get so bad, and when I found out about the hep C, I was very upset and depressed. I felt very ashamed and dirty. I didn’t know how it even could have happened.

“This is what structural stigma is. It is stigma fuelling discrimination that is built into the system, in this case, the system of health care that should have been supporting me just like any other person.”

After finding out, I talked to my doctor about what I could do. I was very scared and overwhelmed trying to process what I had done to myself. I needed to better myself for my family and friends and my health. It took a number of years before I was able to see a hep C specialist. The specialist asked if I was drinking, which I was. Because of this, they said I wasn’t a candidate for treatment. I was disappointed and went home hurt and crying because of the stigma of all this just because of my addiction to alcohol.  

READ MORE: The impact of stigma

There was no compassion, despite the fact that I had this potentially life-threatening disease. I couldn’t even get out of bed and there was nowhere I could turn for information. They wouldn’t even tell me the condition of my liver or issues with my blood. They simply said not to come back until I was sober. This was one of the biggest blows of my life. 

This is what structural stigma is. It is stigma fuelling discrimination that is built into the system, in this case, the system of health care that should have been supporting me just like any other person. People with drug and alcohol addictions should not have to face this kind of stigma. We need to care for them with more compassion and no longer put them down and make them feel dirty or ashamed for what they are going through. The addiction people experience is often the result of not being able to deal with the trauma they endured growing up.

I was able to change my life. I got sober and the hep C specialist finally agreed to see me. They offered me a new type of hep C treatment: direct acting anti-retroviral. I was fortunate enough to be one of the first in the Yukon to receive this treatment.

My ancestors taught me to be strong and to hold my head up. It helped me to decide that getting sober was what I had to do for me and my children, and I was able to ask for the help that I needed. The help I got was from the Drug Users Group at the Blood Ties Four Directions Centre.  Getting support from people in the same situation as me where I wasn’t judged gave me something good to look forward to every week. Finally, with this group of people who didn’t shun me or make me feel dirty or unworthy, I kept coming back. With this help getting sober, I was able to get the hep C treatment. My first blood test after six weeks showed I had beaten hep C. When I found out, I was so happy I cried, I prayed, I smudged, it was one of the happiest moments of my life. I knew I would never put myself through that again.  

Still, it was a difficult time. Many of my friends were still drinking and drugging, and I ended up staying home by myself most of the time except for visits to Blood Ties. I wanted counselling and treatment, but I couldn’t get it. Only Blood Ties offered anything like bits of work for money, help with housing or transportation, and other daily needs. Staff at Blood Ties saw the work I was doing and offered me to go with them to speak at a national conference.  

READ MORE: Project Inclusion: Confronting Anti-Homeless & Anti-Substance User Stigma in British Columbia

I hope that at least one person will read this story and not have to go through what I went through, and that it will help them understand peer pressure and structural stigma. I would not wish these experiences on anybody. It’s so unfortunate that there are so many people and professionals who don’t care, and it affected me for a long long time. 

There needs to be more awareness on the experiences of Indigenous Peoples, trauma, mission school syndrome, intergenerational trauma, and other issues that are affecting our communities. There needs to be more information out there, especially for young people who are more naive. There needs to be more knowledge about hep C and HIV, peer pressure, and stigma. There also needs to be more supports for counselling so that people don’t get stuck the way I did. And these counsellors need to understand and be able to acknowledge the issues that Indigenous People face. Moreover, there needs to be more Indigenous helpers that are knowledgeable about our culture and can be more compassionate about people’s situations. I try my best. I talk to young people all the time about not sharing works, straws, or pipes. I’ve helped stop a lot of people be unsafe by teaching these harm reduction techniques, and they were all happy to have this knowledge too. In one group I worked with, I was surprised how much people still didn’t know about harm reduction and drug awareness. 

“There needs to be more awareness on the experiences of Indigenous Peoples, trauma, mission school syndrome, intergenerational trauma and other issues that are affecting our communities.”

In the end, the stigma and discrimination were the hardest things and were barriers to me getting help for so long. People need to have access to a safe supply of drugs. This can be life saving especially with the drugs that are out there today being so toxic and causing fatal overdoses. As well, decriminalization is key for heavy users so that they don’t get stuck in the court system for tiny amounts of drugs, which wastes so much time and money. Some people need drugs just to be able to function, to eat, drink, and walk, and we need to help these people. If drugs were decriminalized, it would be easier for people to access the help they need.  

I want to thank my ancestors, my family, my community, and Blood Ties staff who were able help me break through and get the help I needed and deserved. I am happy today that I am strong and healthy—that I am able to hold my head up, to talk, to teach, and to be strong. Please be safe with your supply and always carry naloxone wherever you go. And don’t be scared to ask for help. You deserve it, but you won’t get it if you don’t ask.  

About Canadian Drug Policy Coalition

Advocating for public health- and human rights-based drug policies grounded in evidence, social justice, and compassion. www.drugpolicy.ca