T.O. Drug Strategy

Stigma and Discrimination

picture of a word jumble related to stimga

A key priority of the Toronto Drug Strategy is developing strategies to reduce stigma and discrimination against people who use alcohol and other drugs. The TDS Stigma & Discrimination Working Group has delivered workshops on this topic. The group has also developed resources for service providers, family members and individuals who use substances. 

Learn more about the research and findings of the Stigma, Discrimination & Substance Use Report.

Changing Our Language (PDF)

The language you use can have a great impact on your relationship with people who use alcohol and other drugs. Instead of using negative terms such as 'addict'; use language that puts the person ahead of the problem, such as 'substance use issue'. This shows that you know there is more to them than the issues they are facing.

Why not share this resource with colleagues? Changing Our Language (PDF)

There is a broad range of substance use – from abstinence to dependence. An individual's substance use may change throughout their life, for a variety of reasons.The following information describes the continuum of substance use. Where do you sit on this continuum?

*information adapted from the Ontario HIV & Substance Use Training Program (OHSUTP)

Continuum of use

image of orange double-ended arrow

  • No Use - the person does not use particular substances
  • Experimental Use - the person tries a substance and may or may not use it again
  • Social or Occasional Use - the person uses the substance ion an amount of frequency that is no harmful (e.g., drink on social occasion; ceremonial use)
  • Medication (prescribed) - the person uses a medication as directed, under medical supervision. Risks are minimized.
  • Problematic Use - the person experiences negative consequences from using a substance (e.g., health, family, school, work, financial, legal problems)
  • Dependence - the person is psychologically and/or physically dependent on a substance and continues using, despite experiencing serious problems. Withdrawal symptoms may exhibit if use stops.

Notes about the Continuum of Use

People do not automatically move along the continuum.

  • Some people may stay social users for their entire lives.
  • Some people can move around the continuum over time.

People can be at different points of the continuum for different substances.

Where a person is on the continuum, does not necessarily impact her/his ability to manage and minimize risks. For example:

  • Someone that is "heavily addicted" may still use new equipment every time.
  • A long time cocaine user may overdose.
  • A social user may overdose or spend too much.

For people struggling with dependency, not using for a while, then using again (sometimes referred to as "rrelapse") is the norm.

The reason(s) people start to use are not always the reason(s) they continue to use.

The following strategies will help you identify what you and your organization can do to reduce drug-related stigma and discrimination.

What you can do?

Explore your own values and beliefs about substance use and how they may impact how you work with people who consume alcohol/other drugs:

  • Focus on building respectful and trusting relationships with clients.
  • Use neutral, non-judgemental language.
  • Advocate on behalf of clients to ensure they get the services and resources that they are entitled to.
  • Challenge drug-related stigma and discrimination when you see it.
  • Advocate for systemic change – health, housing, employment sectors, etc.
  • Participate in networks advocating for evidence-based drug policy.

What can your organization do?

Ensure your organization complies with provincial policy and legislation that protects people from discrimination and requires a "duty to accommodate."

  • Ontario Human Rights Code 
  • Policy on preventing discrimination based on mental health and addictions
  • Accessibility for Ontarians with Disabilities 
  • Involve people who consume alcohol/other drugs in developing, implementing and evaluating policies and programs.
  • Involve people who consume alcohol/other drugs on your Board of Directors, staff hiring committees, etc.
  • Develop harm reduction and/or human rights policies for your organization.
  • Create a welcoming, non-judgemental environment.
  • Hire peer workers.
  • Offer low-threshold services, specifically for people who consume alcohol/other drugs.
  • Ensure your intake and assessment forms do not use stigmatizing language or ask for information that is not relevant to the service being provided.
  • Ensure staff and volunteers receive anti-stigma training.
  • Add discussions about stigma and discrimination as a standing item to team meetings.
  • Create a staff group to identify and address service barriers and challenges.

Here are some tips for creating welcoming services for those that use alcohol and/or drugs.

Addressing stigma and discrimination

Some people avoid or stop using health and social services because they are made to feel unwelcome due to their substance use. Strategies to help create more welcoming and supportive services include changes to:

 
 
 
  • Tone and approach
  • Physical environment
  • Programs and services
  • Information and resources
  • Staffing
  • Policies

Set a welcoming tone

The tone you set at the door creates a first impression. Ensure your clients feel immediately welcome.

  • Have someone who reflects the community being served as the first point of contact (e.g., peer worker).
  • Post signs and posters that reflect the approach of the organization - “This is a welcoming, non-judgmental space” -"Positive Space," etc. 

 

Create comfortable spaces

The physical environment you present helps make a client feel welcome. Create an environment that feels safe and comfortable rather than cold and clinical.

  • Paint and add art work to walls.  Use rugs or carpets to warm up concrete floors.
  • Use “warm” lighting options (i.e., not fluorescent).
  • Showcase photographs and client art work.
  • Add flowers and plants, which can also improve air quality.
  • Provide a space for personal belongings (coats, boots).
  • Let people know they are free to get comfortable.
  • Offer refreshments – a cup of tea or a snack.
  • Put out a basket of goodies - safe sex supplies, razors, matches, shampoos, lotion, snacks, etc.

Promote a feeling of communitiy

Foster a sense of belonging to help increase connections and reduce isolation.

  • Create a community space. Invite people to add to the space – to take and bring what they think might be of interest or helpful to others.
  • Invite conversation about people’s hopes and values for their community - stories of how they participate and contribute to their community.

Tailor programs and services

Welcoming and supportive services are responsive. They should reflect and meet the needs of the people being served.

  • Provide service hours that meet client needs.
  • Offer child care.
  • Provide transportation assistance.
  • Accompany people to appointments.
  • Follow-up on referrals.
  • Offer after-hours support and a friendly outgoing phone message.

Provide resources and information

Create information boards with relevant resources.

  • Post information about peer work, housing, harm reduction and safe sex resources, counselling and support, social justice events, etc.
  • Provide "know your rights" resources.
  • Offer to make photocopies.
  • Encourage clients to take anything they, their friends or families may be interested in.
  • Offer information in multiple languages.

Employ diverse staff

Staff should reflect and support the diverse needs of people using your services.

  • Hire staff who represent the diversity of people you serve, including people who use substances. Resource: Harm Reduction at Work
  • Employ and support peer workers. Integrate peer workers into the staff and agency culture (e.g., attends staff meetings, provide supervision and training).

Set anti-discrimination policies

Organizational policies and procedures should ensure a zero tolerance for discrimination and promote non-judgemental, responsive services.

  • Develop clear anti-oppression/discrimination policies.
  • Ensure client representation on the Board of Directors and hiring committees.
  • Involve clients in policy and program development and evaluation. Resource: Nothing About Us Without Us.
  • Provide a formal, regular process for client feedback, and respond to issues raised.
  • Post a “safe space” statement that lets everyone know discrimination is not tolerated.
  • Ensure compliance with the Accessibility for Ontarians with Disabilities Act (AODA).

Supporting a family member with a substance use issue can be challenging and isolating. For many, a family member may be the only person in their lives who is aware of their struggle with alcohol or other drugs. The following information is intended to provide some suggestions, considerations, and resources to help family members.

Learn more about substance use

  • Learn about the substance(s) your family member is/are using, and about drug use in general.
  • Seek out information that is non-blaming and non-judgemental.
  • Many organizations that provide services to people who use drugs have knowledgeable staff who may be able to answer your questions, in addition to providing public information and education sessions and programs.

TIP: The Centre for Addiction and Mental Health (CAMH) offers and online tutorial as an introduction to understanding addiction.

Services and supports available for your family member

Addictions treatment and support services are not a one-size-fits-all situation - depending on a person's needs and goals, some services are better suited than others. Respect your family member's perspective about what services or supports are best for him/her.

Some common treatment approaches include:

  • Abstinence-based programming, requiring people to not be using while accessing services and to have the goal of abstaining from substance use
  • Harm Reduction, which aims to work with people to reduce their use, or to learn strategies to reduce the harm the use is having on their life. Abstinence may be a goal but is not a requirement for service.

TIP:Pushing a person into treatment can strain your relationship and deter them from seeking support. Try finding out what resources are available and share these, providing your family member with the tools to make decisions that work best for them.

Communicate

Open and non-judgemental communication is an important part of any relationship, and even more so for those trying to support family members with a substance use issue. Substance use issue. 
  • Ask your family member how you can support him/her, rather than offering advice or recommending what they should do.
  • Try to understand the role that drug-use has in their lives and what else is going on for them.
  •  Provide a safe and supportive space for them to share their experiences and feelings.

TIP: The language you use can have a great impact on your communication with a family member. Instead of using negative terms such as 'addict', use language that puts the person ahead of the problem such as 'substance use issue'.  This shows that you know there is more to them than the issues they are facing.

Seek out support for yourself and other members of your family

Think about how you can support yourself:
  • Self-care is an essential part of caring for someone else and also model coping strategies to the person(s) you are supporting.
  • Talk to other members in your family or supportive friends or seek individual counselling.
  • Family support programs can connect you with other people experiencing similar situations to information and resources, and teach you new skills to better support yourself and your family. 

 

Finding the right counsellor or service for you or your family member can be challenging. Some things to look for include:
  • The language used by the service (e.g., 'addict', vs. person who uses drugs);
  • The rules, requirements or restrictions of the program (e.g., can you or your family attend for support if you or they are actively using, is regular attendance mandatory for ongoing service);
  • Accessibility and a feeling of safety and comfort in the space the services are offered in;
  • Flexibility in the format of services offered (e.g., open/closed group, individual, and/or family counselling); and
  • Opportunity to talk openly about you or your family member's drug use in a non-judgemental and unrestricted way

TIP: Before you meet with or contact a service think of some questions you would like to ask of them. For example, what is the process for accessing the services?

TIP: METRAC has a Client Rights Guide for interviewing a new therapist, which can help prepare for that first conversation with a new service provider.



Information about free services and supports in Toronto for family and friends.

Breakaway Addiction Services 416-234-1942

Parent Support Group

A one night a week, four-week course that provides an opportunity to learn about: alcohol and other drugs, adolescent behaviour, parenting styles, and communicating skills for negotiating with your teens.

Adult information Night

A one evening, two-hour seminar for parents and other adults who want to know more about substance use and its effects. Attend and gain an understanding of alcohol and other drugs, and the ways they may affect the mind and body. Information discussed includes adolescent development and the factors that put some youth at a much higher risk of developing drug and alcohol problems than others. Learning the signs of drug use and what you can do to reduce the chances your teen will turn to drugs or reduce the risk of dependency.  Find out what parenting styles work and how to help your kids.

Centre for Addiction and Mental Health (CAMH) 416-535-8501

Family Resource Centre   416-535-8501 ext. 4015

This space provides support, understanding, education, coping strategies and opportunities to meet with other families facing addiction and mental health issues. The service is offered to families, friends, clients, students and the general public. The service provides information about CAMH and other community resources, a lending library of books and videos and access to internet information.

Family Addictions Services 416-535-8501 ext. 2105

Provides treatment and support services to anyone who is concerned about someone else's substance use.  The person of concern may or may not be in treatment at the CAMH. Service is provided in both group and individual formats.  Educational workshops and consultation are also provided. Family or couple counselling is provided to clients of CAMH and their family members.

Hospice Toronto 416-364-1666 ext. 231

Young Carers

The Young Carers Program supports children and youth (5-18) who have assumed a significant care-giving role for a family member coping with a mental health or substance use issue, a physical or developmental challenge, a chronic or life-threatening illness, or a language barrier.  The Young Carers Program offers activities and programs throughout Toronto that provide recreational, social, educational and skill development opportunities for young carers, thereby connecting them with peers and giving them time to just have fun.

Parent Action on Drugs (PAD) 416-395-4970

Parent Action on Drugs (PAD)

PAD has a range of resources for parents to approach the issues related to alcohol, marijuana and other drugs with their children. For parents who have concerns about a son or daughter's use of drugs, PAD has resources available including the Parent & Community Handbook.

The Jean Tweed Centre 416-255-7359

Support Group

An open support group for families/friends on Tuesday evenings from 6:00 to 7:30 p.m. New members are invited to arrive at 5:30 to meet the family counselor and other new members. Each night includes a talk about a different area of interest; some topics include:

  • Understanding substance use/gambling and their impact on families
  • Taking care of yourself when someone you care about has a problem
  • Finding and using support
  • Staying safe and handling crises
  • Acknowledging what has been lost
  • Effective communication
  • Setting limits
  • Finding hope again

The Salvation Army Homestead 416-921-0953

Family Support Program

Offers a five-week support group for the families of people struggling with a substance use issue. This is an educational support group where various topics are discussed related to substance use and the family.

Toronto East General Withdrawal Management Services 416-461-2010

Family Support Group

The Family Support Group deals with the impact of someone else's substance use on family members. The program helps family members identify family issues and how to deal with them. The program runs every Wednesday from 6:00 p.m. to 8:00 p.m.. No appointment necessary.