Credit: Subject Matter Health Research Lab
In the first video, “Beyond Stigma,” we showed how stigma surrounding opioid use creates barriers for people seeking treatment for pain. But stigma is experienced differently by everyone.
Consider Marie.
Marie is a First Nations woman who lives in a remote community, several hours from the nearest hospital. She has a history of opioid use (“Addict!”) and is pregnant with her first child. (“They’ll know!”) As an Indigenous person, the stigma Marie faces from her opioid use is compounded by institutional racism and colonialism. And as a pregnant woman, she faces additional stigma.(“They’ll take her away!”)
At last, Marie arrives at the hospital and is ready to give birth. The pain of labour has already begun, and she’s hoping for some relief. But when the doctor sees that Marie is Indigenous (“Might be an addict…”; “IV drug seeking…”; “Check her file!”) he starts firing questions at her. (“What other drugs have you taken? Are you still using? Do you know your baby could go into withdrawal? Should I call child protection services?”)
Marie tries to defend herself, but she’s embarrassed, in pain, and afraid. Eventually, after some debate, Marie receives an epidural and gives birth. (“They won’t let you keep her”)
Later, Marie asks how she can manage any pain. (“Drug seeking…”; “Danger to her child!”; “I won’t be prescribing you any opioids. And I might have to report you to child protection services. If you use again, you could lose custody.”)
“Lose custody…lose custody!”
Marie leaves the hospital, but the shame and fear stay with her. (“Irresponsible!”; “Bad mother!” ; “They’ll report you!”) Remembering how judged she felt, she avoids going to the doctor. And when she needs help managing her opioid use, the threat of losing her child prevents her from getting it.
But it doesn’t have to be this way. Health care providers must learn how colonialism and forced child separation have traumatized Indigenous communities, and eroded trust in healthcare. They must also learn how stigma keeps patients from getting the help they need. Our healthcare system must incorporate Indigenous culture provide better support for families and remove the threat of separation. Above all, patients must be treated with respect, dignity, and compassion.
To learn more about what you can do to combat stigma, visit subjectmatter.ca/circlesofcare.
