Addiction – Stigma, Inequalities and Punishment
CHAD and the Faculty of Public Health hosted the first webinar of the series for this academic year (2022-23), which was focused on the inequitable pathways to addiction, treatment, and outcomes, alongside the punishment of addiction.
Over 120 delegates attended, representing local government, national government, third sector and academia.
We first heard from Rona Epstein, an honorary Doctor of Law at Coventry University. Rona explained how anti-social behaviour legislation is unjust and must be repealed. This was exemplified through presenting the case study of a young girl with mental health problems, Charlotte N, who had breached an Anti-Social Behaviour Injunction (ASBI). Charlotte had disturbed her neighbours, leaving the property to become neglected and verbally abused an employee of the housing trust. Rona explained that this behaviour was unacceptable, but not criminal. Yet Charlotte was taken from a psychiatric hospital to serve a 6-month prison sentence; an inappropriate and unhelpful outcome.
Rona then discussed her ongoing research, which covers 236 cases (to date) of contempt of court decisions between 2019-2022. Of the 236, 130 individuals, many of whom appeared to be particularly vulnerable, had received immediate imprisonments. Examples given included Michelle P who was sentenced for 7 months for drug addiction and anti-social behaviour, Martin G who was given 18 weeks for sleeping rough and possession of a crack pipe, and another individual sentenced to 1 year for severe addiction.
Collectively, these cases provided a stark illustration of the need to revise how the criminal justice system treats those with mental health and addiction problems who receive custodial sentences that are far more costly, and far less productive than treatment.
We then heard from Tony Mercer, a Consultant in Public Health.
Tony explained the link between socio-economic deprivation and the prevalence of addiction to alcohol and drugs, whereby addiction is far more prevalent among more deprived groups. Framed using the biopsychosocial model, Tony discussed a number of potential mediating factors that could explain why we observe this unequal distribution of addiction, e.g., trauma, adverse childhood experiences and access to economic resources.
Tony also outlined inequalities in treatment for drug addiction. He described the 12-step facilitation as “one of the closest things we have in public health to a free lunch”, but which is largely accessible to more affluent individuals, and not the majority of those who need it. Tony proposed that the 12-step facilitation or introduction to the 12-step mutual aid groups to overcome addiction, is a good place to start in addressing the inequalities in addiction.
The webinar ended with a range of questions and comments from delegates, which demonstrated the importance of, and interest in this public health area. The Centre for Health and Development and the Faculty of Public Health are hugely grateful to Rona and Tony for the insightful session and for sharing the webinar materials.
You can access the webinar recording and materials here: https://www.chadresearch.co.uk/webinar-addiction-stigma-inequities-and-punishment/
