Addiction wears many faces: alcohol, drugs, gambling, sex, and countless other compulsions impact health, unravel relationships, and erode a sense of self. Even as neuroscience reveals addiction as a brain disease, it continues to be one of the most misunderstood and heavily stigmatised health challenges worldwide.
At its heart, this stigma is rooted in years-old prejudice and judgement.
The stigmatisation of addiction goes back centuries. Historically, addiction has been painted as a moral flaw or a lack of willpower, an entrenched view that overshadows the intricate web of brain chemistry, human vulnerability, life experience and environment that truly drives it. This narrow perspective causes intense harm, shaping how society thinks and even steering public policy. Most damaging of all, it prevents people from reaching out for the help they desperately need.
Stigma is not only external. It is also based on internalised beliefs. We judge others according to these beliefs. In the case of addiction, the person affected is often seen as responsible for their behaviour. This makes addiction appear to be a matter of choice. When someone does not change, they are blamed and seen as weak or morally bad.
The same beliefs can be applied to oneself. Over time, they become internalised as self-stigma. As self-stigma grows, shame, secrecy, and fear of exposure can affect a person as deeply as the addiction itself.
Not all addictions are viewed equally
Some addictions are tolerated in society more than others, even when the pain they cause is the same.
Take alcohol dependence as an example. In many workplaces and social circles, heavy drinking is sanctioned or even celebrated. Substance use, on the other hand, is more often linked to crime and moral delinquency. Behavioural addictions sit somewhere in the middle, generating acceptance or blame, depending on the consequences and circumstances.
Gambling addiction sometimes draws sympathy when seen as a mental health struggle (although the sympathy fades when the debts pile up). Food addiction is generally viewed as a weakness of willpower, while sex addiction is shrouded in misunderstanding and often dismissed as a convenient excuse for a promiscuous lifestyle.
Whatever the type of addiction, the underlying causes are often very similar. Understanding depends largely on how willing people are to question their beliefs and respond with empathy.
Stigmatising attitudes: room for rent study
A research study in Germany by Angermeyer and Matschinger examined the stigmatising attitudes concerning mental illness.[1] In a representative survey, respondents were asked if they had a room to rent, would they let it to a person with a mental illness? Several specific mental health conditions were presented, including alcoholism.
Results revealed the following:
- 29.9% said they wouldn’t rent a room to a person with panic disorder
- 33.5% wouldn’t rent a room to a person with narcissistic personality disorder
- 34.4% wouldn’t rent a room to someone with MDD (major depressive disorder):
- 54.7% wouldn’t rent a room to someone suffering from schizophrenia
- 62.9% wouldn’t rent a room to a person with alcohol problems
These numbers illustrate just how deeply negative stereotypes shape our views of mental health and, especially, addiction. In this scenario, people struggling with alcohol problems faced the harshest rejection.
Addiction, responsibility and the myth of choice
A stubborn story persists that addiction is just a string of conscious but bad choices. It ignores the complex reality of how addiction actually takes hold.
As Oliver Neubert, Founder and Chairman of NEOVIVA, understands from his own experience of addiction and from observing others during his thirty-eight years in recovery, most addictions begin with experimentation and an experienced benefit. The substance or the behaviour provides something desirable for the individual.
People usually begin regularly taking drugs or drinking alcohol for a reason, he explains. It might be to find relief from anxiety, to create emotional numbness, improve performance, escape from pressure, or succumb to peer pressure. Sometimes, it is simply out of curiosity and a desire for pleasure. It might even be that people engage with drugs or alcohol simply because that is what people do. To have a drink at a cocktail party may not be preceded by the conscious decision to consume a mind- and mood-altering substance but the drink is taken simply because “that’s what you do in this setting”.
Regardless of the reasons or motivations for its use, our brain will react to the substance. With regular use, over time, the brain’s reward system adapts. The tolerance for the substance increases, and as people slide further towards addiction, their control diminishes, and they begin to experience negative consequences. Initially, the negative consequence may simply manifest as a hangover, but can escalate to more severe issues such as memory loss (blackout), social problems, legal issues (DUI), serious medical issues, etc. If the behaviour is repeated, we may see a pattern of using that continues despite increasing negative consequences. Not everyone who tries a drug or drinks alcohol becomes addicted, but for some, the progression to addiction happens very quickly. Even the first use can trigger changes in the brain’s reward circuit. Genetic predisposition also plays a role. The same activation applies to behaviours like gambling, sex, or shopping.
Once addiction rewires the brain’s chemistry and dopamine system, free choice becomes a fallacy. Addiction doesn’t develop due to moral weakness, but rather as the result of a complex web involving neurobiology, coping mechanisms, and, more often than not, hidden wounds that caused the need for relief from suffering by using drugs or alcohol in the first place. Drugs and alcohol will do that; they alleviate distress instantly.
Self-stigma: the silent barrier
Societal stigma is damaging enough, but self-stigma is just as devastating. In many ways, Neubert sees self-stigmatisation as the biggest problem of all. When people absorb public judgement, it quickly turns into a harsh inner critic. After all, they themselves are the ones taking the substance; nobody is making them do it. So they feel they should be able to control it. This belief can push a person struggling with addiction to see themselves as broken, weak, or beyond hope, with such self-stigmatisation further fuelling the isolation and secrecy.
Research consistently shows that addiction has one of the lowest rates of treatment engagement across all mental health conditions. Many people live for decades without ever asking for support. The statistics don’t lie.
- For schizophrenia, 80-90% of people access treatment over their lifetime
- For depression, it’s 40-50%
- For anxiety, 30-40%
- But for alcohol addiction, just 8-10% seek help and receive treatment
So, what are the barriers? Treatment pathways clearly need improvement, but we can’t ignore the fact that the effect of stigma is significant in preventing people from seeking help. External stigma and subsequent self-stigma warp reality. The result? People feel deep shame for their behaviour, downplay their struggles and avoid asking for help. Yet, reaching out early almost always leads to better outcomes.
Stigma within healthcare
Unfortunately, stigma about addiction still persists within ordinary healthcare. So, even when people do try to seek the help they need, they’re often not met with understanding. When those with alcoholism or substance use disorders disclose their struggles in a clinical health setting, they often face judgement, openly or hidden, from the very professionals who are supposed to help. Outdated models, negative assumptions, and gaps in training still shape the care pathways and the help patients receive.
This can lead to poor diagnosis, not just of addiction, but of other co-existing health conditions. When individuals feel they are being judged, they are less likely to disclose symptoms or behaviour honestly, and they often under-report their substance use. And even when treatment is offered, it can become something to endure, rather than a collaborative process towards positive change, especially if the trust isn’t there.
For recovery to be effective, trust and compassion must guide clinical expertise.
Wealth, success and hidden addiction
The stereotype of addiction is familiar: visible decline, public consequences, loss of control. People who suffer addiction are homeless, unemployed, dropouts, or criminals, aren’t they?
Of course, this isn’t true.
In fact, in many wealthy, high-achieving circles, a plethora of addiction hides in plain sight. Money shields reputations and enables people to keep up appearances. Unfortunately, this can make the judgement feel even heavier. When people fear losing their status or credibility, they are even less likely to admit they have a problem and open up.
Entrepreneurs, executives and high achievers face unique risk factors. There is relentless pressure, isolation, identity tied to performance, and limited psychological safety. As Oliver Neubert often points out, economic success does not shield against addiction; more often than not, it speeds it up. An addiction can become deeply rooted when substances or behaviours become coping tools, so it is especially prevalent in high-pressure business environments.
Within wealthy circles, stigma grows stronger because of the belief that someone in their position should always be able to cope. They are the leaders and the problem solvers, after all. Accepting help may feel especially difficult if you’re always the person others turn to for support and advice. Additionally, when negative consequences are absent, and others are reluctant to intervene, reaching out becomes even more difficult, leaving those in need of help isolated.
Gender roles and addiction
Stigma is intertwined with gender. Women with addictions, especially mothers, are judged more harshly. Their struggles are seen as betrayals of care and responsibility. Their judgement is moral; they may be called “fallen women”. Whereas men with addiction, while also not immune to judgement, are judged from a performative view. Their behaviours are often excused as being due to stress or pressure. And the old idea of “work hard, play hard” is still very much present. If they are fathers, they may be seen as weak providers. A judgement about performance rather than morals.
This influences who seeks help and when. Women are more likely to refrain from seeking help as they fear repercussions, such as losing custody of their children. It’s also true that men may avoid seeking support to protect an image of strength, but, in general, men are applauded for their bravery when they admit they have a problem, something that is less common for women.
And even when women do access treatment, the model of care often falls short in terms of distinctive needs. That’s why NEOVIVA has a specially designed programme for women to address the unique challenges faced in addiction and recovery.
Moving beyond stigma
Reducing stigma demands a significant shift in how we think and talk about addiction. Words matter when challenging stigma-based views. In addition, we must hear more from people with lived experience to better understand the challenges they face.
NEOVIVA’s Chairman, Oliver Neubert, is himself in recovery. His team of addiction experts also includes recovery counsellors with lived experience. Many of NEOVIVA’s clients report that having people beside them during treatment who have walked the same path is invaluable.
Blaming someone for their addiction forces them deeper into isolation. To change this, we must approach addiction with curiosity, respect, understanding, and genuine care. The conversation needs to be more open about antiquated treatment models. To focus on detoxing without addressing the root cause makes relapse more likely.
Oliver Neubert emphasises that recovery can only begin when people feel safe enough to speak about their struggles and feel supported to explore where these struggles originate.
The need to feel safe cannot be emphasised enough, and the cost of doing nothing is too high. Untreated addiction leads to poor health outcomes and broken relationships. It doesn’t just affect individuals, but also families, communities and wider society. In business, the cost of lost productivity and creativity is huge. As an example, according to Public Health England, the economic consequences of alcohol problems in the UK are estimated to be up to 2.7% of GDP! That’s a staggering loss.
In conclusion, we must continue to challenge stigma and talk about addiction as a treatable illness. When we treat addiction, recovery becomes a possibility.
Seeking help at NEOVIVA
The first step is often the hardest. We know that reaching out for help usually happens at a moment of crisis. When you contact NEOVIVA, you will find complete confidentiality, compassion and genuine understanding. We are here for you. Book a free consultation today and begin your journey to recovery.
[1] Angermeyer MC, Matschinger H. Causal beliefs and attitudes to people with schizophrenia: Trend analysis based on data from two population surveys in Germany. British Journal of Psychiatry. 2005;186(4):331-334. doi:10.1192/bjp.186.4.331
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