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Substance Use Stigma: The Impact on Adolescent Substance Use

Picture of By: Dr. Gabrielle Jones
By: Dr. Gabrielle Jones
February 28, 2023

Substance Use Stigma: The Impact on Adolescent Substance Use

“Hello, my name is Gabrielle, and I am an addict”. This is the way people in recovery are generally introduced in recovery meetings. They say their name and declare their addiction to substances. This process over decades has created an identity. The statement, “I am an addict”, has become a point of pride for some, as it represents not only who they believe they are, but also an admission of their past transgressions and the idea that addiction is forever their identity. What many fail to realize, is this declaration of addiction has the capacity to ignore all other aspects of a person’s identity. Further, when considering adolescent development, societal norms carry a significant weight. Adolescents are grounded in their ethical values but are still discovering their social values. If an adolescent is attempting to abstain from substance use, yet the identity imposed on them by society is that they are an “addict”, how will they ever see themselves as anything other than…an “addict”? There are several efforts to de-stigmatize mental health, and recent studies have shown that Gen Z is very invested in mental wellness (Cuncic, A., 2021). However, substance use stigma falls far behind in these efforts. Language, drug type, and differences of opinion in conceptualization of substance use are three aspects of substance use stigma I will address in this blog.

1. Language stigma

As mentioned in the introduction of this blog, “addict” can be a term that many people in recovery take pride in. People who refer to themselves as “addict” with pride generally have participated in Alcoholics Anonymous (AA), or an affiliate Anonymous group. In several other cases though, this label elicits shame, guilt, or blame if used to describe someone else. In the general mental health discussion conversations, there is much encouragement to use person-first language, that is, refer to the person, then identify what behavior in which they engage. An example of this would be, “person with anxiety”. If this concept is used for addiction, the example would be “person with a substance use disorder”, or “person who uses substances”. This form of describing someone, particularly an adolescent who uses substances, helps remove the label of “addict” and opens the door for the teen who uses substances to understand that their substance use does not have to be who they are; it doesn’t have to define them. They have an opportunity to learn about what aspects of themselves they would like to focus on. Using personfirst language not only reduces substance use stigma, it also provides adolescents a chance to see themselves beyond their addiction or substance use.

2. Drug type stigma

Societal depictions of substance use range widely. There are the movies that depict people smoking marijuana as unintelligent and with lack of motivation, while movies with MDMA/ecstasy depict people who are in school and attend raves. Unfortunately, these depictions also have cultural associations. People depicted smoking marijuana are generally BIPOC individuals, and people taking MDMA/ecstasy are depicted as white college students. These depictions create stigma around what type of substance someone may be using by providing examples of the “type” of person who would use a specific substance. This is critical for adolescent substance use treatment because it creates a narrative for an adolescent that is much easier than trying to come up with an identity. There is a level of influence that social media and the entertainment industry have on societal trends. These influences may contribute to an adolescent leaning into a specific “type” of identity without even realizing it. Additionally, as adolescents are developing their identity, social acceptance from peers is important, so mimicking these depictions may be a way to “fit in” a certain desired social group. We can mitigate this by challenging the concept that some drugs are “ok” and provide a more balanced idea of substances. Step away from creating a hierarchy of “good” drugs and “bad” drugs. An example of this can be providing psychoeducation that all substances alter you as a person, and regardless of what the substance is, the behavior change is what we are trying to work through. This does not mean that all substances are the same, I am just encouraging us to think about the desired outcome, and that is to reduce and/or eliminate the substance use regardless of the substance.

3) Conceptualization stigma

This point is related to professionals who work with people who use substances. Some medical providers believe substance use is a moral issue. Others think it is completely behavioral. Many professionals have landed on the conceptualization of substance use as a “brain disease”. Since there are so many different schools of thought regarding substance use origins, treatment gets stalled. Some providers refuse to prescribe medications until an adolescent is no longer using substances. Others want an adolescent’s substance use to be eliminated before admitting them into a program for their depression. I leave you with a few questions to ponder: If a child came to a program for depression related to parental conflict, would you say “the parental conflict needs to be resolved before we can treat the child”? Or a child comes to treatment for self-harm behavior, and has depression, would you say “the depression needs to be resolved before we treat the self-harm”? The differences in conceptualization of substance use contribute to the variance in treatment approaches. Similar to point 3, let us shift to focusing on the desired outcomes and reduce the likelihood that conceptualization is prohibiting a teen from getting much needed treatment for their substance use.

To learn more about substance use stigma reduction, and culturally responsive substance use treatment, visit https://steadyllc.com/blog/

Reference

Cuncic, A. (2021, Mar 25) Why gen z is more open to talking about their mental health. Verywellmind. https://www.verywellmind.com/why-gen-z-is-more-open-to-talking-about-theirmental-health-5104730

Dr. Gabrielle Jones
Picture of Dr. Gabrielle Jones

Dr. Gabrielle Jones

Gabrielle Jones, Ph.D., is the founder of Steady Clinical Training, Consultation, and Development Services. She has over a decade of experience working with marginalized communities, specifically, adolescents labeled “at-risk”, people involved in the juvenile justice system and their families, and people who have substance use concerns or have been diagnosed with a substance use disorder. Dr. Jones has worked in direct care hospital settings, community mental health settings, primary school settings, and university settings as a faculty member. She provides training to non-profit organizations related to substance use and cultural responsiveness in the context of mental health treatment, and consultation to individuals working with populations listed above. Dr. Jones also carries a small caseload in which she provides individual therapy. In addition to Dr. Jones’s consultations and training, she serves as the Membership Board Chair for the American Psychological Association, and as a board member for The Miles Hall Foundation; an organization committed to creating an alternative to calling the police during a mental health crisis.

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Examples of What We Offer

Here are some specific examples of what partnership with us can look like. Every plan is customized — this is just a starting point.

PD Workshop Examples

Classroom wellbeing audit 

Classroom teachers assess their current wellbeing supports, identify specific strengths and gaps, and actively engage with research-based strategies to create an action plan for supporting student wellbeing in the classroom. This audit is more than a checklist—it’s a mirror that reflects how your everyday choices shape the mental health and wellbeing of everyone in your classroom. By pausing to rate, reflect, and plan, you will:

  1. Surface hidden stress points and strengths in your routines, environment, and relationships
  2. Connect concrete teaching practices (pacing, feedback, space design) to student and educator wellbeing
  3. Build shared language and data‐driven insights to guide micro‐interventions and systemic change
  4. Empower yourself and colleagues to co‐design evidence-based strategies that boost resilience, engagement, and trust
  5. Establish a continuous improvement cycle: audit → act → measure → refine

Specialized mental health skill-building workshops 

This goes beyond basic literacy to provide staff with practical skills and techniques for managing specific situations and promoting positive mental health within the school. 

Examples

  1. “De-escalation Strategies for School Staff.” A hands-on workshop teaching verbal and non-verbal techniques for safely de-escalating agitated or distressed students. 
  2. “Building Resilience and Coping Skills in the Classroom.” A training focused on equipping teachers with activities and strategies they can directly implement with students to foster resilience, teach coping mechanisms for stress, and promote emotional regulation. 
  3. “Creating Trauma-Informed Classrooms.” A workshop series exploring the impact of trauma on learning and behavior, and providing practical strategies for creating a safe, predictable, and supportive classroom environment that promotes healing and learning.
  4. “Mental Health & Wellbeing First Operational Mindset for Administrators”: When school leaders shift from a purely operational mindset to a mental‑health‑first mindset, the entire culture changes—students feel safer, staff feel supported, and families feel more connected. This workshop provides high‑impact, administrator‑friendly strategies. They’re concrete, actionable, and designed to fit into the real world of school leadership.

Adult SEL development 

Just as students benefit from developing social-emotional skills, so do adults. Adult SEL focuses on educators understanding their own emotions, managing impulses, setting goals, showing empathy, building healthy relationships, and making responsible decisions. 

Examples

  1. Interactive Workshops: Conduct workshops exploring each of the core SEL competencies (self-awareness, self-management, social awareness, relationship skills, responsible decision-making) through activities, group discussions, and reflection exercises.  
  2. SEL Integration Training: Train staff on how to weave SEL into their daily interactions, curriculum, and classroom management strategies. This includes explicit instruction on SEL concepts for students, creating opportunities for students to practice SEL skills, and integrating SEL into academic content.
  3. Emotion Regulation Strategies: Provide specific training on recognizing and managing challenging emotions in the workplace, including strategies for de-escalation and maintaining composure during stressful situations.

Integration of mental health into curriculum 

Embedding mental health education within the regular curriculum normalizes these topics, reduces stigma, and equips all students with foundational knowledge and skills related to their emotional well-being. Rogers’ understanding of key mental health concepts can inform curriculum development.

Examples

  1. Developing SEL Lessons with Mental Health Components: Collaborate with teachers to integrate lessons on topics like emotional regulation, empathy, and conflict resolution into existing Social-Emotional Learning (SEL) curricula, drawing on Rogers’ therapeutic approaches.
  2. Incorporating Mental Health Themes into English Language Arts: Suggest age-appropriate literature that explores themes of mental health, resilience, and seeking help, and provide teachers with discussion guides developed with input from mental health professionals.
  3. Creating Interactive Activities for Health Class: Develop engaging activities and projects for health classes that teach students about common mental health conditions, coping strategies, and how to access support.

PD Training Examples

Mental health literacy training 

This partnership focuses on equipping school staff with a foundational understanding of mental health concepts, common disorders in children and adolescents, and the importance of early identification and intervention.

Examples

  1. Elementary School Workshop: “Understanding Childhood Anxiety.” Topics could include:
    1. Different types of anxiety in elementary-aged children (separation anxiety, social anxiety, generalized anxiety).
    2. Observable signs and symptoms in the classroom (e.g., avoidance behaviors, physical complaints, difficulty concentrating).
    3. Strategies teachers can use to create a more supportive and less anxiety-provoking classroom environment (e.g., predictable routines, clear expectations, calming techniques).
  2. High School Professional Development Day: “Recognizing and Responding to Teen Depression and Suicidal Ideation.” Topics could include:
    1. Distinguishing between typical adolescent moodiness and signs of depression.
    2. Understanding risk factors and warning signs for suicide.
    3. Evidence-based strategies for talking to students who may be struggling.
    4. School protocols for reporting concerns and accessing support services.
  3. Customized Training for Special Education Staff: “Mental Health Considerations for Students with Learning Differences.” A tailored workshop addressing the unique mental health challenges that students with IEPs may face and strategies for integrating mental health support into their educational plans.

Trauma-Informed practices 

Trauma-informed practice recognizes the widespread impact of trauma and understands potential paths for recovery. In a school setting, this means understanding that students (and staff) may have experienced trauma and that these experiences can affect behavior, relationships, and learning. Training helps staff recognize the signs of trauma, respond in a way that avoids re-traumatization, and create a safe and supportive environment. It also includes understanding secondary trauma or compassion fatigue that educators may experience when working with individuals who have experienced trauma.

Examples

  1. Introductory Workshop: A foundational training on the prevalence and impact of trauma, the principles of trauma-informed care (safety, trustworthiness, peer support, collaboration, empowerment, cultural humility), and recognizing signs of trauma in students and colleagues.
  2. Skill-Building Sessions: Workshops focused on specific trauma-informed strategies, such as creating predictable routines, using de-escalation techniques, fostering a sense of safety and control, and promoting student voice and choice.
  3. Addressing Secondary Trauma: Training specifically addressing the impact of working with traumatized individuals on the helper, providing strategies for self-care and seeking support to prevent compassion fatigue and burnout.

Educator Resilience-Building Workshop Examples

Mindfulness and stress reduction workshops for staff 

Mindfulness involves paying attention to the present moment without judgment. Stress reduction techniques are practical strategies designed to lower physiological and psychological responses to stress. Training in these areas equips educators with tools to manage the inherent demands and pressures of their job, cultivate a sense of calm, and increase their capacity to be present and responsive.

Examples

  1. Workshop Series: A series of workshops (30-60 minutes each) delivered after school or during professional development time. 
  2. Short, Practical Sessions: Offer 15-minute guided mindfulness or breathing exercises before staff meetings or during designated breaks.
  3. Online Modules: Provide access to self-paced online modules on stress management and mindfulness techniques.

Building resilience (CLE)

Resilience is the ability to adapt well in the face of adversity, trauma, tragedy, threats, or significant sources of stress. Training in resilience helps educators identify their strengths, develop positive coping mechanisms, cultivate optimism, and build strong support networks. 

Examples

  1. Interactive Workshops: Sessions exploring the key components of resilience (e.g., self-awareness, self-regulation, optimism, connection, purpose). Activities could include identifying personal strengths, developing positive self-talk strategies, and practicing problem-solving skills.
  2. Goal Setting and Action Planning: Training on setting realistic goals and developing action plans to navigate challenges and achieve a sense of accomplishment.
  3. Building Support Networks: Facilitating discussions and activities that encourage staff to build strong relationships with colleagues and identify external sources of support.

Enhancing school climate – for the staff

School climate refers to the quality and character of school life. A positive school climate for staff is characterized by trust, respect, collegiality, collaboration, and a sense of belonging. Consultation focuses on identifying areas for improvement and implementing strategies to foster a more supportive and positive environment.

Examples

  1. Team-Building Activities: Recommending and facilitating team-building activities that promote positive relationships and a sense of community among staff.
  2. Recognition and Appreciation Programs: Consulting on developing formal or informal programs to recognize and appreciate staff contributions and efforts.
  3. Creating Opportunities for Social Connection: Advising on creating spaces and opportunities for informal social interaction among staff.

Systemic Examples

Needs assessment and strategic planning (CLE)

A systematic process of gathering information about the current state of staff wellbeing within the school, identifying key stressors, and understanding the needs and preferences of the staff. This data then informs the development of a targeted and effective plan for implementing wellbeing initiatives.

Examples

  1. Administering Surveys: Using anonymous surveys to gather data on staff stress levels, workload perceptions, access to resources, and interest in different types of wellbeing support.
  2. Conducting Focus Groups: Facilitating small group discussions with staff from different roles (teachers, administrators, support staff) to gain deeper qualitative insights into their experiences and needs.
  3. Reviewing Existing Data: Analyzing existing school data such as attendance records (staff absences), staff turnover rates, and incident reports (if relevant to stress/conflict).
  4. Collaborative Goal Setting: Working with the school leadership team and wellbeing committee to set specific, measurable, achievable, relevant, and time-bound (SMART) goals for improving staff wellbeing.

Developing supportive policies and practices 

Examining existing school policies, procedures, and unwritten norms to identify those that may contribute to staff stress or hinder wellbeing. Consulting on modifications or new policies that actively promote a healthy work environment.

Examples

  1. Communication Protocols: Advising on establishing clear and efficient communication protocols to reduce ambiguity and information overload.
  2. Meeting Structures: Consulting on making meetings more efficient and purposeful, perhaps by designating some meetings specifically for collaboration or wellbeing check-ins rather than just information dissemination.
  3. Establishing Boundaries: Providing guidance on establishing and respecting professional boundaries regarding work emails and communication outside of school hours.

Consultation on school mental health systems 

This involves leveraging Rogers’ understanding of best practices in mental health care to advise schools on the development and implementation of comprehensive systems that support student and staff well-being.

Examples

  1. Developing a School-Wide Mental Health Protocol: Consulting with a school district to create a clear and consistent protocol for identifying students in need of mental health support, conducting initial assessments, making referrals, and collaborating with external providers (including Rogers, if appropriate).
  2. Implementing a Multi-Tiered System of Supports (MTSS) for Mental Health: Advising a school on integrating mental health supports within their existing MTSS framework, ensuring that all students receive appropriate levels of support based on their needs.
  3. Conducting a Mental Health Needs Assessment: Partnering with a school to administer surveys and conduct focus groups with students, staff, and parents to identify key mental health needs and inform the development of targeted interventions and supports.

Integrating wellbeing into existing structures 

Embedding wellbeing initiatives within the school’s existing operational framework rather than treating them as separate, add-on programs. This ensures long-term sustainability and demonstrates that wellbeing is a priority.

Examples

  1. Professional Development Alignment: Integrating wellbeing topics into regular professional development days or staff training sessions.
  2. Staff Meeting Agendas: Including a dedicated agenda item for staff wellbeing check-ins or sharing wellbeing tips during weekly staff meetings.
  3. School Improvement Plans: Incorporating goals related to staff wellbeing into the school’s overall improvement plan.

 

Coaching Examples

Leadership coaching

Coaching specifically designed for school administrators and team leaders. This focuses on developing their leadership skills related to supporting staff wellbeing, creating a positive team culture, and effectively managing workplace dynamics that can impact stress levels.

Examples

  1. Promoting Work-Life Balance: Coaching leaders on modeling healthy work-life boundaries and encouraging their staff to do the same.
  2. Building Team Cohesion: Working with leaders on strategies to foster a sense of teamwork, trust, and psychological safety within their teams.
  3. Mentor Coaching for New School Administrators on Fostering a Positive School Climate: Pairing experienced administrators with new leaders and providing coaching focused on creating a supportive and mentally healthy environment for both students and staff.

Individual wellbeing coaching

A confidential and supportive partnership between a trained coach and an individual staff member. The coach helps the staff member identify their wellbeing goals, explore challenges, develop strategies, and build self-awareness and resilience. This is particularly helpful for staff experiencing high levels of stress, burnout, or those seeking to proactively enhance their wellbeing.

Examples

  1. Goal Setting Sessions: Initial coaching sessions focused on helping the staff member clarify their wellbeing goals (e.g., reducing stress, improving work-life balance, developing better coping skills).
  2. Strategy Development: Working with the staff member to identify and practice specific strategies for managing stressors and improving wellbeing (e.g., time management techniques, communication skills, boundary setting).
  3. Reflection and Problem-Solving: Providing a space for the staff member to reflect on their experiences, process challenges, and problem-solve difficult situations.

Instructional coaching with a wellbeing lens 

Integrating conversations and support around wellbeing into existing instructional coaching cycles. This recognizes that teacher wellbeing is intertwined with their classroom practice and provides a holistic approach to support.

Examples

  1. Managing Classroom Stressors: Coaches can work with teachers to develop strategies for managing challenging student behaviors, reducing classroom disruptions, and creating a more calm and predictable learning environment.
  2. Building Positive Student Relationships: Coaching on techniques for building strong, positive relationships with students, which can be a source of both joy and stress for teachers.
  3. Workload Management within Instruction: Helping teachers prioritize tasks related to planning, grading, and differentiation in a way that feels manageable.
  4. Reflecting on Emotional Responses: Coaching teachers to reflect on their emotional responses to classroom situations and develop strategies for managing those emotions constructively.

Peer coaching programs 

Training selected staff members to serve as peer coaches for their colleagues. This leverages internal expertise and fosters a culture of mutual support within the school. Peer coaches can provide a confidential and relatable source of support, sharing strategies and offering encouragement.

Examples

  1. Coach Training: Training peer coaches in basic coaching skills, active listening, confidentiality, and boundary setting.
  2. Structured Check-ins: Establishing a structure for peer coaching interactions, such as regular informal check-ins or more formal scheduled conversations.
  3. Providing Resources: Peer coaches can share relevant wellbeing resources with their colleagues.