Stigma, Substance Use, and the Struggle to Access Rehab

17 Oct

Phoenix Futures provide a wide range of harm reduction, treatment and advocacy services. We have a keen interest, and long history, in addressing stigma and on behalf of the Anti-Stigma Network we seek to broader anti-stigma movement. In this blog we look at stigma experience by people seeking to access Phoenix's residential treatment service. These findings are derived from a recent survey of our resident's experiences.

We know that despite growing awareness of addiction as a health issue, stigma remains one of the most persistent and damaging barriers to recovery. The Footprints Residential Survey 2025 from Phoenix Futures reveals just how deeply stigma and discrimination continue to shape the experiences of people seeking help for substance use.

Stigma Is Widespread—and It Hurts

In 2025, 75% of residents reported being occasionally or frequently discriminated against due to their substance use. This isn’t just a social inconvenience—it’s a structural barrier. 31% of respondents identified stigma as a direct obstacle to accessing residential treatment pathways.

The survey highlights that health professionals were frequently cited as sources of discrimination. The reasons for this are complex and it's important not to identity easy targets for blame but this finding is troubling, as it suggests that stigma is not confined to public attitudes but is embedded in the very systems meant to support recovery.

Substance Type Matters

Experiences of stigma vary significantly depending on the substance used:

100% of residents who reported crack cocaine as their primary substance experienced discrimination.
In contrast, 65% of alcohol users reported experiencing stigma.

This disparity suggests that societal perceptions of certain substances—particularly those associated with poverty, crime, or visible distress—continue to influence how people are treated, both socially and institutionally.

Gender Differences in Discrimination

Gender also plays a role in how stigma is experienced:

79% of women reported experiencing discrimination.
71% of men reported the same.

Women, particularly those with childcare responsibilities, may face unique forms of stigma—often compounded by societal expectations around motherhood, responsibility, and shame.

Where Is Discrimination Happening?

The survey identifies several key spaces where discrimination is most commonly felt:

Public and societal settings (e.g. community and social interactions)
Healthcare environments, including hospitals and GP practices
Access processes for treatment and support services

These are not fringe experiences — prior to accessing treatment discrimination has been normal for many residents.

The Impact on Access to Treatment

Stigma doesn’t just affect self-esteem—it affects outcomes. When people feel judged, dismissed, or devalued, they are less likely to seek help, persist in treatment, or believe in their ability to recover.

The survey shows that 48% of residents found access to rehab either neutral or difficult, with funding and stigma consistently cited as barriers across the last three survey cycles (2013, 2020, and 2025). in 2025 only 8% said it was an easy process.

Access to rehab has in reality become much more difficult in England over the last decade with more than half of rehabs closing and significant parts of England now without access to rehab.

It's important to note that these survey results are responses from people who managed to negotiate pathway to access. For the many people who were excluded we may see even more reported experiences of discrimination.

Reframing Addiction as a Health Issue

Encouragingly, the survey also shows a shift in how residents view their recovery: mental health is now the most commonly cited motivation for change (88%). This reframing—from a traditional stigmatised view of addiction as a moral failing to a more accurate framing as a health challenge—is essential.

But for this shift to be meaningful, it must be reflected in how wider public services, especially healthcare services are designed, funded, and delivered. Reducing stigma isn’t just about changing minds—it’s about changing systems.

What Needs to Change?

Training for health professionals to reduce unconscious bias <add link to training>
Policy reform to ensure equitable access regardless of gender and substance type.
Fair access to rehab - an end to the postcode lottery
Public education to challenge stereotypes and promote empathy.
Trauma-informed care models that recognise the complex roots of substance use.

Stigma is not just a personal burden—it’s a public health issue. If we want to build a recovery system that works, we must start by dismantling the barriers that keep people out.