SNA (New York) — A government is beholden to its citizens. So why is the Japanese government killing those it is meant to protect?

In Japan, the stigma of drug use silences those suffering from substance use disorder. Anyone found to be using drugs is publicly shamed and shunned, as was the case with former celebrity actress Erika Sawajiri. After she was convicted of possessing MDMA and LSD, her career collapsed before she even appeared in court.

The country’s strict moral code dictates that those suffering from substance use disorder are bad people. Not only have they failed themselves and their families, they’ve also failed society. Such a stigma dehumanizes and it kills. Stigma steals away the compassion that those suffering so desperately need.

The Japanese government perpetuates the same stigma that has taken countless lives, that has broken families and that made those suffering from substance use disorder feel less than human. Overdose fatalities are grossly downplayed and under reported, and public policy is strictly punitive. Positive coverage for the issue is scarce, as the government keeps the media under its thumb through the press club system.

One could argue that this is a suppression of free speech. Stories about substance use disorder are rife with stigmatized, outdated language and fail to separate the illness from the individual.

All too often the health and wellbeing of people is overlooked. No one—the government least of all—wants to acknowledge that there even is a problem.

Most people would rather suffer in silence than risk tainting their reputations. There are no dinner table discussions; no open, loving conversations. Substance use disorder is a taboo topic. And that’s exactly the heart of the problem.

For now, Japan’s hidden drug problem will only get worse. As a third wave of Covid-19 threatens the island nation, overdose fatalities could increase as already scarce treatment options are removed. Because many hospital detox beds will be converted to Covid beds, those in immediate danger of overdosing are less likely to be admitted. Furthermore, in-patient drug rehabilitation facilities are losing more beds as well. New patients must be quarantined, so rehabs are losing square footage.

Twelve step abstinence-based programs such as Narcotics Anonymous host in-person meetings where those suffering from this chronic illness are given the tools to maintain their sobriety and are held accountable to their peers to implement them. Because of social distancing requirements, these meetings may be shut down, and this critical support network will be lost. Virtual meetings are much less effective, and an individual’s chances of maintaining sobriety are reduced exponentially.

Added job insecurity as a result of the pandemic, on top of Japan’s already brutal corporate culture, will also exacerbate the issue. Workers seeking stress relief in the form of drugs may turn to street drugs and stimulants laced with fentanyl, which is highly addictive and in many cases fatal.

Countries like Portugal have proven that de-stigmatization and decriminalization are the keys to successfully combating drug use. When it openly offered those suffering from substance use disorder resources and treatment options, it was able to reverse its prolific heroin epidemic. People were talking about the issue, and those suffering were treated as human beings with an illness rather than just “addicts.”

Fortunately, there are immediate short and long-term treatment options available for those suffering from substance use disorder.

Individuals can seek professional individual and group therapy and doctor-prescribed medication-assisted treatment with the comfort of knowing that doctor-patient confidentiality will shield them from stigma.

As a last resort, online twelve step abstinence-based programs provide a connection to people with similar struggles. They are a resource for those not yet ready to publicly ask for help.

For those who have the means, treatment is also available outside of Japan. Countries where substance use disorder has been partially or completely destigmatized, such as Portugal or the United States, have more hospital and in-patient rehab capacity and are able to offer more short-term and long-term support.

Almost all pathways to recovery are acceptable, so those seeking treatment have a variety of options.

Changing Japan’s attitude toward substance use disorder will take time, but it can’t happen without grassroots support. Japanese citizens, both in and out of recovery, need to appeal to politicians—preferably ones who have been personally affected by drug use. They must encourage politicians to change the language being used. They encourage politicians to have open, honest conversations about the damage stigma is causing in their society.

Any significant cultural change requires nothing short of a social movement, and removing the barriers of the stigma of substance use disorder is no different. A face and voice must be placed on the stigma, and the shame must be discussed because talking about it takes away its power.

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