stigmatizing any disease keeps some afflicted individuals from getting help for themselves and often prevents family, friends, and employers from knowledging the existence of a problem and urging a loved one or colleague to seek treatment.

The stereotype that drug abusers could change their behavior if they were sufficiently motivated is inconsistent with understanding the complex multiple factors involved in addiction. When policymakers view drug abusers as untreatable or undeserving of public support, treatment programs, insurance coverage, and research and training programs may be underfunded or abolished.

Undervalued Area of Research

The stigma associated with drug addiction has directly deterred young investigators who might otherwise be interested in pursuing careers in addiction research and treatment. Their frustration was expressed forcefully and consistently at the March 1996 workshop. For example, one of the new investigators in attendance said, "The biggest problem specific to drug abuse is one of public perceptions. Many times in my career, I have been asked by people outside science, 'Why are you studying drug abuse? Why don't you study something important like cancer?'"

In addition to the discouraging words of friends, families, and colleagues, addiction researchers described concrete reminders of the low status of their field. One new investigator described the "rusting trailer" where their research offices were located; another described how addicted patients were relegated to outbuildings because they were considered undesirable and not wanted in the main medical facility.

As a result of stigma, the realities of studying often difficult and sometimes frightening patients, and the lack of public funding and support, addiction research is often an undervalued area of inquiry with low visibility, and many scientists and clinicians choose other disciplines in which to develop their careers (IOM, 1995). In addition, many believe the field suffers from a lack of prestige stemming from what is seen as a lower quality of some of the research. These perceptions stem from several factors, including a lack of understanding about the complexities arising from multiple determinants of addiction, the difficulties involved in conducting clinical and behavioral research in this field, and other research issues, such as the regulation of drugs and confidentiality requirements (IOM, 1995, 1996). Investigators in drug abuse research are often paid less than their peers in other fields (IOM, 1995).



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