The Vicious Cycle of Substance Use Disorder, Promiscuity and Shame

Shame Versus Guilt

Shame is defined by the Cambridge Dictionary as “an uncomfortable feeling of guilt”[1]. It is a universal emotion which has been felt, in varying degrees, by everyone on the planet. Guilt, shame and Substance Abuse are all interlinked. Shame has been shown to impact negatively on recovery[2] and has been linked to relapse[3]. For some people, the stigma of being diagnosed with a Substance Use Disorder elicits shame[4]. This article will examine the link between Substance Use Disorder (SUD) and shame, with a focus on promiscuity.

While “guilt” and “shame” are related and used interchangeably by many outside of the profession, psychologists draw a distinction between the two terms. Miceli and Castelfranchi state that shame is concerned with “a perceived discrepancy between one’s actual and one’s ideal self,” whereas guilt is related to “one’s responsibility for a harmful attitude or behavior[5].” Shame is about one’s personhood, whereas guilt pertains to one’s behaviors. If a person steals from a shop, they may feel guilty about the specific action but may not feel like an intrinsically bad person. Shame, on the other hand, is the feeling that the person is generally bad. Shame has also been linked to a lack of conformity to the norms and values of the society one inhabits; an individual feels shame when they break these rules[6].

Public Shaming

Public shaming for breaking these values has also been the norm since the middle ages, when perceived offenders were put in stocks and publicly humiliated. Although modern shaming may not be as overt, it is still present and still has an impact on individuals in society.

Promiscuity, which is the practice of having multiple sexual relationships, is one of these perceived offenses which has been persecuted since the days of ancient Rome[7]. Drug use can be linked to promiscuity as it can lower inhibitions and increase sexual desire[8], and substance abusers are also more likely to resort to sex work[9] and engage in high-risk behaviors[10], such as sharing needles and having unprotected sex. These carry with them the risks of sexually transmitted infections such as HIV or herpes, which in turn carry their own stigma.

Whether or not substance abuse is a disease has been debated by many a researcher. However, it is widely accepted that Substance Use Disorder alters the brain’s neurological make-up, particularly the dopamine system. Dopamine is our “feel good chemical,” and it has been shown that substance abuse can disrupt this system, leading to increased impulsivity[11].

This often leads to compulsive behaviors in which the individual is not totally in control  due to a power of diminished choice. Promiscuity has been shown to be a side effect of drug addiction, so why does society shame a behavior which is merely a symptom of a wider illness? We would not chastise a cancer sufferer for having low energy or a person with schizophrenia for hearing voices, so why do we feel entitled to pass these moral judgments?

Often arbitrary social values play a lead role in both shame and guilt. Since the 1860s, when religious campaigners lobbied to have opium made illegal due to its being “sinful,” Substance Use Disorder has been treated as a moral failing rather than a disease[12]. This was compounded by Reagan’s “War on Drugs,” in which drug users were portrayed as degenerate criminals and recommended for long jail sentences. Promiscuity has an even longer history of persecution; it is also portrayed as sinful in several of the main religious texts. However, it is important to note that this standard society viewpoint seems to unfairly target women and people who do not identify as heterosexual, who are looked down on for being “loose” or “perverted” and met with derogatory terms, while heterosexual men are held in high regard for having multiple sexual partners.

Internalized Shame and its Effects on Promiscuity

With our modern understanding of substance use and recognition of the increased needs for women’s rights, why do we allow these values to persist in modern society? Substance abuse is linked to trauma[13], so shaming individuals for their condition and associated behaviors is counterproductive, especially since shame is a key indicator for relapse[14].

Sex itself can also be used as a maladaptive coping mechanism, can be addictive in its own right[15], and can further traumatize individuals. For example, if a 20-year-old  is addicted to heroin and has no money, they are desperate and may be facing life-threatening withdrawal symptoms. (NOTE: I think you could argue that they are raped since they’re not in a frame of mind to consent). In this impaired state, they might encounter a predatory drug dealer who forces them to have sex in exchange for drugs.  This ensuing sexual assault, or rape, is a deeply traumatic event, which the victim often perceives as their fault and as going against their morals and values, and which leaves them feeling shame and self-loathing. This, in turn, yields further self-destructive behaviors.

Transcending Shame and Guilt

Short of a massive societal change, which is possible though takes time, how can the individual suffering Substance Use Disorder break this cycle of shame and addiction? Self-forgiveness and self-compassion, be it through a 12-step program or via counseling, have been shown to mediate guilt and shame, which in turn reduces the risk of relapse[16]. Recognizing that shame can also be a symptom of addiction can be helpful to some individuals, as can harnessing shame through creative arts[17].

Another crucial step that could be taken to help de-stigmatize addiction and its side-effects would be to increase and modify drug education, both in schools and society as a whole. We need to shift away from shame and scare tactics toward a calm approach that emphasizes compassion, hope, and reintegration into society without stigma. Onus does not need to be solely on the schools to teach this, parents could also do this by showing their kids that drugs are bad without extending this to “drug users are bad people to be avoided.”

As destructive as shame can be, it does not have to be a defining factor in a person’s life. Recovery from addiction is possible, and it is possible to re-understand shame and to learn to forgive oneself. Self-forgiveness increases with time spent away from the triggering behavior, meaning that as an individual’s length of time in recovery increases, shame should diminish accordingly[18].

For more information on treatment, contact Heather R. Hayes & Associates – call 800-335-0316 or email today.


[1] “SHAME | Meaning in The Cambridge English Dictionary”. Dictionary.Cambridge. Org, 2020,

[2] Wiechelt, Shelly A., and Esther Sales. “The Role Of Shame In Women’s Recovery From Alcoholism”. Journal Of Social Work Practice In The Addictions, vol 1, no. 4, 2001, pp. 101-116. Informa UK Limited, doi:10.1300/j160v01n04_07. Accessed 27 July 2020.

[3] Brown, Harry M. “Shame And Relapse Issues With The Chemically Dependent Client”. Alcoholism Treatment Quarterly, vol 8, no. 3, 1991, pp. 77-82. Informa UK Limited, doi:10.1300/j020v08n03_07. Accessed 27 July 2020.

[4] Flanagan, Owen. “The Shame Of Addiction”. Frontiers In Psychiatry, vol 4, 2013. Frontiers Media SA, doi:10.3389/fpsyt.2013.00120. Accessed 27 July 2020.

[5] Miceli, Maria, and Cristiano Castelfranchi. “Reconsidering The Differences Between Shame And Guilt”. Europe’S Journal Of Psychology, vol 14, no. 3, 2018, pp. 710-733. Leibniz-Institute For Psychology Information (ZPID), doi:10.5964/ejop.v14i3.1564. Accessed 27 July 2020.

[6] Nir, Bina. “The Individual And Society: The Social Role Of Shame”. Journal Of Philosophical Criticism, vol 1, 2018, p. 1. Https://Philpapers.Org/Rec/NIRTIA-2, doi:10.17605/OSF.IO/JF32V. Accessed 27 July 2020.

[7] Webb, Lewis Mark. “Shame Transfigured: Slut-Shaming From Rome To Cyberspace”. First Monday, 2015. University Of Illinois Libraries, doi:10.5210/fm.v20i4.5464. Accessed 27 July 2020.

[8] Rhodes, Tim, and Gerry V. Stimson. “What Is The Relationship Between Drug Taking And Sexual Risk? Social Relations And Social Research.”. Sociology Of Health And Illness, vol 16, no. 2, 1994, pp. 209-228. Wiley, doi:10.1111/1467-9566.ep11347330.

[9] Pandiyan, Kasthuri et al. “Psychological Morbidity Among Female Commercial Sex Workers With Alcohol And Drug Abuse”. Indian Journal Of Psychiatry, vol 54, no. 4, 2012, p. 349. Medknow, doi:10.4103/0019-5545.104822. Accessed 27 July 2020.

[10] Calsyn, Donald A. et al. “Sex Under The Influence Of Drugs Or Alcohol: Common For Men In Substance Abuse Treatment And Associated With High-Risk Sexual Behavior”. The American Journal On Addictions, vol 19, no. 2, 2010, pp. 119-127. Wiley, doi:10.1111/j.1521-0391.2009.00022.x. Accessed 27 July 2020.

[11] Volkow, N. D. et al. “Addiction: Beyond Dopamine Reward Circuitry”. Proceedings Of The National Academy Of Sciences, vol 108, no. 37, 2011, pp. 15037-15042. Proceedings Of The National Academy Of Sciences, doi:10.1073/pnas.1010654108. Accessed 14 July 2020.

[12] Harding, Geoffrey. “Constructing Addiction As A Moral Failing.”. Sociology Of Health And Illness, vol 8, no. 1, 1986, pp. 75-85. Wiley, doi:10.1111/1467-9566.ep11346491.

[13] VOLPICELLI, JOSEPH R. “Uncontrollable Events And Alcohol Drinking”. Addiction, vol 82, no. 4, 1987, pp. 381-392. Wiley, doi:10.1111/j.1360-0443.1987.tb01494.x.

[14] Randles, Daniel, and Jessica L. Tracy. “Nonverbal Displays Of Shame Predict Relapse And Declining Health In Recovering Alcoholics”. Clinical Psychological Science, vol 1, no. 2, 2013, pp. 149-155. SAGE Publications, doi:10.1177/2167702612470645. Accessed 27 July 2020.

[15] Carnes, Patrick, and Kenneth M Adams. Clinical Management Of Sex Addiction. Brunner-Routledge, 2002.

[16] McGaffin, Breanna J. et al. “Self-Forgiveness, Shame, And Guilt In Recovery From Drug And Alcohol Problems”. Substance Abuse, vol 34, no. 4, 2013, pp. 396-404. Informa UK Limited, doi:10.1080/08897077.2013.781564. Accessed 27 July 2020

[17] Wilson, Marie. “Creativity And Shame Reduction In Sex Addiction Treatment”. Sexual Addiction & Compulsivity, vol 7, no. 4, 2000, pp. 229-248. Informa UK Limited, doi:10.1080/10720160008403699. Accessed 27 July 2020.

[18] Hall, Julie H., and Frank D. Fincham. “The Temporal Course Of Self–Forgiveness”. Journal Of Social And Clinical Psychology, vol 27, no. 2, 2008, pp. 174-202. Guilford Publications, doi:10.1521/jscp.2008.27.2.174. Accessed 27 July 2020.

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