Words Matter in the Substance Use Conversation
By Caroline Kahiu
In public health or policy issue, it is important to consider the language used to discuss the people affected. The substance abuse crisis continues to touch many families and communities. Substance Use Disorders (SUDs) carry a burden of stigma and fear of judgement. Two main factors affect the burden associated with stigma: perceived control that a person has over the condition and the perceived fault in acquiring the condition.
According to the National Institute on Drug Abuse (NIDA), stigma is defined as a label with an associated stereotype that elicits a negative response. Simply put, stigma is a mark of disgrace and infamy. Typical stigma related to addiction patients: they are dangerous, unpredictable, incapable of managing treatment or at fault for their condition. For people with SUDs, stigma may stem from antiquated and inaccurate beliefs that addiction is a moral failing, instead of what we know it to be- a chronic, treatable disease from which patients can recover and continue to lead healthy lives.
To reflect this, medical practitioners, academics and journalists are in a unique position to reduce stigma surrounding substance use. The language we use to discuss SUDs either formally, as part of prevention messaging, or informally, in conversations with colleagues and stakeholders, can either increase or decrease stigma. For people with SUDs, stigma disproportionately influences health outcomes and mental well-being.
The language we use to talk about SUDs shapes how the public views the condition. Unintentionally stigmatizing language can perpetuate negative stereotypes about the types of people who are affected by substance abuse and can decrease public support for prevention and treatment programs. By contrast, language that supports pro-health activities, even if a person is actively using substances, can help decrease stigma.
What should we keep in mind?
Use the first-person language. Avoid labels such as “addicts,” “drug users,” or “junkies” as they are inappropriate and diminish the humanity of people with SUDs. Instead, acknowledge that the person has a problem that can be addressed and the person is not the problem. Similarly, perform a language audit of existing materials for language that may be stigmatizing and replace with more inclusive language.
Drop the negative connotations. Individuals who have stopped using drugs are sometimes said to be “clean.” This implies that SUDs cause one to be “dirty.” Such people are best described as “being in recovery.” In addition, moral panic inevitably marginalizes people who are vulnerable and often bring their morality or even humanity into questions. This may prevent those affected by SUDs from seeking medical care because they are afraid of being judged or mistreated.
Treat SUDs like any other medical condition. Like many other chronic illnesses, SUDs can be managed with evidence-based and on-going treatment that allows individuals to live productive lives. Just as insulin would not be called medication-assisted treatment for diabetes, methadone should not be referred to medication-assisted treatment for opioid/heroin dependence.
With careful attention to language, we can reduce the burden of stigma surrounding substance use disorders, improve access to health care for people with SUDs and save lives. Words matter-if you have to say it. Say it nicely.
Published: Daily Nation 23/02/2022.