“In the end, language matters…The labels applied to
individuals affect how they are perceived by others and
howthey perceive themselves. Stigma and discrimination are couched in a language that reinforces stereotypes and elicits fear…”
William White
He also says, “Whether you are the one struggling, a loved one, or simply want to be better educated as a parent or leader, the language must change….. We need to be very clear about what we are talking about.”
There are some common words that we all associate with addiction. Everyone probably recognizes words like junkie, clean, dirty, sober, abuse and addict. Words like junkie and dirty carry obviously derogatory connotations that greatly contribute to stigma and shame. Stigma remains the biggest barrier to people getting treatment for their disease.
Although researchers and other experts have clarified and proven that it is a real disease and a chronic medical illness, most people still view it as a weakness. To be an addict is to carry the stigma of being someone who cannot control their impulses, who can’t get their life together and who is morally weaker than non-addicts.
Changing the stigma will benefit everyone. It will allow people to more easily regain their self-esteem, allow lawmakers to appropriate funding, allow doctors to treat without disapproval of their peers, allow insurers to cover treatment, and help the public understand this is a medical condition as real as any other. Choosing the words we use more carefully is one way we can all make a difference and help decrease the stigma.
Talk about and treat addiction as a chronic illness, not a moral failing.
Addiction is a primary disease, meaning that it’s not the result of other causes, such as emotional or psychiatric problems. About 40 to 60% of addiction is based on genetic vulnerability, but other factors are also at play. 90% of those who go on to develop an addiction problem started using drugs or alcohol as an adolescent. And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person’s lifetime.
From a person in recovery:
“I’ve been in recovery since March 2007. There were a lot of terms and phrases I didn’t like in the beginning. Luckily, liking them was not a requirement. There were no requirements. For me, the path I chose was entirely voluntary. Still, the language did bug me.”
In the end, says William White, “Language matters. It is far more than superficial concerns about political correctness. The labels applied to individuals affect how they are perceived by others and how they perceive themselves. Language that focuses on the person is more respectful and less stigmatizing than language that defines a person in terms of an illness.”
Language that Matters:
Below is the current and recommended terminology is regarding people with substance use disorders.
| Stigmatizing Term: | Reason for Stigma: | Preferred Term: |
| Addict, Abuser, Junkie | These terms are demeaning because they label a person by his/her illness. In addition, these labels imply a permanency to the condition, leaving no room for a change in status. | Person in active addiction, person with a substance use disorder |
| Abuse | This word negates the fact that addictive disorders are a medical condition. It also blames the illness solely on the individual, ignoring environmental and genetic factors. | Misuse, harmful use, inappropriate use, problem use, risky use. |
| Clean, Dirty | Used to describe drug test results, these terms are stigmatizing because they associate the person as well as the illness symptoms (i.e. positive drug tests) with filth. | Negative, positive, substance-free. |
| Habit or Drug Habit | Calling addictive disorders a habit denies the medical nature of the condition and implies that the problem is simply a matter of willpower, | Substance use disorder, active addiction. |
| Replacement or Substitution Therapy | This implies that treatment medications such as buprenorphine are equal to street drugs like heroin. With successful buprenorphine therapy, as part of a comprehensive treatment plan, the dangerous addictive behavior is stopped not replaced | Treatment, medication-assisted treatment, medication. |
| User | This term labels a person by his/her behavior. It is also misleading because the term user has come to refer to someone who is engaged in risky misuse of substances, but ‘use’ alone is not necessarily problematic. | Person who misuses alcohol/ drugs; Person engaged in risky use of substances. |
| Crack head, pot head | This term is derogatory and implies that the person with a substance use disorder is less than others. | Cocaine addicted, THC abuse |
| Strung out | This term is derogatory and stigmatizing. | Debilitated, intoxicated |
| Relapsed | The term has negative connotations for it often has projected a tone of moral judgment | Reoccurence |
| Problem Drinker | This word describes and identifies the person as a problem. The use of the word drinker as a label for the person reduces the person’s essence and identity to one (problematic) behavior. Like abuser, alcoholic, and addict, this term denies the dignity and humanity of the individual. | Person experiencing an alcohol problem, person with a substance use disorder |
| SelfHelp Groups | The term is a misnomer because such groups are formed for the express purpose of providing an environment for individuals to support one another. | Recovery support groups, mutual aid groups |
| Substance Abuse | This term is stigmatizing because of the association of the word “abuse” with illicit activities such as child, domestic, and sexual abuse. It also infers the substance abuses the individual, not the other way around. | Substance use disorder, harmful use of substances, alcohol and drug disorder |
