14 Stigma and Addiction

Words Matter: Preferred Language for Talking About Addiction

Addiction is a chronic but treatable medical condition. Often unintentionally, many people still talk about addiction in ways that are stigmatizing—meaning they use words that can portray someone with a substance use disorder (SUD) in a shameful or negative way and may prevent them from seeking treatment.9 With simple changes in language, harmful stigma and negativity around SUD can be reduced or avoided. Read on to learn more about what stigma is, how it affects people with SUD, and how you can help make a change.

Stigma and Addiction

What is stigma?

Stigma is a discrimination against an identifiable group of people, a place, or a nation. Stigma about people with substance use disorders might include inaccurate or unfounded thoughts like: they are dangerous, incapable of managing treatment, or at fault for their condition.

Where does stigma come from?

Stigma around addiction may come from old and inaccurate ideas, or fear of things that are different or misunderstood. Today, we know that addiction is a chronic, treatable medical condition. We also know that people can recover and continue to lead healthy lives.

How does it affect people with SUD?

  • Feeling stigmatized can make people with SUD less willing to seek treatment.1,2
  • Negative stereotypes about people with SUD can make others feel pity, fear, and even anger.2

How can we make a change?

  • When talking to or about people with SUD, make sure to use words that aren’t stigmatizing. See the table below for some helpful tips to get started.
  • Use person-first language, which focuses on the person—not their illness. It focuses on removing words that define a person by their condition or have negative meanings.4 For example, “person with a substance use disorder” has a neutral tone and separates the person from his or her disorder.5
  • Let people choose how they are described.3 If you’re not sure what words to use, just ask! Check in with friends or loved ones about how they refer to themselves and how they would like others to refer to them.

Terms to use, terms to avoid, and why

The chart below can help you choose words to reduce stigma and use person-first language when talking about addiction.

Talking About Yourself or Others with Substance Use Disorder
Use… Instead of… Because…
  • Person with a substance use disorder10
  • Person with an opioid use disorder (OUD) or person with opioid addiction
  • Addict
  • User
  • Substance or drug abuser
  • Junkie
  • Using person-first language shows that SUD is an illness.
  • Using these words shows that a person with a SUD “has” a problem/illness, rather than “is” the problem.6
  • The terms avoid elicit negative associations, punitive attitudes, and individual blame.6
  • Person with alcohol use disorder
  • Person who misuses alcohol/engages in unhealthy/hazardous alcohol use
  • Alcoholic
  • Drunk
  • Person in recovery or long-term recovery/person who previously used drugs
  • Former addict
  • Reformed addict
  • Testing positive (on a drug screen)
  • Dirty
  • Failing a drug test
  • Use medically accurate terminology the same way it would be used for other medical conditions.8
  • These terms may decrease a person’s sense of hope and self-efficacy for change.6

 

Talking about Using Substances
Use… Instead of… Because…
  • Substance use disorder
  • Drug addiction
  • Habit
  • “Habit” implies that a person is choosing to use substances or can choose to stop. This implication is inaccurate.5
  • Describing SUD as a habit makes the illness seem less serious than it is.
  • Use (for illicit drugs)
  • Misuse (for prescription medications used other than prescribed)
  • Abuse
  • The term “abuse” was found to have a high association with negative judgments and punishment.7
  • Use outside of the parameters of how medications were prescribed is misuse.

 

Talking about Recovery and Treatment
Use… Instead of… Because…
  • Medication treatment for OUD
  • Medications for OUD
  • Opioid agonist therapy
  • Pharmacotherapy
  • Medication for a substance use disorder
  • Opioid substitution
  • Replacement therapy
  • Medication-assisted treatment (MAT)
  • It is a misconception that medications merely “substitute” one drug or “one addiction” for another.5
  • The term MAT implies that medication should have a supplemental or temporary role in treatment. Using “MOUD” aligns with the way other psychiatric medications are understood (e.g., antidepressants, antipsychotics), as critical tools that are central to a patient’s treatment plan.
  • Being in remission or recovery
  • Abstinent from drugs
  • Not drinking or taking drugs
  • Testing negative (on a drug screen)
  • Clean
  • Use of medical terminology (the same way you would for other illnesses) can help reduce stigma.8

 

Talking about Babies Born to Parents Who Used Drugs
Use… Instead of… Because…
  • Baby born to a parent who used drugs while pregnant
  • Baby with signs of withdrawal from prenatal drug exposure
  • Newborn exposed to substances
  • Baby with neonatal abstinence syndrome
  • Addicted baby
  • Babies cannot be born with addiction because addiction is a behavioral disorder.
  • Using person-first language can reduce stigma.
  • Use of medical terminology (the same way you would for other illnesses) can help reduce stigma.8

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937046
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5854406
  3. https://www.ncbi.nlm.nih.gov/pubmed/31140667
  4. https://apastyle.apa.org/6th-edition-resources/nonhandicapping-language
  5. https://obamawhitehouse.archives.gov/sites/whitehouse.gov/files/images/Memo%20-%20Changing%20Federal%20Terminology%20Regrading%20Substance%20Use%20and%20Substance%20Use%20Disorders.pdf
  6. www.thenationalcouncil.org/wp-content/uploads/2016/10/Substance-Use-Teminology.pdf
  7. https://journals.sagepub.com/doi/abs/10.1177/002204261004000403
  8. https://jamanetwork.com/journals/jama/article-abstract/1838170
  9. https://pubmed.ncbi.nlm.nih.gov/29863411/
  10. https://pubmed.ncbi.nlm.nih.gov/31551647/

Source: NIDA. 2022, June 1. Stigma and Discrimination. Retrieved from https://nida.nih.gov/research-topics/stigma-discrimination on 2024, July 1.

 

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Addictions Counseling Essentials Copyright © 2024 by Andrea Polites; Bruce Sewick; Jason Florin; and Julie Trytek is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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