Do Words Matter When Talking About Addiction?

Summary: Words matter when talking about addiction because many words we’ve used to talk about addiction perpetuate stigma and misunderstanding about addiction and addiction treatment.

Key Points:

• Words commonly used to talk about people with addiction, such as junkie, addict, and alcoholic have negative connotations to most people who hear them.
• Some people may use this language because they don’t know it’s stigmatizing or understand the damage it can cause.
• When we use person-first language and medical terminology, it reduces stigma and increases the likelihood a person who needs addiction treatment will seek the treatment they need.

What Should We Call Addiction?

We should call it substance use disorder (SUD) like doctors, mental health experts, and addiction clinicians do.

People with substance use disorder (SUD) need professional support and treatment in order to grow and heal, and when they’re thinking about seeking the addiction treatment they need, words matter – especially the words other people use.

Why?

In many cases, the language we use to talk about addiction – in formal and informal situations – increase the stigma associated with addiction. In this article, we’ll talk about stigma, language, their relationship, and how we can reduce stigma by changing the language we use when we talk about the disordered use of substances, a.k.a. addiction.

What is Stigma in The Context of Addiction?

According to the experts at Johns Hopkins University School of Medicine, stigma related to addiction:

“…refers to negative attitudes, labeling, stereotyping, and discrimination towards individuals suffering from substance use disorders.”

Stigma connected to people with substance user disorder (SUD) and people in treatment for SUD includes beliefs that they are:

• Dangerous
• Unpredictable
• Irresponsible
• Selfish
• Incapable of managing treatment
• Only have themselves to blame for addiction condition
• No self-control
• Morally deficient
• Make bad decisions

In most cases, stigma related to addiction is the direct result of a lack of knowledge, inaccurate knowledge, or incomplete knowledge about addiction and addiction treatment. These deficits result in the attitudes we describe above. We can reduce a vast majority of stigma around addiction by teaching people the medical definition of addiction:

“A chronic, treatable disease from which patients can recover and continue to lead healthy lives.”

Once people understand that addiction is a disease, they’ll most likely re-evaluate their attitudes toward people with substance use disorder (SUD). An effective way to reach people is to compare SUD to other chronic diseases characterized by periods of disease activity and remission, which are akin to periods of disordered use and recovery.

The hard thing about stigma is that it involves personal attitudes and beliefs, which are hard to gauge and hard to change. The fact is that we rarely truly know what’s going on in the hearts and minds of other people. However, we can formulate good guesses by listening carefully to the language they use when talking about addiction.

Because, as we mention above, words matter when talking about addiction. They’re a reflection of how we think and feel about things. If we change the way we talk, we may be able to influence the way others talk about addiction, which may, over time, change the way they think and feel about addiction. In other words, language is one of our most powerful and effective tools for reducing stigma.

What Impact Does Stigmatizing Language Have on People with SUD?

The Substance Abuse and Mental Health Services Administration (SAMHSA) indicates stigmatizing language can have negative consequences for people with SUD. These consequences include:

• Reduced willingness to seek treatment
• Reduced self-esteem/belief in self
• Decreased trust toward people who use stigmatizing language
• Increased tendency of others to default to emotions like pity, fear, or anger/judgment toward/about people with SUD
• Increased tendency for others to distance themselves from people with an SUD
• Negative perceptions of people with SUD among healthcare providers
• Reduced quality of care delivered by healthcare providers

Stigmatizing language has an impact on the emotions of people with SUD and the people without SUD. It can color attitudes of doctors, teachers, and potential employers, which puts people with SUD at a disadvantage: when people in positions of power or influence have predetermined negative attitudes toward them, it makes success – in relationships, at work, at school – more difficult to achieve.

Thankfully, since we all have power over the words we say, we can change those we use when talking about substance use disorder and related topics, which, in turn, can help reduce stigma overall.

What Exactly Do We Need to Change?

The first thing we need to do is align our language with facts. According to SAMHSA, non-stigmatizing language:

“…reflects an accurate, science-based understanding of SUD.”

That means we all need to reacquaint – or acquaint – ourselves with the medical model of addiction (see above) and everything it implies, including the fact that when we talk about addiction, our words matter. We’ll share a list of changes we need to make in order to use language that’s consistent with current scientific knowledge.

Before we share that list, it’s crucial to clarify one key point: the use of person-first language. There’s a very easy way to grasp this notion. When someone has cancer, we don’t substitute the name of the disease for them. We don’t say they’re a cancer. We say they have cancer. Or better yet, we say they’re a person with cancer.

Or, to put it more directly:

A person with a disease is not the disease, they’re a person with a disease. By extension, a person with addiction is not addiction, they’re a person with a medical condition.

Now let’s have a look at that list.

How We Can Reduce Stigma by Changing the Language We Use

Avoid using these words:

• Addict
• User
• Substance abuser
• Drug abuser
• Junkie
• Alcoholic
• Drunk
• Former addict
• Reformed addict

Instead, use these:

• Person with substance use disorder
  • Person with opioid use disorder, person with alcohol use disorder, etc.
• Patient
• Person in recovery
• Person in long-term recovery

When talking about alcohol use, avoid saying “abuse.” Instead, say:

• Alcohol use/unhealthy alcohol use/harmful alcohol use

When talking about illicit drug use, say:

• Drug use

When talking about using prescription medication, say:

• Misuse
• Use other than prescribed

Instead of the word “clean” for a drug test or in reference to a person, say:

• Testing negative
• In remission
• In recovery
• Abstinent
• Not drinking
• Not taking drugs

Instead of the word “dirty” for a drug test or in reference to a person, say:

• Testing positive
• Person who uses drugs
• Person who drinks alcohol

We suggest reading this list and thinking about language use talking about addiction, with a person-first perspective. It also helps to engage in a thought experiment:

What if you were the person being talked about?

Think about some of the language above, and consider whether it would increase or decrease your likelihood of seeking treatment, seeking support, or being honest with friends, family, coworkers, or others about your use of alcohol or drugs.

That often drives the point home when everything else fails.

Recap: Addiction, Language, and Why Words Matter

When talking about addiction, words matter because they reflect how we think and feel. They reveal what we understand, and what we need to learn. They matter because of their impact on other people. We mean anyone listening, not only people with substance use disorder: the words you use can impact their perception, which informs how they think and talk about SUD. If your share or use imprecise or inaccurate language, that can perpetuate stigma, and cause harm.

Almost all of us a direct, personal experience with the power of language. We know what it feels like when a parent, a teacher, or friend makes an ill-advised offhand remark. It can be devastating. It can feel awful. It’s worse when it comes from the right person at the wrong time, like a parent when you’re looking for advice, a friend when you’re looking for support, a teacher when you’re looking for help, or a healthcare professional when you’re looking for care. If they say something that hurts, intentionally or unintentionally, it degrades trust and reduces the likelihood you’ll go to them for that purpose at any time in the future.

That’s how language works with substance use disorder: intentional or unintentional, it can have a negative impact on people with substance use disorder, and decrease the chance they’ll open up, ask for help, and start on the road to recovery.

That’s why, when talking about addiction, our words matter.

Those are the real reasons we need to reevaluate the way we talk about substance use disorder: not only can it cause short-term harm, but it can also prevent a person from seeking the long-term support they need to address and resolve exactly the problem that elicits the stigma.

Therefore, moving forward, we encourage everyone to be mindful of the language they use when talking about substance use disorder, and work to replace stigmatizing language, with non-stigmatizing, inclusive, person-first language.

How to Find Non-Stigmatizing Treatment for Addiction

The best way to find non-stigmatizing treatment for addiction – a phrase we encourage people to move away from in favor of substance use disorder – is to review the website of any treatment center you may consider and analyze the way they talk about treatment and support for people with alcohol and/or substance use disorder (AUD/SUD).

We should realize that for the general public, stigmatizing language won’t disappear overnight. We use the word addiction because substance use disorder (SUD) and alcohol use disorder (AUD) have not been around long enough for people to understand what me mean instantly.

However, while the word addiction may persist as a result of both inertia and practicality, words like addict, junkie, alcoholic, and drunk, as well as phrases like alcohol abuser and drug abuser are easy to leave behind. For most people, even saying them feels judgmental, when they reflect upon the actual words and how they might affect the people they’re talking about. And that’s really the outcome we want, at the end of this blog: we want people to take a moment to reflect on the words they use related to addiction, understand that they matter, and learn how to use language that harms no one, and can help people who really need non-judgmental, non-stigmatizing support and compassion.