Much of the language that has been used to describe substance use disorder and drug use is loaded with stigma and carries real world harm. Take the term "substance abuse" as an example: Child abuse, spousal abuse, these are criminal acts carried out by abusers. Calling addiction "substance abuse," or calling people who use drugs "substance abusers," further criminalizes a treatable health condition and perpetuates stigma. De-stigmatizing the language of addiction is a public health priority.
This is not simply a matter of policing language. Rigorous research has proved that terms like "substance abuser" elicit bias and negative attitudes in health care and policymaking settings. One study by the Recovery Research Institute at Mass General Hospital found that describing a person as a “substance abuser” increased the likelihood of evoking more punitive attitudes. "Substance abusers" were more likely to be viewed as: less likely to benefit from treatment; more likely to benefit from punishment; and more likely to be blamed for their illness. These results have been confirmed by the Johns Hopkins Stigma Lab and recovery scientist Robert Ashford.
Alternatives to stigmatizing nouns and identifiers:
Terms and phrases to be avoided in specific context and situations:
Trying to move away from criminalization while simultaneously using words like "substance abuse" that further criminalize people runs at cross purposes to the goal of humanizing people who use drugs. In health care settings and in policymaking, it is critical to avoid stigmatizing language that is known to elicit negative attitudes that result in further punishment instead of treatment and compassion. Using person-first language can drastically improve people's lives by changing the public's assumptions and misconceptions about a marginalized group.
Harmful language ultimately increases stigma on the individual, which reduces one's belief in the ability to change as well as their motivation to ask for help.
Use of the Word "Addict" Among News Articles
Between January 2015 and June 2019, we tracked the use of "addict" among 508 local, state and national news articles. Over 85% of the articles used "addict" in a stigmatizing manner and a majority was employed by journalists or editorial staff of the respective news outlets. Other relative trends were further explored.
We utilized the Media Cloud information system to compile a dataset of mainstream media content related to the opioid crisis from January 2015 to June 2019. Within this larger database, we queried 11 search terms specific to prescription and street-level opioids, enhanced by boolean and wildcard operators. Using Media Cloud's social media capabilities, we quantified the number of Facebook shares for each article. The top 131 national articles and the top 5 -10 articles shared in each state were redundantly coded. Articles were coded as "corrective narrative" if "addict" was used to call attention to its stigmatizing nature.
Connect with Expert Sources:
Robert Ashford, recovery researcher, University of the Sciences
Brandon Bergman, PhD, associate director & research Scientist, Massachusetts General Hospital Recovery Research Institute at Harvard