For those who are attempting to recover from a Substance Use Disorder (SUD), the recovery process can be very challenging. Unfortunately, substance use is one of the most stigmatized topics in the world. For decades, substance use has been seen as a moral, social, or criminal issue instead of as a medical issue, which deserves treatment. This article aims to inform you about the stigma that surrounds substance use, particularly the language and problematic terminology.
The team at Pacifica Treatment Centre understands the importance of removing the stigma that surrounds substance use and mental health disorders. In order to see progress, the conversation around these topics must be approached through a lens of compassion and understanding. Changing the conversation can help our community to get the social support systems they need.
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Defining Stigma
In order to understand stigma and the language that is associated with it, we need to fully understand the term itself.
Stigma is defined as “A set of negative and often unfair beliefs that a society or group of people have about a topic.” This can apply to a person’s lifestyle, mental health, appearance and more.
Stigma often surrounds divisive topics and becomes ingrained due to a lack of compassionate understanding, a lack of education on the topic, as well as societal norms.
What Is Stigmatizing Language?
With regards to substance misuse, stigmatizing language are words or phrases that are emotionally and psychologically charged and meant to shame or belittle people. These terms often lead to people feeling isolated and marginalized, as if they are outsiders.
Language and words are powerful tools. When used with bad or harmful intentions, they can significantly impact a person’s self-confidence, self-worth, and can actually influence the support and services that are made available to them. If society has deemed it acceptable to ‘look down’ on certain people, then that group faces a tremendous challenge as they attempt to better themselves.
Think of it as a public relations campaign. If the information being spread is hurtful and belittling, the opinions and beliefs of the general public are formed by that information, and they will likely take that information and make broad assumptions. If you change the language to be more compassionate and informative, a person can be introduced to the topic with a healthier, more constructive foundation.
Substance Use and Stigma
SUDs are some of the most stigmatized conditions in the world. For far too long, the language and information surrounding problematic substance use (drugs and alcohol) have been hurtful, degrading, and void of any compassionate understanding. The terms ‘alcoholic’, ‘addict’, and the wide range of slang terminology used in pop culture and casual conversation have affected millions of people who struggle with SUDs. Individuals have been ostracized and marginalized from the rest of society, made to feel ashamed.
The negativity surrounding these terms carries preconceived ideas. People assume individuals who deal with substance use are homeless, jobless, and are viewed as ‘others’. People may assume that those with SUDs lack the conviction needed to function in society. While in reality, there are countless individuals with SUDs who are hyper-successful, wealthy, and driven.
Examples of Stigmatizing Language:
- Judging a person’s identity based on substance use, past or present
- Belittling a person’s value because of substance use
- Dehumanizing a person through labels, names, or terms
| TOPIC | AVOID THESE STIGMATIZING TERMS | ALTERNATIVE NON-STIGMATIZING TERMS | BACKGROUND/ RATIONALE |
|
People Who Use Substances
People Who Use Substances | – Drug users – Drug abusers | – People who use substances – People who actively use drugs – People with a substance disorder (context-dependent) | – Not everyone who uses substances, including in ways that cause social or physical harm, has a SUD so the use of this language depends on the context. |
| – Addicts | – People living with a Substance Use Disorder (SUD) – People with the living experience of a SUD | ||
| – Injectors | – People who inject drugs | – Substance use-related stigma varies by many factors, including substance and methods of use. Since the injection is more stigmatized than other methods of substance use, the label “injectors” conveys greater prejudice. | |
| – Alcoholics | – People with alcohol use disorder | ||
| – Binge-users – Binge-drinkers | – People who engage in heavy episodic drinking | ||
| – Recreational substance users | – People who use substances for non-medical reasons (in some contexts) – People who occasionally use substances (in some contexts) | – “Recreational” implies that substance use is something people choose to do “for fun”. “Recreational substance user” to denote someone who uses substances outside of a medical context can be stigmatizing to people with SUDs. | |
| – Former drug addicts – Ex-addicts
| – People with lived experience of substance use [disorder] – People who have used substances – People who formerly used substances – People who have a history of substance use | ||
| – Recovering addicts | – People in recovery [from a SUD] | – Being in recovery from a SUD can, but does not have to mean, abstinence from substances. | |
| – Former alcoholics | – People with lived experience of alcohol use disorder | ||
| Recurrence of Substance Use | – Relapse, lapse – Slip – On/off the wagon – used again – Setback | – Recurrence of substance use – Recurrence of SUD [symptoms] | |
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Substance Use | – Substance abuse – Substance misuse – Substance habit
| – Substance use – SUD (in some contexts) | – “Misuse” and “abuse” and “habit” are highly stigmatizing as the terms express judgement, and suggest deliberate misconduct or a moral failing. – Not everyone who uses substances has a SUD, so the use of these terms will be appropriate only in cases where it is medically accurate. |
| – Alcoholism – Drug of choice – Opioid Addiction | – Alcohol Use Disorder (AUD) – Substances used – Opioid Use Disorder (OUD) | – The current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists “alcohol use disorder” as a type of SUD, replacing “alcohol abuse” and “alcohol dependence”. |
How Stigmatizing Language Affects People
The next step in the process of understanding is becoming aware of how stigma affects the communities it is used against. Being able to see people as humans, and being able to relate to the feelings they experience can dramatically change how they are perceived. Below are a few examples of how being stigmatized can make a person feel:
- It creates a deep sense of shame that prevents people from seeking help
- People believe they will not receive help if they ask for it, feeling isolated and misunderstood
- Imagine feeling invisible. You feel like you are not heard, seen, cared about, or valued in society
- Stigma creates barriers and limitations regarding access to support services and can reduce the quality of care you receive.
- Influences public opinion when it’s time to implement public policy, laws, funding, and more
Person-First Language Is the Answer To Removing Stigma
Person-first language is the language that acknowledges someone as a person before describing their personal attributes or health conditions. Person-first language does not identify people by secondary or incidental qualities or conditions. Instead of “druggie,” use “person who uses substances.” Instead of “addict,” use “person with a substance use disorder.”
| Instead of This | Think Like This |
| You’ve been drinking a lot lately, why can’t you just choose to stop? | It seems like you’re drinking more than usual? Is there something difficult you’re dealing with that I can help you with? |
| I’ve heard you’ve been clean for 3 months now? | “I hear you haven’t taken any substances in months” |
| “They always smell like alcohol, they’ll sober up soon and they’ll be fine” | “This person may be dealing with a traumatic life event – they deserve the same level of care as everyone else” |
| “I think they’re getting high at work, they should be fired immediately” | “This person may have a substance use problem – we should provide resources to help them and ensure their safety at work!” |
Other Useful Resources
Canadian Center on Substance Use and Addiction
- Overcoming Stigma Through Language – Printable PDF
Government of Canada
- Communicating About Substance Use in Compassionate, Safe, and Non-stigmatizing Ways – Printable PDF
Substance Use Treatment Available In Vancouver, BC
If you or a loved one are struggling with substance use, reach out to the team at Pacifica Treatment Centre to learn more. Pacifica provides in-residence treatment and community-based services for individuals experiencing problematic substance use, in conjunction with concurrent mental health concerns and trauma.
To learn more about our programs or to take the first step toward recovery, call our offices or schedule an appointment online today!