Social stigma and substance use: Why language matters

Today I am once again turning over Smart Approaches to guest columnist Alison Jones Webb who has a great article on social stigma and substance use.

Research shows that one reason people with addiction don’t seek treatment is the shame they feel about their condition. The shame springs, in part, from the social disgrace associated with having a substance use disorder (the medical term). As a society, we devalue, exclude, and discriminate against “those people.” We find them socially unacceptable. That, in a nutshell, is stigma.

There is plenty of stigma to go around. Research indicates that people with substance use disorder experience labeling, shame and rejection from family members, friends, teachers, co-workers, supervisors, and health care professionals. This stigma contributes to their poor physical health and risky behavior. Stigma also delays re-integration into the community because people in recovery from substance use disorder experience discrimination in housing, employment, and education.

People in recovery, especially in the early weeks and months of recovery, need support and encouragement. Stigma can get in the way of that support and reduces a person’s ability to seek and maintain physical, emotional and spiritual wellness.

According to the Anti Stigma Toolkit: A Guide to Reducing Addiction-Related Stigma, there are some concrete ways you can help prevent and reduce stigma, and in the process become part of the solution. The language we use when we talk about people with substance use disorder is one important aspect of stigma that we can do something about.

Here are some suggestions for using stigma-reducing language:

  • Call it what it is: substance use disorder (or alcohol use disorder, cocaine use disorder, etc.) or substance dependence (or alcohol dependence, drug dependence, etc.). In a non-clinical environment, addiction is also acceptable.
  • Use “people first” language and refer to people with substance use disorder, people with drug dependence, people with addiction.
  • Avoid negative terms like addict, junkie, wino, boozer, drug fiend, and bum.

People with substance use disorder, or people who are in recovery, are not defined by their condition any more than people with diabetes are defined by their health problems. As the Anti Stigma Toolkit says, “addiction doesn’t define who a person is, it describes what a person has. A person’s addiction represents only a part of the person’s life. Defining people exclusively by their addiction diminishes the wholeness of their lives.”

Two weeks ago, a man who was a son, a father, a partner, and a friend died from a drug overdose. He was an eloquent and fierce advocate for the rights of the homeless and people with addictions and people with mental illness. He was intelligent and funny. He was also a person with an addiction.

He summed up the impact our language has like this: “When you call me an addict, you take away everything that is lovely about me.”

Alison Webb, MA, MPH, is an independent public health consultant with over 20 years experience in community outreach and organizing, substance use and overdose prevention, community based substance use recovery supports, and linking community members with healthcare services. She participates in the Maine chapter of Young People in Recovery, the Maine Harm Reduction Alliance, and the Maine Recovery Communities Coalition. She is President of Nautilus Public Health.

Scott M. Gagnon, MPP, PS-C

About Scott M. Gagnon, MPP, PS-C

Scott M. Gagnon, MPP, PS-C is a Certified Prevention Specialist and is the Director of Operations at AdCare Educational Institute of Maine, Inc. He currently serves on the Maine Substance Abuse Services Commission as well as the U.S. Substance Abuse and Mental Health Services, Center for Substance Abuse Prevention National Advisory Council. Scott volunteers as the Chair of the marijuana policy education and advocacy group, Smart Approaches to Marijuana Maine and is the current Board President of the Maine Council on Problem Gambling. Scott also serves as a Co-chair of the Prevention & Harm Reduction task force of the Maine Opiate Collaborative, the effort convened by U.S. Attorney Thomas E Delahanty, II to address Maine's growing opiate and addiction crisis. Scott is the recipient of the 2015 Maine Public Health Association's Ruth S. Shaper Memorial Award and 2015 Healthy Androscoggin Will Bartlett Award and is also the 2013 recipient of the Maine Alliance to Prevent Substance Abuse Prevention Award.