By Jules Murtha | Fact-checked by Barbara Bekiesz  MD Linx
| Updated December 20, 2022

Key Takeaways

• Those who struggle with substance use disorders often deal with the stigma of being perceived as dangerous, incapable of recovering, or blamed for the state of their condition.
  
• To help destigmatize patients who deal with substance misuse, clinicians can use person-first language and scientifically accurate terminology when talking about addiction.
  
• Examples of non-stigmatizing language include “return to use” (instead of “relapse”), “drug misuse” (instead of “drug abuse”), and “person in active use” (instead of “junkie”).
  

“The only constant in life is change.”
This quote from Heraclitus didn’t specifically refer to the evolving nature of medical terminology, or the consequences of stigmatizing language. Yet, it perfectly applies to research on the language of addiction, which urges clinicians to rethink how they speak about the disease.
The link between language and stigmaThe US government has recognized the harsh effects of stigmatizing language on patients with substance use disorders.
A 2017 memo written by Michael P. Botticelli, the former director of the White House Office of National Drug Control Policy, recognized how stigmatizing language may negatively alter societal perceptions of people with substance use disorders.[1]
According to Botticelli, although people with substance use disorders are capable of recovery, “sometimes the terminology used in the discussion of substance use can suggest that problematic use of substances and substance use disorders are the result of a personal failing; that people choose the disorder, or they lack the willpower or character to control their substance use.”
This, along with the perception that those who use substances are dangerous, could converge to create a stigma associated with substance use that can do real damage. This is especially true for women and mothers, who often have poor self-esteem, depression, fear, and anxiety as a result of addiction-related stigma.
A 2021 article published by the NIH stated that stigma has the power to prevent patients with substance use disorders from seeking proper treatment, as well as negatively affecting physicians’ understanding of them.[2] This may ultimately influence the quality of care they receive.
Person-first languageResearchers urge doctors to adapt their terminology by using person-first language.
Person-first language is defined by the NIH as language that “maintains the integrity of individuals as whole human beings by removing language that equates people to their condition or has negative connotations.”[3]
But what does person-first language sound like? What vocabulary should be used in the hallways and the exam room, when referring to substance use disorders and the patients who struggle with them?
Read Next: Identifying drug-seeking behaviors in your patients

Different ways to describe substance useWhen it comes to changing the language of addiction, there are a few concrete terms and phrases to use in place of potentially stigmatizing ones.
According to the NIH and an article published by StatNews.com, this list of revised, person-first terms is as follows:[4]

• Abuse → Use, misuse, or used other than prescribed
  
• Addict → Person with substance use disorder
  
• Alcoholic → Person with alcohol use disorder
  
• Junkie → Person in active use
  
• Relapse → Return to use
  
• Former addict → Person in recovery or person in long-term recovery
  
  ​TO CONTINUE: https://www.mdlinx.com/article/the-evolving-language-of-addiction-your-words-matter-to-your-patients/4OhHwgrWfLUbSlXjBw7RHa?show_order=2&article_
  
  

Too many Americans are missing out on a cure for hepatitis C
ByLAURAN NEERGAARD AP Medical Writer   ABC News-  December 20, 2022, 12:35 PM

WASHINGTON -- Too many Americans are missing out on a cure for hepatitis C, and a study underway in a hard-hit corner of Kentucky is exploring a simple way to start changing that.
The key: On-the-spot diagnosis to replace today's multiple-step testing.
In about an hour and with just a finger-prick of blood, researchers can tell some of the toughest-to-treat patients — people who inject drugs — they have hepatitis C and hand over potentially life-saving medication.
Waiting for standard tests “even one or two days for someone who’s actively using drugs, we can lose touch with them,” said Jennifer Havens of the University of Kentucky, who's leading the study in rural Perry County. To start treatment right away "that’s huge, absolutely huge.”
Single-visit hepatitis C diagnosis already is offered in other countries, and now the White House wants to make it a priority here.
​
​“It’s frankly an embarrassment” that the U.S. doesn’t have such an option, said Jeffrey Weiss of New York’s Mount Sinai health system, who works with a community hepatitis C outreach program. “We have many people we’ve tested and want to give their results to and can’t find them.”
At least 2.4 million Americans are estimated to have hepatitis C, a virus that silently attacks the liver, leading to cancer or the need for an organ transplant. It leads to more than 14,000 deaths a year. That's even though a daily pill taken for two to three months could cure nearly everyone with few side effects.
Yet in the U.S., more than 40% of people with hepatitis C don't know they're infected. Fewer than 1 in 3 insured patients who are diagnosed go on to get timely treatment. And new infections are surging among younger adults who share drug needles.

​“This is a travesty,” said Dr. Francis Collins, the former National Institutes of Health director who’s now a White House adviser devising a new national strategy to tackle hepatitis C.
Most likely to fall through the cracks are “people in tough times” -- those who inject drugs, are uninsured or on Medicaid, or are homeless or incarcerated -- who can’t navigate what Collins calls the “clunky” diagnosis process and other barriers to the pricey pills.

“It’s frankly an embarrassment” that the U.S. doesn’t have such an option, said Jeffrey Weiss of New York’s Mount Sinai health system, who works with a community hepatitis C outreach program. “We have many people we’ve tested and want to give their results to and can’t find them.”

​At least 2.4 million Americans are estimated to have hepatitis C, a virus that silently attacks the liver, leading to cancer or the need for an organ transplant. It leads to more than 14,000 deaths a year. That's even though a daily pill taken for two to three months could cure nearly everyone with few side effects.
Yet in the U.S., more than 40% of people with hepatitis C don't know they're infected. Fewer than 1 in 3 insured patients who are diagnosed go on to get timely treatment. And new infections are surging among younger adults who share drug needles.

“This is a travesty,” said Dr. Francis Collins, the former National Institutes of Health director who’s now a White House adviser devising a new national strategy to tackle hepatitis C.
Most likely to fall through the cracks are “people in tough times” -- those who inject drugs, are uninsured or on Medicaid, or are homeless or incarcerated -- who can’t navigate what Collins calls the “clunky” diagnosis process and other barriers to the pricey pills.

​TO CONTINUE STORY: https://abcnews.go.com/Health/wireStory/us-starts-grappling-travesty-untreated-hepatitis-95611164

DEATH SENTENCE

There is a simple, outright cure for hepatitis C. But state prisons across the country are failing to save hundreds of people who die each year from the virus and related complications.
 
A STAT investigation has found that more than 1,000 incarcerated people died from hepatitis C-related complications in the six years after a curative drug hit the market. The death rate in 2019 was double that of the broader U.S. population.In the stories on this page, reporter Nicholas Florko documents prisons’ blatant refusal to test and treat people with the condition, even, in some cases, in the face of legal orders to do so. He introduces incarcerated people who watched their health deteriorate or lost their lives because of the rationing of hepatitis C drugs. Prisons say the medicine, even as its price drops, is too expensive for them to distribute widely. But incarcerated people are fighting back: Some have fought for the treatment in the courts and won, forcing the system to care for them and, in some cases, other incarcerated hepatitis C patients.
​
TO READ MORE:​ https://www.statnews.com/death-sentence/?utm_source=email_nns&utm_campaign=hep_investigation_launch&utm_medium=email&utm_source=STAT+Newsletters&utm_campaign=6315953c4e-EMAIL_CAMPAIGN_2022_12_08_08_25&utm_medium=email&utm_term=0_-6315953c4e-%5BLIST_EMAIL_ID%5D