The evolving language of addiction: Your words matter to your patients

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_