It’s likely you know someone who uses substances or has a substance use disorder, even if you don’t realize it. It's important that we are careful with the words surrounding substance use. Language can further the stigma around substance use and even affect how people get care1.
Download Stigma and Substance Use Overview
What is stigma? 
Stigma is a set of negative beliefs and stereotypes about people that belong to a specific group. Stigma can lead to shame and discriminatory behavior2.
There are three main types of stigma3,4:
- Public/Social – The negative attitudes and beliefs others have for a group of people.
- Structural – Policies that restrict (intentionally or not) the opportunities of targeted groups.
- Self – This happens when people start believing the negative stereotypes they hear about themselves. It increases shame and reduces self-worth.
Why does stigma matter?
Stigma matters because it places blame on a person. This can
make it hard for others to understand the complex factors related to substance use. It’s one of the biggest barriers for people who use substances to get the care they need and deserve3,4.
What can you do to fight stigma?
There are many ways you can help reduce stigma, including2,3,4:
- Learn more about stigma and help bring awareness to it.
- Use person-first language and help others do the same.
- Listen to, learn from and partner with people who have lived with substance use.
- Help educate decision makers about policies that increase justice for people who use substances.
Person-First Language Guide
Download Person First Language Guide
Person-first language focuses on the whole person, not their substance use. This puts the person’s worth before their condition or circumstances1,5.
This type of language helps break down stereotypes and fosters understanding. It can be more supportive for people who use substances. Use person-first language for all groups of people, not only those who use substances.
Recommended Language to Use | Stigmatizing Language to Avoid or Use with Caution | Why? | ||
| Substance Use | Substance Abuse | The term "abuse" is associated with criminal activity (ie. domestic abuse, child abuse). | ||
| Person with substance use disorder or challenge. | Addict Junkie Abuser Druggie User | People cannot and should not be defined by one behavior or characteristic. The person should always come first to avoid stereotypes and stigma. "Substance use disorder" should not be used interchangeable with "substance use." Not everyone who uses substances has a substance use disorder. | ||
| Person with alcohol use disorder | Alcoholic Drunk | People cannot and should not be defined by one behavior or characteristic. The person should always come first to avoid stereotypes and stigma. "Substance use disorder" should not be used interchangeable with "substance use." Not everyone who uses substances has a substance use disorder. | ||
For illicit drugs:
For prescription medication:
| Abuse Drug of choice Habit | The term “abuse” is associated with criminal activity (i.e., domestic abuse, child abuse). People who use substances are not inherently criminals. “Drug of choice” or “habit” implies that a person chooses to have a substance use disorder. | ||
| Substance free or No longer using . . . | Clean | The terms “dirty” and “clean” are adjectives used to describe filth or the lack thereof. They further negative stereotypes. | ||
| Testing negative/positive for substance use | Clean/Dirty | The terms “dirty” and “clean” are adjectives used to describe filth or the lack thereof. They further negative stereotypes. | ||
| Resumed or experience a recurrence of substance use or substance use disorder symptoms. | Relapse/Slip | The terms “relapse” and “slip” do not accurately represent a person’s pathway to self-defined recovery and places blame on the individual rather than the disease. | ||
| Well, Healthy, or In Recovery | Sober | The term “sober” implies a person is not under the influence of any substance. However, people self-define their own recovery and do not have to abstain from all substances to be healthy and well. | ||
Medication for Opioid Use Disorder (MOUD) Medication-Assisted Recovery (MAR) | Medication-Assisted Treatment (MAT) | Medicines that treat other diseases are not referred to as “medication-assisted treatment.” The term implies medication is only a supplement to treat opioid use disorder and downplays its importance. | ||
Baby born to mother who used drugs while pregnant. Newborn exposed to substances. Neonatal Abstinence Syndrome | Addicted baby | A baby cannot have an “addiction” because it is a diagnosed behavioral disorder. The focus should be on clinical solutions for the mother and baby. | ||
Learn more about person-first language
The information in this guide was pulled from the following language guides. They can help you learn more about the importance of using person-first language.
- Shatterproof Addiction Language Guide
- Words Matter: How Language Choice Can Reduce Stigma
- Addictionary
- Words Matter: Terms to Avoid When Talking About Addiction
- Remove Stigma: Talk with Your Patients About Substance Use
Citations
1. Kimberly Goodyear, Carolina L. Haass-Koffler, and David Chavanne. “Opioid use and stigma: the role of gender, language and precipitating events.” Drug and Alcohol Dependence 185, April 1, 2018: 339-346.
2. Centers for Disease Control and Prevention. "Overdose Data to Action Case Studies: Stigma Reduction." National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 2022
3. Committee on the Science of Changing Behavioral Health Social Norms; Board on Behavioral, Cognitive, and Sensory Sciences; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine. "Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change." Washington, D.C., National Academies Press (US), August 3, 2016.
4. Jenifer Wogen, MS, Maria Teresa Restrepo, MPH, MA. “Human Rights, Stigma, and Substance Use.” Health and Human Rights Journal 22, June 2020: 51–60.
5. Shatterproof. “Addiction Language Guide.” Retrieved from https://www.shatterproof.org/sites/default/files/2021-02/Stigma-AddictionLanguageGuide-v3.pdf