Words are important. By using person-centered language, you can help reduce a deadly stigma.
By Laura Morrison-Roets, EdD, PhD, CTRS/L, LADC, CRAADC/Supv., AADC, CM III
NAP Project Coordinator/Cox Health
In a culture full of “isms” (ageism, racism, sexism, etc.), and words attributed to others, which aren’t kind, humane, or even PC (politically correct), there is yet another area that needs to be addressed; the language used when addressing issues related to substance use disorders.
In therapy and counseling, the positive use of terminology is called “person-centered language.” But wait!! Before you quit reading what you think might be a totally boring subject and because of what might seem to be simply a therapeutic term, please let this author explain very simply what it means in this field.
There are so many variations and connotations used everyday in face-to-face communication and mainstream media, which attack those with substance use issues. One of the latest was from a politician who referred to the Irish as “drunkards who at least are honest.” This of course, attacks two cultures, and is demeaning to both. It is a good example of how easy it has become to attack individuals with or without forethought; not as any type of political statement. These types of stigmas hurt. They hurt individuals and they hurt the field of substance use disorder treatment as a whole.
Howard Koh, MD, MPH, in Community Approaches to the Opioid Crisis, states, “Viewing substance use disorders as a chronic disease that waxes and wanes, not as a moral failing, may help overcome stigma that prevents affected people from seeking treatment. Encouraging public dialogue that refers to a “person with a substance use disorder” (instead of “addict”) and “person in recovery” (instead of “former addict”) can medicalize what many still view as primarily a criminal problem.”
“Research shows that the language we use to describe this disease can either perpetuate or overcome the stereotypes, prejudice and lack of empathy that keep people from getting treatment they need”, US Drug Czar Michael Botticelli told The Huffington Post. “Scientific evidence demonstrates that this disease is caused by a variety of genetic and environmental factors, not moral weakness on the part of the individual. Our language should reflect that.”
In IS IT TIME FOR PERSON-FIRST LANGUANGE IN ADDICTION TREATMENT?, by William White and Alisha White, the following is posed: “There is a long history of ‘problem first language’ used to morally isolate people with severe AOD (alcohol and other drug} problems. Since the early 1900s, persons entering treatment for such problems have been labeled inebriates, dipsomaniacs, habitués, addicts, alcoholics, problem drinkers, and substance abusers. An equally long history of such designations pervades popular culture in the U.S, including such terms as drunkard, drunk, sot, tippler, wino, boozer, alky/alki/alkie, runnie, rumhound, dope fiend, doper, junky, viper, speed freak, crack head, crack whore, meth head, tweeker, and stoner, to name just a few.”
In light of this, in using compassion and kindness, and to help provide better quality of access and care, the following are suggested by the Office of National Drug Control Policy:
| Words to avoid | Words to use |
| Addict | Person with substance use disorder |
| Alcoholic | Person with alcohol use disorder |
| Drug problem, drug habit | Substance use disorder |
| Drug abuse | Drug misuse, harmful use |
| Drug abuser | Person with substance use disorder |
| Clean | Abstinent, not actively using |
| Dirty | Actively using |
| A clean drug screen | Testing negative for substance use |
| A dirty drug screen | Testing positive for substance use |
| Former/reformed addict/alcoholic | Person in recovery, person in long-term recovery |
| Opioid replacement, methadone maintenance | Medication assisted treatment |
Words are important and can be uplifting and esteeming or, on the far end of the spectrum, devastating and demeaning, when they allow another to define you. As a community of healers, we need to be careful in the language used dependent upon the audience to whom we are speaking. For example, the language used with a treatment center staff peer will be different than used with a PTA group and typically different to a street person, than with an academic. Stigmatizing keeps individuals and communities stuck.
**Note** As a result of the shift from “problem-centered language” to “person-centered language”, the Stone & Taney Counties Substance Abuse Initiative has changed the project’s name to the Stone & Taney Counties Substance Use Initiative and will endeavor to utilize person-centered language in all aspects of the project.