Words Matter: Avoiding Stigmatizing Language

in SUD Treatment

By Scott Weiner, MD, MPH, Brigham and Women’s Hospital
 

The word “stigma” has roots in both Latin and Greek, meaning a mark on the skin usually from a pointed instrument, tattoo or burning. In Shakespearean times, stigma became used more figurately, to indicate a mark of disgrace attached to a person on account of evil conduct. People who use drugs are frequently subjected to stigma, particularly in our society which equates substance use disorder as a conscious choice and moral failing. In more recent years, we have learned that this is simply not true, and reasons for drug use are complex and not the “fault” of the individual. Still, the persisting stigma of people who use drugs can be extremely detrimental towards these individuals, especially when the stigma comes from medical professionals.

Even just reading a vignette in which a patient is referred to as “a substance abuser” vs. “having a substance use disorder” can change impressions of medical professionals about the patient. For this reason, the National Institute on Drug Abuse (NIDA) created an initiative called “Words Matter”, with a list of terms to use and avoid when talking about addiction. Some of the words are not surprising, such as the heavily stigmatizing “junkie” or “abuser.” Other words are less obvious. For example, referring to a urine drug screen result as “dirty” may make the individual feel that the word is being applied to them and it is better to just use factual language like “the test was positive for oxycodone”. Other words like “alcoholic” and “addict” may be used by patients themselves in the context of recovery (e.g. Alcoholics Anonymous) but really have no place in the medical environment where person-first language is not only preferred, but vital to approaching care from an anti-stigmatizing perspective.

We invite you to explore these resources from the ATTC Network that address Substance Use Disorder in Native American populations. 

• Honoring National Native American Heritage Month - Great Lakes ATTC, November 2023

• Centering Indigenous Knowledge, Culture and Communities: Approaches to Indigenous Evaluation and Opioid Overdose Prevention Programming (webinar) - Northwest ATTC, June 2023

• How Being Trauma Informed Improves Criminal Justice Responses (webinar) - Northeast and Caribbean ATTC, October 2023
• Clinical Supervision Skills Demonstration Videos and Incorporating Cultural Material into the Professional Development Process (webinar) - Northwest ATTC, April 2023

Seeking Masters-level counselors who are employed full-time at substance use treatment programs to participate in a brief survey for a dissertation study about factors that may contribute to counselor workplace well-being in substance use treatment organizations. 

The study is being conducted under the supervision of Susan Lahey at Trevecca Nazarene University in Nashville, Tennessee, and has IRB approval from Trevecca Nazarene University. 

Counselors who are a good fit are: 

• Employed full time at a substance use treatment agency 
• Working in direct client care 
• Graduated from a Master's level counseling program
• Pre-licensed or licensed as LPCs,  LMFTs, LMHCs, LCPCs, or LPCAs

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