The language we use when referring to people speaks volumes about how we think about them. And how we think about things impacts our attitudes and approaches to addressing them. Calling someone an “addict” or “crazy” not only reduces them to just that, it also increases negative perceptions that influence the value of our social and public health policies.
Person-first language puts a person before a diagnosis, describing what a person “has” rather than asserting what a person “is.”
Person-first language is humanizing. When we use terminology like “addict” or “crazy,” we may unknowingly begin to objectify the person and strip away their individuality. This often reduces the person into a predetermined box that discriminates.
By placing the person first, the person is what is important. Addiction or mental illness is no longer the primary, defining characteristic of an individual, but one of several aspects of the whole person. We must speak, write and think in a way that acknowledges the human being first, rather than their condition or disease.
Instead of “Addict”
Use “Person with Substance Use Disorder”
Instead of “User”
Use “Person with OUD or person with opioid addiction” (when substance in use is opioids)
Instead of “Substance or Drug Abuser”
Use “Patient”
Instead of “Junkie”
Use Person in active use; use the person’s name, and then say “is in active use.”
Instead of “Alcoholic”
Use “Person with alcohol use disorder”
Instead of “Drunk”
Use “Person who misuses alcohol or engages in unhealthy or hazardous alcohol use”
Instead of “Former Addict”
Use “Person in recovery or long-term recovery”
Instead of “Reformed Addict”
Use “Person who previously used drugs”
Instead of “Drunk”
Use “Person who misuses alcohol/engages in unhealthy/hazardous alcohol use”
Words can heal. Words can hurt. Words can poison. Labels can lead to stigma. And stigma leads to discrimination.
Addicted people are not all the same. They are as varied as the general population. There is no “addictive personality” common to addicted people. There is as much biological, psychological, and sociological variety among addicted people as there is among the general population. Don’t generalize.
Speaking out is central to the prevention and reduction of stigma. On the most basic level, stigma prevention involves people in recovery, treatment providers and advocates, and people concerned about stigma speaking out. There is power in people telling their stories. Perceptions can change. Attitudes can shift. Behaviors can be modified. Knowledge can be increased. But none of these will happen unless people speak out. When people speak out, the power of stigma is diminished. When people tell their stories, others struggling with recovery receive encouragement, recognize that someone else has taken this journey, and perceive that they too can stay on the journey to recovery. It gives people in recovery hope.
Explore Our Stigma Resources
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Healthcare Professionals
Learn More About MAT
The treatment and recovery communities can help recovering people grow by recognizing that they have a disease but are not defined by that disease. Recovery is about becoming a caring husband or wife, a loving father or mother, or perhaps a better son or daughter. Helping people achieve healthy biopsychosocial and spiritual lives and helping them to recognize that they have the capacity to do so is the greatest tool we have to prevent and reduce stigma.
—Richard Landis, Senior Vice President of Operations, Danya International, Silver Spring, Maryland
When a patient comes in for the first visit, focus on three things to minimize stigma and promote an effective dialogue:
Let the patient tell their story.
Start out broadly, asking open-ended questions to get the patient talking about their story—not their substance use disorder story, but rather their personal story. People really want to tell their story, but they often feel constrained in a medical environment. But if you allow them to [tell their story,] it can be the most efficient thing of all…. People want to be heard. You can get a lot of relevant information right up front. Certainly, by the time [a patient] is open to treatment, they’re not having a good time. They’ve really exported to a phase of substance use disorder that’s miserable in trying to avoid withdrawal and struggling with something that feels like it’s got a stranglehold on them.
Get to the heart of the matter.
Understanding the reason for a patient’s substance use is key to finding the treatment option most suitable for that patient. “They’re usually really hurting, and almost always they have some story of trauma that underlies it.
Convey respect.
Stigma is a big issue in these conversations, and respect is a key ingredient to avoiding it. “People with substance use disorders, because of the stigma, are used to being treated badly,” Dr. Komaromy said. “It’s so important to convey respect. The message—on a really gut level—is that I’m just another human being like you, and I want to figure out how I can help.”
Pay attention to the following:
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Never conduct the interview while standing.
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Try to sit at the same level as the patient.
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Make eye contact.
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Say things that are encouraging, empathetic and simple during their story such as, ‘That sounds really difficult.’
Impact of Person First Language in Addiction Treatment
Using appropriate language in a rehab treatment setting can positively affect the ways individuals view themselves and their ability to make lifestyle changes. Inappropriate language can have the opposite effect by stigmatizing certain groups and depersonalizing someone who is attempting to withdraw substance use from their individual identity.
Stigmatizing words can discourage, isolate, shame and embarrass someone with a substance abuse disorder. Entire groups of people become devalued and excluded from society when identity first language is used to describe socially unacceptable health conditions. People may decide not to seek the treatment they need because of the stigma and social or economic consequences resulting from the way they’ve been defined.
MAT Stigma
Medication for Addiction Treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications used in MAT are approved by the Food and Drug Administration (FDA) and MOUD programs are clinically driven and tailored to meet each patient’s needs.
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Pharmacists & Pharmacy Chains
Stigma may be experienced in all areas of life, but stigmatizing language or actions from pharmacists is particularly harmful because it negatively affects people seeking medication at a time when they are their most vulnerable. Stigma in pharmaceutical practices undermines proper medication administration, treatment, and successful health outcomes. And as a result, is a barrier to care for people seeking services for disease prevention or treatment of acute or chronic conditions like Opioid Use Disorder, Substance Use Disorder, HIV and Hepatitis C, and Mental Illness. Using appropriate terminology, language, and actions—free from bias and discrimination—positively affects the way patients may view themselves and their willingness to continue treatment.
Hear the voices of people who know only too well what stigma looks like—because they have faced it. There is no one-size-fits-all approach to ending stigma. We hope these voices enlighten you and help you consider different approaches and new solutions to ending stigma.
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Law Enforcement
Impact of Person-First Language for Law Enforcement. When police officers interact adaptively with those suffering from mental illness, opioid use disorder, substance use disorder, and HIV, outcomes are generally more positive. Effective communication skills, understanding these disorders and their consequences, and treating people with compassion and respect, will more likely lead to non-violent conflict resolution. Encounters between the police and people with these disorders have most likely increased as part of the deinstitutionalization process of some mental health and recovery services. The use of appropriate language BY law enforcement can positively affect the ways individuals VIEW law enforcement. Inappropriate language can have the opposite effect by stigmatizing individuals suffering and lead to a higher level of conflict.
Stigmatizing words can discourage, isolate, shame, and embarrass someone with a chronic condition. Entire groups of people become devalued and excluded from society when disorder-labeling language is used to describe socially unacceptable health conditions. People may decide not to seek the treatment they need because of the stigma and social or economic consequences resulting from the way they’ve been defined.
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Community Partners
Impact of Person-First Language for Community Partners. Stigma blocks access to employment, housing, assistance, and quality healthcare. So it is critical that community partners that may help provide these and other resources use appropriate language. One in four Americans lives with a mental health or substance use disorder. The stigma experienced by individuals living with mental health, substance use disorder, opioid use disorder, or HIV is one of the biggest barriers to treatment and recovery. When we stigmatize, we view others through a lens of false assumptions, focus solely on a diagnosis, and reduce a person to a label.
Stigmatizing words can discourage, isolate, shame, and embarrass someone with a chronic condition. Entire groups of people become devalued and excluded from society when disorder-labeling language is used to describe socially unacceptable health conditions. People may decide not to seek the critical—often life-saving—services offered by the community because of the stigma they encounter from these providers.
CAMPAIGN PARTNERS
The Alabama Department of Public Health and the Alabama Department of Mental Health launch a statewide campaign, Stop Judging. Start Healing, aimed at assisting friends, family, physicians, mental health care clinicians, substance abuse prevention and treatment providers and all people in Alabama to change the way we speak about individuals with mental health illness, substance and opioid use disorders, HIV and Hepatitis C.
The language we use can be hurtful and harming to the people we care about. Using words that help and support others is important. Decreasing stigma surrounding mental health illnesses, substance and opioid use disorders and HIV and Hepatitis C is vital to ensuring accurate information is shared with those we love and care for.
“People with these conditions often fear that others are blaming or judging them,” State Health Officer Dr. Scott Harris said. “These conditions are manageable, and so it is important for everyone to understand that irrational fear creates barriers to people seeking and receiving care. Compassion helps break these barriers. Everyone deserves dignity, compassion and support.” The campaign encourages the public to have open conversations to break the cycle of stigma by sharing kindness and understanding. Changing the way we talk changes people, and the words providers and families use are powerful.
The statewide campaign consists of television, social media and radio advertisements, with a targeted delivery of information to medical professionals to increase awareness of the importance of the use of people-first language.
Watch the videos, share on social media using #stopjudgingstarthealing, and help change the conversation.
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