Addiction is a disease. It’s important that we use language that frames it as a health issue and shows respect to people with addiction and their families who are impacted. Just like we would with any other disease, like diabetes or asthma.
A person shouldn’t be defined or labeled by his or her disease or illness, it is something they have. For example: Instead of calling someone a “diabetic,” it’s preferable to use person-first language and say “someone with diabetes.” The same goes with the word “addict.”
We have a choice when we communicate. We can use words that perpetuate the negative stigma around substance use – words that label people with an addiction in a negative, shameful and judgmental way. Or we can use words that are compassionate, supportive and respectful – words that help others understand substance use disorder as the health issue that it is.
By choosing to rethink and reshape our language, we will allow people with an addiction to more easily regain their self-esteem and more comfortably seek treatment, allow lawmakers to appropriate funding, allow doctors to deliver better treatment, allow insurers to increase coverage of evidence-based treatment and help the public understand this is a medical condition and should be treated as such.
The Associated Press took an important step to stop using stigmatizing language toward people struggling with a substance use disorder, recognizing that words have power. We invite you to do the same.
How to change the language of addiction
The following is a list of words and phrases to avoid and words to use in their place. Together, with a unified language, we can help reshape the landscape and end the negative stereotypes and stigma of addiction. And by doing so, we can remove barriers that continue to hold back too many people from the lifesaving treatment they need.
Abuse / Abuser
EXAMPLE: He’s a drug abuser.
WHY? Linked with violence, anger or a lack of control. Not positioned as a health issue and places blame on the person with addiction.
INSTEAD SAY: “Using” with an object (i.e. using opioids), risky use, harmful use, inappropriate use, unhealthy use, hazardous use, problem use, individual struggling with substance use, individual with substance use disorder.
Addict
EXAMPLE: She’s an addict.
RELATED: alcoholic, crackhead, druggie, dopehead, doper, drunk, drunkard, junkie, pothead
WHY? The word addict is stigmatizing, reducing a person’s identity down to their struggle with substance use and denies their dignity and humanity. In addition, these labels imply a permanency to the condition, leaving no room for change. It’s better to use words that reinforce the medical nature of the condition.
INSTEAD SAY: A person with a substance use disorder (SUD), with addiction, person with an alcohol/drug problem, a person struggling with addiction; patient (if receiving treatment services).
User
EXAMPLE: He’s a drug user.
WHY? The term is stigmatizing because it labels a person by his or her behavior (much like “addict”).
INSTEAD SAY: Person who uses substances.
Clean/Sober/Staying Clean/Clean Test
EXAMPLE: She smoked pot for many years but now she’s clean; His test was clean.
WHY? It associates illness symptoms with filth and implies a person struggling with a dependence on drugs or alcohol is inherently “dirty” or socially unacceptable. Same goes when referring to a drug test as a “clean test” (i.e. a negative result/no evidence of use) or “dirty test” (i.e. to a positive result/evidence of use). These terms regarding tests should also be avoided.
INSTEAD SAY: In recovery, on the path toward recovery, not currently using substances; positive test or negative test.
Habit
EXAMPLE: She has a bad drug habit.
WHY? A habit is something that can easily be broken through persistence or willpower. Addiction is more complicated. As a disease of the brain, it requires medical treatment in addition to an emotional commitment to treatment and recovery. Calling addictive disorders a habit denies the medical nature of the condition and implies that resolution of the problem is simply a matter of willpower.
INSTEAD SAY: Substance use disorder (SUD), alcohol and drug use disorder, active addiction, problem use, non-medical use, unhealthy use, risky use, harmful use; person struggling with substance use, person with substance use disorder, person who suffers/suffered from addiction.
Replacement/Substitution Therapy
Example: He takes Suboxone, a replacement therapy for his opioid addiction.
WHY? The use of this term applies to discussions surrounding treatments for opioid dependence like Methadone, Suboxone and Vivitrol. By describing them as “replacements,” it minimizes the validity of these treatments and implies that the individual is still actively using drugs. Methadone, Suboxone and Vivitrol are medications prescribed to a person suffering from an illness, opioid use disorder (opioid addiction). Addiction is an uncontrollable compulsive behavior. The first goal of addiction treatment is to stop this dangerous behavior. With medication-assisted treatment as part of a comprehensive treatment plan with behavioral counseling, the dangerous addictive behavior is stopped, not replaced – and life can be extended.
INSTEAD SAY: Medication-assisted treatment, medication for addiction treatment, medication, treatment.
“For a long time, we’ve known that language plays a huge role in how we think about people and how people think about themselves. Words have to change so attitudes change.”
Michael Botticelli
former director of the Office of National Drug Control Policy in The Boston Globe
Editor’s Note: Some of the personal stories featured on our site use “addict” and other words from the above list. We respect and understand those who choose to use certain terms to express themselves. However, we will always strive to use language that’s health-oriented, accurately reflects science, promotes evidence-based treatment and demonstrates respect and compassion.