Psychologists who study stigmas around opioid use say that the scientific community can help dismantle unfair stereotypes by correcting language in clinical and research settings.
"Language that's medically accurate will ultimately trickle down into mainstream media and popular culture," says David Eddie, PhD, clinical psychologist and research scientist at the Recovery Research Institute at Massachusetts General Hospital in Boston.
Here are examples of stigmatizing language to avoid and alternative terms to use.
"Drug abuse" and "drug abuser"
Research by John Kelly, PhD, founder and director of the Recovery Research Institute, suggests that clinicians show increased bias toward patients described as "drug abusers." Instead, Kelly recommends using the terms "substance use" and "person with a substance use disorder."
"We don't speak this way about other health conditions, so we shouldn't speak this way about addiction," he says. For example, we refer to people with eating-related problems as having an eating disorder rather than being food abusers.
"Addict," "alcoholic" and "user"
The terms "addict," "alcoholic" and "user" define people solely by their behavior around substances, implying that other aspects of their identities are insignificant. Psychologists should avoid these words and instead use person-first language to describe patients or research participants. Terms such as "person with a substance use disorder" or "person in recovery" are less stigmatizing and more accurate.
"Clean" and "dirty"
For decades, clinicians have used the words "clean" and "dirty" to describe both individuals and the results of their drug screen tests. Howard Koh, MD, MPH, a professor in Harvard's T.H. Chan School of Public Health, urges providers to forgo such language. Drug screens should be described as "positive" or "negative" and patients as "in recovery," "abstinent" or "resuming use of a substance."
"Medication-assisted treatment"
Even the term "medication-assisted treatment," which describes rehabilitation involving medications such as methadone and buprenorphine, is often misinterpreted and can worsen stigmas around opioid use, says Kelly. The use of such language to describe treatment for addiction—but not for the thousands of other health conditions treated with medications—reinforces the misconception that those who rely on such treatments have simply developed a "replacement addiction." A good alternative is to refer to these substances as "medications for addiction treatment."
