The death rate due to overdose continues to rise in the United States each coming year, solidifying our country’s state of emergency in the face of the opioid crisis. Unfortunately, the stigma surrounding individuals who use drugs poses a barrier to both receiving and administering life-saving treatment. Reducing this stigma is the first, and one of the most important steps, to reversing the effects of the opioid crisis and creating a welcoming environment for patients and their families.

“Stigma” Defined

The word “stigma” derives from Latin and Greek, originally meaning a burn or other mark inflicted on a person to signify their dishonorable position in society. Today, the word can be defined as a means of labeling, stereotyping, or discriminating against other members of a community. The different categories of stigma are as follows:

Structural/Institutional Stigma: The stigmatization of a group of people by way of policies and procedures. It is manifested in “societal-level conditions, cultural norms, and institutional practices (laws, regulations, etc.) that constrain opportunities, resources, and wellbeing for stigmatized populations.”

Public Stigma: Negative social norms (attitudes, beliefs, and behaviors) held within a community or a larger cultural context.

Self/Internalized Stigma: An individual’s acceptance of negative beliefs, views, and feelings towards themselves and the stigmatized group to which they belong. It often arises as a result of previous experiences of discrimination or rejection and can lead to denial of symptoms, rejection of treatment, and contribute to the isolation of people with substance use disorders (SUDs).

These levels of stigma present a larger issue for those dealing with SUDs beyond negative public perception. The stigma surrounding drug use directly affects the quality of care provided within the healthcare system and hinders the likelihood that patients will seek treatment within their own communities.

Combatting Stigma Surrounding Addiction

Many individuals believe that addiction is an active choice that reflects a lack of self-control or serious moral dysfunction. In reality, addiction is a disease in the same way depression, anxiety, and other mental illnesses are considered. Reducing the stigma surrounding substance use disorders is a key aspect of battling the opioid crisis. Not only will it encourage more individuals to seek assistance, but it will also aid healthcare providers in administering quality treatment to all patients.

Research has shown that focusing on the person, and not the condition, is an essential strategy for combatting the stigma surrounding SUDs. “Person-first language” humanizes the individual and helps others overcome their negative feelings toward persons who use drugs.

When working with people who use alcohol and other drugs:

Try “substance use” instead of “abuse,” “misuse,” or “problem use.”

Try “person who uses/injects drugs” instead of “drug user/abuser.”

Try “person with a dependence on…” instead of “addict,” “junkie,” or “druggie.”

Try “currently using drugs” instead of “using again,” “fallen off the wagon,” or “had a setback.”

There are a number of person-first words and phrases that can be used instead of the verbiage commonly used to describe substance use disorders. This article from Johns Hopkins Medicine offers additional phrases and information that help in combatting the stigma surrounding patients with substance use disorders. Look out for loved ones, and pay close attention to how you speak of patients dealing with SUDs. Your words matter, and together we can reduce the rate of drug overdose in our communities.

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