How To Refer to Someone Suffering With Addiction

Substance use disorder (otherwise known as addiction) has a devastating effect on the health of Americans as well as their families and loved ones. It is the public health crisis of our time.

In the United States, approximately 115 people die every day from opioid-related causes, and 88,000 people per year suffer alcohol-related deaths. The rate of drug overdose deaths exceeds that of motor vehicle accidents. And yet, of the 21 million Americans with substance use disorders, fewer than 3.8 million receive treatment.

A major barrier to that treatment is the stigma attached to addiction. People with severe substance use disorder don’t seek treatment because of the fear of being stigmatized or discriminated against by their friends, neighbors, co-workers, or employers.

The latest research in recovery science shows that the language we use perpetuates that stigma. It also affects access to quality treatment and negatively impacts medical professionals’ perception of people suffering with this serious medical condition.

Changing the way that we refer to people with substance use disorder is crucial if we want to get people the help they deserve.

How we should refer to people with addiction

While some say labels don’t matter, the intention behind the label does. Some labels create negative perceptions that attach shame, blame, and judgment — not to mention bias that affects access — to treatment.

We don’t add modifiers to describe any other medical conditions, even conditions that can arise out of personal choice — for instance, we refer to a smoker, not a tobacco abuser. Someone who develops diabetes isn’t identified as “Jim the diabetic.” So why do we do this with substance use disorders?

The Recovery Research Institute conducted a study where physicians were asked how they felt about two people who were actively using drugs and alcohol. One person was referred to as a substance abuser and another as having a substance use disorder. They revealed that participants in the study felt that the “substance abuser” was:

• Less likely to benefit from treatment

• More likely to benefit from punishment

• More likely to be socially threatening

• More likely to be blamed for their substance-related difficulties

• Less likely to be perceived as having a problem that is the result of an innate dysfunction over which they have no control

• More able to control their substance use without help

Source: Recovery Research Institute

Building upon the already existing foundation of work, researchers Robert Ashford, Austin Brown, and Dr. Brenda Curtis of the Recovery Research Institute conducted a larger study of the general public measuring the explicit and implicit bias elicited by using a more extensive list of key words and phrases. They too found that certain phrases elicit bias (see below).

Ashford, Brown, and Curtis produced a helpful diagram to be used as a tool in finding the appropriate language to use when referring to people with substance use disorder.

The Recovery Research Institute also recommends that to destigmatize addiction, we need a unified language. They have provided an incredibly helpful and extensive Addictionary.

To be clear, no one is suggesting that people should stop identifying themselves by certain phrases in the safety of a mutual-aid meeting, like AA or NA (as the diagram indicates). That is a personal choice and one made within the parameters of that culture. However, outside of meetings, the science clearly states that some labels are stigmatizing, and that using them may contribute to the problem rather than a solution: getting more people the help they need.