The language we use to describe drug use and opioid use disorder (OUD) can increase bias and stigma towards people with OUD and those living in recovery. When patients are described with stigmatizing language such as “substance abuser”, healthcare professionals have more negative views of the patient.1In these scenarios, healthcare professionals assign more blame to the patients for their disorder and believe the patients to be more deserving of punishment than patients who are described with more neutral terminology such as
“having a substance use disorder”.2 This has been shown in other settings with people outside of the healthcare profession as well, including in the general public.3,4 As discussed earlier in this module, bias and stigma towards patients with substance use disorders including OUD can directly impact the treatment patients receive or seek out.
What Language Should We Use?
In general, we should talk about addiction using person-first language that is “neutral”, “precise”, and “respectful”.5 Person-first language recognizes that someone with a disorder is a person who has a disorder, rather than a person who is their disorder. For example, someone who uses heroin is not an “addict.” They are a person who also has an opioid use disorder. Using non-biased language is also critical— words like “abuser” and “abuse” denote
morally bad people such as “child abuser” or “physical abuse.” Words like “clean” to refer to a urine drug screen or a person in recovery implies that a person with an active substance use disorder is in some way “dirty.” Furthermore, these are not precise medical terminology.
Here are some examples of stigmatizing language and preferred terminology to use instead:
Drug misuse
Substance/opioid use disorder
(if clinically appropriate)
Person with substance/opioid use disorder
Negative vs. positive (as a test result)
In recovery Not using drugs
Pharmacotherapy Medications for opioid use disorder Medications for addiction treatment Opioid agonist therapy Treatment
“Medication-assisted treatment” suggests that medication on its own is not full treatment for addiction, whereas data show improved outcomes for people on these medications as their main treatment modality. “Substitution therapy” implies that being on medication is “substituting one addiction for another”, whereas medications for OUD are actually treating addictions rather than creating new addictions.