Words matter: De-stigmatizing substance use disorders

March 31, 2023 | by Lekshmi Venugopal, M.D.
Categories: Healthy Driven Minds

Words matter. The words used to describe a person can impact their identity, self-image and even their health.

Mental illnesses and substance use disorders are among the most stigmatized of health conditions. Stigma stems from inaccurate beliefs that mental illness and/or addiction are a moral failing, or that people with these diseases are at fault for their condition.

Substance use disorder (SUD) is a major public health concern in the U.S., impacting more than 21 million people, yet only 3.8 million receive care. Why aren’t people getting the care they need?

When a person with a mental illness or SUD experiences stigma, they may begin to internalize it. Research shows that self-stigma can lead to lower self-worth and create barriers to treatment and recovery.

As the National Institute on Drug Abuse (NIDA) states: “Often unintentionally, many people still talk about addiction in ways that are stigmatizing—meaning they use words that can portray someone with a SUD in a shameful or negative way and may prevent them from seeking treatment. With simple changes in language, harmful stigma and negativity around SUD can be reduced or avoided.”

Person-centered language puts people first, rather than their illness or disability. It focuses on respecting the dignity, worth and strengths of an individual. This means choosing words that express that a person has a problem/illness, rather than is the problem.

According to a 2018 study by Robert Ashford et al, “terms that label people elicit the strongest negative biases.” In the behavioral health field, work has been done to reduce negative terms, such as “addict,” “alcoholic” or “relapse,” and re-frame them with more positive, person-centered terms, such as “person with substance use disorder,” “person with alcohol use disorder,” or “recurrence of use.” 

Stigma around treatments for substance use disorder is also an issue. It has been established that substance use disorders and mental health disorders are chronic diseases of the brain, like diabetes is a chronic disease of the pancreas.

Nobody questions medications to treat cancer, hypertension or diabetes. We do not use the term medication-assisted treatment when referring to insulin for the treatment of diabetes. Why do we use it for the treatment of substance use disorder?

The team at Linden Oaks Behavioral Health is challenging the stigmatization of treatment for mental health and substance use disorder. The focus on recovery starts with changing the name of our “Medication-Assisted Treatment Clinic” to OARS, or Ongoing Addiction Recovery Services.

In efforts to provide person-centered care and use person-centered language, the Linden Oaks team encourages the medical community to adopt a more positive recovery and strength-based language when addressing chronic brain diseases like substance use disorder and mental illness. We will continue to look for ways to de-stigmatize mental illness and remove this barrier to recovery.

How can you do your part to help de-stigmatize mental illness and substance use disorder? Here are 4 steps you can take:

  1. Educate yourself. Know the facts about mental illness and substance use disorders, which are treatable medical conditions.
  2. Be aware of your attitudes and behavior. Examine your own judgmental thinking, reinforced by your upbringing and society.
  3. Choose your words carefully. When talking to or about people with substance use disorder, don’t use words that are stigmatizing. Instead, use person-first language that separates the person from his or her illness.
  4. Treat others with respect and dignity. Offer support and encouragement for people in your community who are battling a chronic brain disease like substance use disorder or another mental health disorder.

Let’s all agree that words matter. Let’s make an effort to use appropriate language to describe mental illness and substance use disorders. It could encourage someone who needs help to get the care they need and to be their best.

Lekshmi Venugopal, M.D., is a psychiatrist who specializes in addiction medicine and is Chief Medical Director of PHP/IOP at Linden Oaks Behavioral Health.

If you or a family member needs help with drug or alcohol addiction, you aren’t alone. Get support from Linden Oaks Behavioral Health.

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