Some words carry negative connotations. Calling someone an “addict” or an “alcoholic,” defines that person by a behavior, and downplays their humanity. These labels imply a permanency to the condition, leaving no room for change. Substance use disorder is a chronic disease. As such, it’s better to use words that reinforce the medical nature of the condition.
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The Importance of Person-First Language
Say This |
Not That |
Here’s Why |
| person with a substance use disorder (SUD) | addict, junkie, druggie, crackhead, pothead, pill popper, abuser, user, cokehead, dope fiend, doper, drug fiend | Using people-first words can reduce the shame some people feel and make it easier for them to seek help. The change shows that a person has an illness – one that can be treated. |
| person with an alcohol use disorder (AUD) | alcoholic, drunk, lush, wino, heavy/hard/serious drinker, boozer, partier, problem drinker | |
| substance misuse, non-medical use | substance abuse, drug abuse | The word abuse is almost always connected with violence, anger, or a lack of control. It perpetuates the idea that the person is choosing to misuse a substance, not struggling with substance use disorder/alcohol use disorder. |
| medication-assisted treatment | opioid replacement, methadone maintenance | Describing these treatments as “replacements,” minimizes their validity and implies that the individual is still actively using drugs. Methadone, Suboxone, and Vivitrol are medications prescribed to a person with a substance use disorder. With medication assisted treatment, the substance misuse is stopped, not replaced. |
| abstinent, not actively using, in recovery, on the path toward recovery, not currently using substances, person in long-term recovery, substance free | former/reformed addict, former/reformed alcoholic, clean, off the sauce, off drugs, gave up the needle, put down the pipe, on the wagon, dry |
Using clinically accurate language the same way you would for other medical conditions reduces the stigma surrounding SUD. Antiquated and inaccurate beliefs about SUD view it as a moral failing. These labels lead to feelings of pity, fear, and anger toward those with an SUD, and reinforce negative stereotypes. |
| actively using, actively drinking, testing positive for substance and/or alcohol use | dirty, a dirty drug screen, dirty drop, tested dirty, I am dirty | This terminology implies a person struggling with a SUD/AUD is inherently “dirty”. If test results indicated that insulin levels of an individual with diabetes had increased, you would never say their test results came back dirty. Both diabetes and substance use disorder are medical conditions and should be discussed as such. |
| recurrence, resumed drinking, experienced a recurrence | relapse, slip, fell off the wagon | Words like “relapse” and “slip” can make an individual feel damaged, defective, or unsuccessful, rather than a person with a legitimate medical condition. They may also decrease a person’s sense of hope, confidence, and optimism. |
| Substance use disorder (SUD), alcohol use disorder (AUD), non-medical use, unhealthy use, risky use, harmful use | habit | A habit can be broken through persistence or willpower. Calling substance use disorders “a habit” undermines the seriousness of the disease, denies the medical nature of the condition, and implies that resolution of the problem is simply a matter of willpower. |
| a person whose family member has a SUD | co-dependent, enabler | The words co-dependent and enabler can categorize family members’ concern and care for their loved one as abnormal or unhealthy. They also have a tendency to increase shame. |
| baby born to mother who used drugs while pregnant, baby with signs of withdrawal from prenatal drug exposure, baby with neonatal opioid withdrawal/neonatal abstinence syndrome | crack baby, methadone baby, drug baby, addicted baby, addict baby | Babies exposed to SUD in utero experience symptoms associated with substance withdrawal. If a mother does not know the options available to her or can’t access care, it can be detrimental to both her and the baby. If a mother stops using without the care of a physician, it puts the baby at risk of dying in utero. |