We live in a world where labels can make or break a person. Diagnoses are no different. Fortunately, most physical healthcare providers don’t allow diagnoses to define their patients. They see a diagnosis as a small piece of the individual who is learning to survive, despite a medical battle. Unfortunately, we allow addiction to define approximately 21.5 million Americans each day. Society views those diagnosed with cancer, diabetes, asthma and other medical conditions as unfortunate victims of a disease that requires treatment, support and assistance. Conversely, those who abuse illicit substances are at times viewed as offenders, moral failures and agents of their illness. The medical community utilizes scientifically proven medications and lifesaving treatments to stabilize and manage those with chronic physical health conditions. On the other hand, the idea of medication to treat addiction, or Medication Assisted Treatment (MAT), is oftentimes viewed by society as a crutch or replacing one addiction for another. Medications for other chronic physical health conditions are not referred to as MAT although they are used to manage physical conditions along with healthy lifestyle changes and behavioral modification the same way MAT is utilized in addiction treatment. Medications to treat substance use disorders such as Buprenorphine, Naltrexone and Methadone Maintenance should not require a different label.
Stigma and discrimination, simply stated, are the reasons for the behavioral health disparity. The solution, although a bit more complex begins with simple changes. To reduce the stigma of substance use disorders we must support the implementation of clinical language that promotes improved treatment and access to care. To improve care, we must use medically accurate, person-first language that focuses on the individual and not the disorder. We must begin to describe those with the disease of addiction as individuals with substance use disorders. To change treatment outcomes, we must alter the language of treatment. In short, language matters.
Fortunately, on an industry level the change has already begun. In 2013 the DSM-V announced a shift in terminology by emphasizing the use of the term “substance use disorder” as opposed to previously accepted terms such as abuse and dependence which illicit pejorative biases. Following suit, the Office of National Drug Policy (ONDCP) published Changing the Language of Addiction, to align with the DSM-V. As treatment providers there is a wealth of information available to train and educate staff. Of significant note is the ADDICTIONary, a comprehensive glossary of key terms concerning addiction and recovery developed by Facing Addiction and the Recovery Research Institute (RRI). Check it out here.
So where do individuals start? Avoiding terms such as “drug addict” and “alcoholic can assist in reducing bias. Person first language means using the words “person with substance use disorder” instead of “addict”, “abstinent” instead of “clean” and “positive test result” instead of “dirty”. Identifying addiction as a chronic, relapsing brain disorder and not a moral failure is a great start. Supporting individuals that seek MAT as a means of treating their chronic brain disorder will make a difference. Addiction is a medical condition and we must start treating people with substance use disorders with the same dignity that the medical community offers their other patients.
Quality treatment is available, and recovery is possible. Adopting unbiassed person first language and utilizing appropriate clinical terms can help to reduce the stigma and discrimination associated with substance use disorders. As a result, we can increase the likelihood that individuals with substance use disorders will seek and receive equitable treatment. If we change the words, we can change the conversation.
Author: Bridgette Vail – Footprints to Recovery – Executive Director, Pennsylvania