People who use drugs play a critical, often unacknowledged and unsupported, role in responding to overdoses. Overdose Awareness Day, on August 31, is a good opportunity to recognize the contributions of these individuals and reframe the way in which we think about and describe drug use.
“Stigma around drug use is widespread,” said Dr. Jane Buxton, harm reduction lead at the BC Centre for Disease Control (BCCDC). “Reducing stigmatization contributes to people feeling less isolated, and means people will be more likely to access services. The language we use has a direct impact on the health of people who use drugs.”
The BCCDC regards people who use drugs, also known as peers, as the experts in the reality of drug use and believes that engagement with peers is a critical component of effective program and policy development to reduce substance-related harms. Their lived experience means they can identify the needs of their community and what is acceptable to people who use drugs.
“Most of the innovation is from the local community of people who use drugs and activists,” said one attendee of the 2017 Overdose Action Exchange.
Peers are also are regularly the first to respond to an overdose and provide emergency care.
“Being aware that our words can cause isolation and discrimination helps us understand why we need to show compassion and reframe language,” said Dr. Buxton. “We have a responsibility to use appropriate language which can influence the public discourse and reduce stigma around substance use.”
A study by the Centre for Addictions Research of B.C. found that in hospital, people who use or used illicit drugs often feel excluded and judged. They described their hospital care experience as disrespectful and lacking compassion. A common fear expressed by patients was that in hospital they would be judged, labelled and blamed for their current health problems and drug use.
The BCCDC has created guidelines to using non-stigmatizing language.
- Use people-first language
This means referring to a person before describing his or her behaviour or condition. This is important because it acknowledges that a person’s condition, illness or behaviour is not that person’s defining characteristic.
vs. Opioid user or addict
- Use language that reflects the medical nature of substance use disorders
There are a multitude of factors contributing to drug addiction, ranging from personal factors to social, environmental and political ones. Avoid terms that reinforce a belief that addiction is a failure of morals or personality, rather than a medical issue.
vs. Abuser or junkie
- Use language that promotes recovery
This means healthcare professionals should use language that conveys optimism and supports recovery, and respects the person’s autonomy.
vs. Unmotivated or non-compliant
- Avoid slang and idioms
Slang terms and idioms have negative connotations and a significant level of stigma attached to them. While slang and idioms are rarely used in professional literature, they are also important to avoid when speaking to other colleagues or healthcare professionals.
vs. Dirty test results or clean test results
We all have a role to play in applying these guidelines in our everyday life and work. With careful attention to language, we can reduce the burden of stigma surrounding drug use and improve access to health care for people with substance use disorders. What we say, and how we say it, matters; it saves lives.