The power of words: Identifying the causes of stigma toward people who use drugs and taking steps to reduce it through appropriate language

The words we commonly use have a direct impact on the people around us. When we talk to or about people in vulnerable situations, there are words that hurt, words that degrade, words that divide. To use these words is to fuel stigma against the people concerned.

This is a daily reality in the field of mental health and in particular in the field of substance use and other addictive disorders. The stigmatization of a health condition is influenced by two main factors: cause and controllability. People living with HIV, for example, are still widely stigmatized by those who believe that having been infected with the virus is the consequence of “morally unacceptable” choices, particularly in relation to sexuality (cause).

As regard addiction to illegal drugs, the social stigma is even more acute: not only is it considered as choice people make (“they could say no to drugs”), but also as something “they could stop if they really wanted to” (cause and controllability).

We now know that the chronic use of substances produce profound changes in brain structure and function that radically impair efforts to control use despite harmful consequences. We also know that half the risk for addiction is conferred by genetics.

Yet, despite evidence pointing out that people are not responsible for their condition, stigma is alive and well. And research is now showing that one contributory factor to the perpetuation of stigma may be the language we use every day.

Aggressive, punitive language including words and phrases as “addict”, “war on drugs”, “drug abuse” only serve to send disparaging messages implying willful misconduct: “you use, you lose”, “they could help it but they don’t want to”, “it is their fault”… These messages only serve to increase addiction stigma, reduce help-seeking, and even impair the effectiveness of health care services.

With “The Power of Words”, Dianova’s objective is to make clear recommendations on the words that should clearly be avoided from now on, while suggesting respectful, person-first alternatives. The document also offers an explanatory overview of the different substance uses, the causes and consequences of stigmatization and, lastly, the process of stigmatization through language.