“Sticks and stones may break my bones, but words will never hurt me.” Remember learning to say that old adage as a kid? Well, as you’ve probably realized by now, that statement is not true at all. Words can hurt, and they can hurt a lot. There may be some painful words that were said about you that still linger today, whether you heard them yesterday, a month ago, or even decades past.
With the realization that words really do matter, the addiction and mental health communities have taken notice. Words that were used for so long to describe people struggling with substance abuse or mental health have led to an entrenched addiction and mental illness stigma in our society. Even professional clinicians have been guilty of using words that further the stigma of alcoholism or drug addiction and so forth.
In response, destigmatizing mental health and addiction has become a collective effort in hopes of creating positive change. And part of this process has been replacing hurtful words with person-centered language around addiction and mental health terminology.
Addiction Stigma, Explained
The Merriam-Webster Dictionary defines stigma as “a set of negative and unfair beliefs that a society or group of people have about something.” Tellingly, an example sentence that Merriam-Webster uses for “stigma” pertains to addiction stigma. In society, stigmas are often formed around certain types of people. If someone has a stigma towards another person, then they will likely think less of that individual. Once stigma forms, discrimination typically follows. This discrimination acted out leads to unfair or prejudicial treatment of the person who’s been stigmatized, shares the American Psychological Association (APA).
Stigma on paper may seem straightforward, but it can actually get complex. That’s because there are different types of stigma that can occur, including:
- Structural stigma: Any negative attitudes, beliefs, and practices that occur in societal systems (education, medicine, employment, and beyond) that lead to stigma
- Community stigma: Negative attitudes, beliefs, and practices that people experience in the community where they live
- External stigma: Negative attitudes, beliefs, and practices directed toward a specific individual by someone else
- Internal stigma: The negative attitudes, beliefs, and practices from external stigmas that you start to believe about yourself, shaping how you feel and who you are
SOURCE: Washington State Department of Health
Those who struggle with substance abuse, addiction, and mental health disorders are often some of the most vulnerable to experiencing stigma. Disparaging and judgmental terms are often used to describe them, addiction itself, and even addiction treatment, shares Johns Hopkins Medicine.
Consequently, the treatment that people with addictions or mental health challenges receive can be negatively affected by stigma. For example, a study by Harm Reduction Journal found that among people who inject drugs in New York City, 78% reported at least one instance of stigma as they engaged the health care system. As stigmas persist, they create a major barrier to seeking help for and overcoming addiction or mental health challenges.
What Causes Stigma?
So what causes stigma, exactly? For starters, our brains naturally put everything into categories. It’s our way of making sense of the world around us. These values that we place around different categories are learned, however, typically from our parents, friends, and our own observations, explains the APA.
Considering our natural tendency to categorize, stigma often results from a lack of understanding and fear, shares the American Psychiatric Association. Inaccurate or misleading media representations often exacerbate these fears, especially around people with addiction or mental illness. When you lack knowledge about a subject like addiction, it’s easy to believe common misconceptions. Often these misconceptions provide oversimplified, black-and-white answers that make it easy to categorize or perceive someone who’s different from you. People can even label or stigmatize others as a way to feel better about themselves.
Consequently, stigma and addiction get easily intertwined in our culture today. One of the most pervasive examples of addiction stigma — rooted in misconception and fear — is the belief that addiction is a personal choice that comes from a lack of willpower, self-discipline, and moral failing. It’s your own fault if you have a cocaine addiction, someone may believe. A related mental illness stigma is that people with mental health disorders are dangerous or unintelligent. In reality, however, the truths around these stigmas are much more nuanced and complex.
Harmful Language and the Stigma of Drug Addiction
As mentioned earlier, the words we use when discussing mental health and addiction are often what allow our society’s common stigmas to persist. Words that may seem minor or innocuous to us when used can reverberate as they become widespread. Eventually they define how we discuss the topics of addiction and mental health. Though we may not want to further harmful stereotypes, the words we use can do just that, especially when it comes to drug addiction. Some harmful words and phrases that encourage the stigma of drug addiction include:
- _______ addict (meth addict, opioid addict, drug addict, etc.)
- Coke head, pot head, or crack head
- Junkie
- Drug offender
- Dope sick
- Dirty
- Clean
- Addictive personality
SOURCE: New York Office of Addiction Services and Supports
Harmful Language and the Stigma of Alcoholism
Stigma and addiction are also incredibly tied to alcohol use disorder. Consequently, the stigma of alcoholism is very present in our cultural vernacular. You may be very familiar with some of the following stigmatizing terms yourself:
- Drunk
- Drunkard
- Boozer
- Alcoholic
- Alcohol problem
- Sober
Harmful Language and Mental Illness Stigma
Stigmatizing language is also rampant in mental health contexts. As mental health disorders and struggles continue to tighten their grip on our society, harmful words only make an even greater negative impact. Common stigmatizing words used to describe mental health disorders include:
- Mentally ill
- Crazy
- Insane
- Disturbed
- Manic-depressive
- Psychotic
- Neurotic
- Bipolar
SOURCE: Mental Health First Aid and Mental Health Foundation
Person-Centered Language for Addiction and Mental Health
As harmful language circulates the mental health and addiction stigma, those struggling with these challenges suffer most. Stigmatizing words tend to identify people more by their disorder or disease, rather than seeing them as a person in need of healing. But people are so much more than their substance use disorder or mental illness. That’s why health professionals are working to make positive changes. Recognizing that a person’s identity is closely linked to words used to discuss them, efforts have been made to replace our culture’s entrenched vocabulary with non-stigmatizing language for addiction and mental health disorders.
As a result, person-centered language has been advocated with the goal of being more inclusive, empowering, and accurate regarding addiction and mental health. According to the University of Minnesota, person-centered language puts the person first rather than the illness. It respects the dignity, worth, strengths, and unique qualities of the human being discussed. By using person-centered language, you shift the focus on the person and their recovery, not just on the illness they’re facing.
In treatment settings and among the professional community, words and terms used to describe addiction and mental health disorders, as well as the people impacted by them, are being revised. While this is helping to make progress in reducing stigma, person-centered language can become all the more effective when adopted by society as a whole. Here are a few examples of situations where non-stigmatizing, person-centered language can be utilized:
- “Person with a substance use disorder” instead of “addict”
- “Person with a mental illness” instead of “mentally ill”
- “Working to recover from” instead of “suffering with”
- “In recovery” instead of “clean”
- “Person with opioid addiction” instead of “opioid abuser”
- “Person who misuses alcohol” instead of “drunk”
- “Use” or “Misuse” instead of “abuse”
- “Person in recovery” instead of “recovering addict” or “recovering alcoholic”
More Work to Be Done
As person-centered language replaces stigmatizing language, the emphasis gets placed more on the person and their recovery. This opens up opportunities for those struggling to seek the help they need with dignity, understanding, and support.
While progress has been made in destigmatizing mental health and addiction through this revised language, stigma still prominently exists in our culture today. A 2021 Drug and Alcohol Dependence study revealed that 80% of publications focusing on opioid use disorder did not follow person-centered language guidelines set by the American Medical Association, for example.
Mental health and addiction stigma continues to prevent people from getting professional care for their conditions. Many with substance use disorders still face mistreatment, stereotyping, and negative bias, so they fear disclosing their substance use to others, shares the National Institute on Drug Abuse. And if they do get help, stigma can prevent them from getting the quality care they deserve. All of this goes to show that there’s more work to be done to change the narrative around addiction and mental health, one non-stigmatizing word at a time.
How to Help Someone With Addiction
If your loved one is struggling with addiction, what can you do to help? For starters, it’s important to adopt person-centered language when talking to them about their disease (or about them in general). But you also need to encourage your loved one to seek professional help, while seeking to educate yourself on addiction in the process.
At Defining Wellness Centers in Mississippi, we offer compassionate, evidence-based addiction treatment programs that don’t stigmatize those struggling. Yet we also provide a holistic family program that equips family members like you to support their loved one in addiction recovery. To learn more about our treatment programs (including dual diagnosis treatment for co-occurring mental health disorders), call us today.