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HEALing Communities: Changing how we talk about addiction

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Consider using these recommended terms to reduce stigma and negative bias when talking about addiction.

People often ask me “What can we do to stop addiction?” Considering that humans have used substances to alter their mood for thousands of years, I don’t think it is realistic to aim for a drug-free world. What we can do, however, is rethink how we approach substance use, misuse and addiction. That starts with how we view individuals who struggle with substance use and how we talk about them. We may not be able to stop substance use altogether, but we can end the stigma, shame and fear associated with it. Reducing stigma starts with every one of us — and it can literally save lives.

Stigma is still a major barrier for people seeking and looking to access addiction treatment. This led the Cayuga HEALing Communities team to make stigma the topic for our final public information campaign over the next few months. We designed a pamphlet with content from the National Institute on Drug Abuse that explains stigma, how damaging it can be, and how changing our language is an important step in reducing stigma. Since we all play a part in framing the discourse around addiction, every household in the county will receive an "End Stigma" pamphlet in the mail as part of our campaign outreach. For more information on stigma or if you would like to download the pamphlet as a PDF, visit If you are interested in displaying pamphlets at your place of business or distributing them to your staff or clients, feel free to email me at the address below and we will provide you with the print material.

What is stigma? Stigma about people with substance use disorders might include inaccurate or unfounded thoughts and beliefs like they are dangerous, incapable of managing treatment or at fault for their condition.

Where does stigma come from? Stigma around addiction may come from old and inaccurate beliefs that addiction is a moral failing or fear of things that are different or misunderstood. Today, we know that addiction is a chronic, treatable medical condition. We also know that people can recover and continue to lead healthy lives.

What are the types of stigma? Social stigma involves the judgment and attitude of those around you, using negative labels in conversations, and discriminating against people with SUD. Structural stigma is perpetuated by individuals who deliver public and private services by treating people with substance use disorder differently, ignoring them or withholding treatment. Self-stigma refers to internalizing negative messages that diminish your self-esteem, self-worth and sense of belonging.

How does stigma affect people with substance use disorder? Feeling stigmatized can reduce the willingness of individuals with SUD to seek treatment. Stigmatizing views of people with SUD are common; this stereotyping can lead others to feel pity, fear, anger and a desire for social distance from these individuals. Stigmatizing language can negatively influence health care provider perceptions of people with SUD, which can impact the care they provide.

Monika Salvage

Monika Salvage

How can we change stigmatizing behavior? When talking to people with SUD, their loved ones and your colleagues, use non-stigmatizing language that reflects an accurate, science-based understanding of SUD and is consistent with your professional role. Because clinicians are typically the first points of contact for a person with an SUD, health professionals should “take all steps necessary to reduce the potential for stigma and negative bias.”

Take the first step by learning the terms to avoid and use. Use person-first language and let individuals choose how they are described. Person-first language maintains the integrity of individuals as whole human beings — by removing language that equates people to their condition or has negative connotations. For example, “person with a substance use disorder” has a neutral tone and distinguishes the person from his or her diagnosis. 

See the chart with this column for terms to avoid, terms to use and why. Consider using these recommended terms to reduce stigma and negative bias when talking about addiction.

Monika Salvage works for the Cayuga County Mental Health Department as the project director for the HEALing Communities Study, a multi-year, multi-state research study to reduce opioid overdose deaths through the implementation of evidence-based practices. If you are interested in learning more or getting involved, please call (315) 253-1522 or email


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