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How changing language of addiction can affect stigma, treatment, recovery

Changing the language used to discuss addiction and substance use disorders may reduce stigma and thus improve treatment and recovery rates, according to an editorial in JAMA.

“Stigma isolates people, discourages people from coming forward for treatment, and leads some clinicians, knowingly or unknowingly, to resist delivering evidence-based treatment services,” Michael P. Botticelli, MEd, of the White House Office of National Drug Control Policy, Washington, D.C., and Howard K. Koh, MD, MPH, of the Harvard T.H. Chan School of Public Health, Boston, wrote.

Despite scientific research that shows addiction is a chronic brain disorder, individuals with substance use disorders continue to be viewed with stigma.

Data from the 2014 National Survey on Drug Use and Health indicated that of the 22.5 million individuals who required specialty treatment for substance use disorders, approximately 2.6 million received treatment in the past year. Of the 7.9 million individuals who required specialty treatment for illicit drug use, approximately 1.6 million received treatment.

Reasons for not seeking treatment included fear that receiving treatment would negatively affect an individual’s job or opinion of neighbors or community members, lack of insurance coverage, cost concerns and no perceived need for treatment.

To address these issues, the AMA is looking to clinicians to help reduce the stigma of substance use disorders and increase access to comprehensive care.

The American Society of Addiction Medicine and key addiction journals are encouraging use of clinical, non-stigmatizing language when discussing addiction.

Further, the 2013 DSM-5 replaced categories of substance “abuse” and “dependence” with “substance use disorder.”

The federal government has also begun to address de-stigmatizing language for addiction, according to researchers. The White House Office of National Drug Control Policy recently released a guide, titled “Changing the Language of Addiction,” to help federal agencies accurately use language regarding substance use disorders.

The guide applies to internal and external communications, including publications, press and web materials and funding announcements and encourages federal officials, contractors, grantees and others to use non-stigmatizing language.

“Changing language and related policies and programs will take time. Some stigmatizing terms and stereotypes related to [substance use disorders] have been ingrained in society for generations. For instance, the word ‘abuse’ continues to appear in the titles of highly respected addiction journals and in the names of federal government agencies,” the researchers wrote. “By beginning to change the language of addiction, it is possible to foster a better future for people with [substance use disorders]. Doing so could help remove barriers that continue to hold back too many people from the lifesaving treatment they need.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.