Language & stigma
How we talk about people who have problems with alcohol and other drugs directly affect those living with dependency issues. Research clearly indicates that using the right language can improve health outcomes, and conversely using stigmatising language can actually prevent people from seeking help and make them feel even more isolation.
For example, calling someone an “addict” dehumanizes that person and an extensive body of research on this topic demonstrates that language and stigma are intrinsically linked.
Research has demonstrated that, whether we are aware of it or not, the use of certain terms generates biases that can influence the formation and effectiveness of social and public health policies to address alcohol and other drug problems.
The use of slang and negative language in the media reflects the wider public’s stigmas and views associated with dependency.
Even best-intentioned media use terms that are outdated and stigmatising and more needs to be done to educate media on the damaging nature of certain terms and phrases. Media should be responsible and careful not to use dramatic headlines and images that reinforce negative stereotypes.
The use of demeaning language feeds into judgments about people, despite the fact that alcohol and other drug problems are now seen as health conditions. This is in contrast to other health conditions such as cancer or heart disease, where often no blame for the cause or controllability of the disease is attributed to the patient.
Hearing degrading language can be highly distressing and can result in people feeling shame, guilt, anger, rejection and a sense of worthlessness or hopelessness which can in turn trigger further problems.
A recent Irish study highlighted the consequences of intense stigmatisation include low self-esteem, feelings of guilt and shame, exacerbation of mental health difficulties and reduced help-seeking.
The study also demonstrated that stigma can be worse for women due to drug dependence challenging social and cultural expectations of women as nurturers, mothers, daughters, sisters, and caregivers. It highlighted that fear of stigmatising experiences is one of the most reported factors hindering women who use substances from accessing treatment.
Stigma among health professionals towards patients with substance use issues and its consequences for healthcare delivery has also been studied. So even when they do seek help, people who use alcohol and other drugs may experience discrimination in the health care setting and receive lesser quality care
A systematic review found that health professionals generally had negative attitudes towards patients with substance use problems. They perceived things like manipulation and poor motivation as impeding factors in the healthcare delivery for these patients. Health professionals also lacked adequate education, training and support structures in working with this client group.
Understanding the environment in which we live and the social norms that people are immersed in is also important as this wider context feeds into the stigmatisation of people who develop problems because of alcohol.
Unfortunately, in western countries such as the US, UK and Ireland, alcohol and other substance related health issues are top public health concerns, contributing significantly to Non-Communicable Diseases (NCDs). Ignoring the wider social context that drives people to high levels of alcohol and drug consumption, and reverting to stereotyping only further increases social segregation and prevents people from accessing proper supports and treatments.
In Ireland, the normalisation of heavy drinking is spurred on by ubiquitous alcohol marketing that glorifies drinking. In this ‘alcogenic’ environment people are lulled into a false sense of security about heavy drinking and don’t get enough public health information about the harms alcohol causes.
Despite progress over the decades in the science of substance use and addiction, the public’s understanding about these issues has not caught up and many fail to make the link between the normalisation of heavy drinking and the inevitable knock-on physical and mental health consequences.
The alcohol industry sells a product that is dangerous for our health, yet global alcohol corporations are allowed to market their products with very little regulation. Their attempts to frame arguments to their own ends, such as focusing on the personal responsibility of the drinker rather than the producer and supplier of alcohol also feeds into the narrative that the person – rather than the product – is to blame when a problem occurs.
What can we do?
A person is not defined by their illness or health condition and using the right words has the power to improve health outcomes.
The right words can reduce stigma and make people who use or have used alcohol and other drugs feel welcome and safe and encourage them to seek the services they need. Once people understand the very real-world impacts of stigma and that it’s not ‘just words’, they will be more open to changing their vocabulary – just as people have in the realm of disabilities and mental health.
Reframing the language around substance use is essential in changing the perceptions of healthcare workers and the public, as it shifts the focus of addiction from being a moral or social issue to a health one that deserves the best possible treatment.
Using person-first, non-stigmatizing language encourages people to seek help, increases the availability of and access to quality healthcare services, and encourages unbiased, effective policy.
Person-first language is language that acknowledges someone as a person before describing their personal attributes or health conditions. Instead of “alco or alcoholic,” use “person who uses alcohol harmfully.” Instead of “addict,” use “person with a substance use problem.
The media can be and should be a source for improving public knowledge and understanding of social issues, especially around mental health and substance use which are very often interlinked. That’s why we have developed not just a language guide for the general public, but also for media, to help them understand why using the correct terminology is so important.
It’s not that difficult to choose your words carefully – start today.
Access our anti-stigma language + media guide here.