Language Matters: We Stand Together Against Stigma

Dr. Erving Goffman, a highly influential sociologist and social psychologist, described stigma as "the process by which the reaction of others spoils normal identity." This social depreciation often takes the form of shaming and belittling language. When stigmatizing language like "junkie" becomes socially acceptable, regardless of intention, it becomes a near invisible mechanism perpetuating harmful stereotypes.

Language matters, whether these words are used in a healthcare setting, in the media, or at the kitchen table. Negative and stigmatizing language discredits people who use drugs and leads to discrimination. This has a direct, detrimental impact on the health of people who use drugs.

Globally, stigma toward individuals who use substances is recognized as a significant barrier to care and a contributor to negative health outcomes. The National Library of Medicine in the U.S. reports that stigma was the most noted barrier to opioid use disorder treatment and was found in 78.9% (15/19) of all analyzed publications.

Stigma often becomes internalized, causing individuals with Substance Use Disorders (SUD) to fear judgment. This fear may lead them to avoid seeking help for their health conditions or to conceal their struggles. As a result, they may experience feelings of shame and hopelessness, which can further jeopardize their well-being if they are driven to use substances alone. Additionally, stigma may prevent community members from offering assistance in emergencies and lead to punitive policies that worsen their isolation.

Siân Lewis, MSW, RSW and Executive Director for the Day One Society shares, “Thirty years ago, when I began my career in social work as a drug and alcohol counsellor, there was a growing understanding of mental illness/health in the general population. However, those with addictions were still viewed as ‘less deserving’ of support and care.”

Research shows that people use language to stigmatize social issues primarily as a means for social control, to create boundaries, and as a cognitive shortcut to simplify complex human behaviours.  The resulting negative stereotypes may be used to justify social exclusion, discrimination, and, in severe cases, violence. The National Institute of Drug Abuse reports that, "Commonly used terms referring to people with addiction often reflect the misconception that their drug use and related behaviours are a choice, rather than a compulsion, and that they are to blame for their medical condition. Studies show that terms like "junkie" and "addict" feed negative biases and dehumanize people. Labelling isolates vulnerable people and makes it harder for them to access social and health resources. It also creates a divisive "us vs them" narrative where only some people belong in a community.

If the negative impact of stigma is so well researched and widely understood, why don't we change?

Fear is recognized as the driving force behind stigma. Education is the enemy of fear. Facilitating dialogue to reveal unconscious biases that support both learning and unlearning is one of the most important strategies. It begins with an awareness of how we think about SUD and shifts when we adjust how we speak about them. It is essential to understand that having a SUD does not define a person. It is not their identity.

First Steps

• Treat every human being with dignity and respect.

• See a person for who they are, not what drugs they use.

• Listen while withholding judgment.

• Avoid using labels.

• Replace negative assumptions with evidence-based facts.

• Use people-first language: Avoid using slang and adopt a people-first rule. Instead of using "addict," say "person with a substance use disorder," "person who uses," or "person in recovery."

Listening Helps

Siân’s offers a hopeful view, “In some respects, we have come a long way with addictions being discussed openly in schools, in the workplace, and across many community forums. All levels of government are actively involved in addressing addictions and the impacts on individuals, families, and communities.”

The Stop Stigma. Save Lives project shares the words of 12 people with firsthand or family experiences of drug use. Stories are what connect us; they give us context and help us understand the "why."

At Toward the Heart, their video "Language Matters" furthers our understanding of how words "other" people. It highlights the significant role language plays in reflecting the medical nature of substance use disorders, to change the conversation regarding overdose and use language that promotes recovery. 

Substance use disorders are treatable medical conditions. Siân notes that, “Many new therapies and treatment approaches have been developed and evolved. Pharmacology specific to addictions has gained momentum, and there have been great strides in treating opioid addiction to ease symptoms and keep people safe, reducing the risk of overdose and death.”

We have the power to support our community members in getting healthy and understanding that language matters is the first step. As always, our compassion is our greatest strength, and our empathy is an important tool.