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Thursday, August 23, 2018

Reducing Stigma Toward Substance Use and Recovery

Stigma arises from strong negative bias, rarely reliant on science. Everyone is entitled to having an opinion; but, when such views keep others from accessing help, we have a problem. In the United States, millions of Americans fail to get the care they require due to social stigma. How society talks about addiction has a lasting impact on those living with the disease. Changing how We view mental health conditions and how we treat people living with mental illness can lead to changes for the better in people’s lives.

Among people who use drugs and alcohol in harmful ways, words and monikers are used to describe or label those living with alcohol and substance use disorders. Addict and alcoholic are perhaps the most common, substance abuser is another standard way of talking about someone with an unhealthy relationship with drugs and alcohol. Of course, some terms make no pretense of hiding a pejorative connotation; we probably don’t need to run down the list of less friendly names used to label those who engage in substance use.

The words people in recovery use to identify inside recovery meetings unintentionally make it harder to change the language of addiction in society. After all, the term alcoholic is the first word in the oldest recovery program in use today, Alcoholics Anonymous. “Hi, my name is X, and I’m an alcoholic” may always be a permanent fixture at AA meetings. The same goes for Narcotics Anonymous, where people with substance use disorders identify as addicts. There may be no need to change how people in recovery talk about their conditions; however, new research suggests that we need to work at changing the words we use in public due to the strong negative bias associated with specific terms.

 

Person-First Language


At the beginning of 2017, the Director of the White House Office of National Drug Control Policy, Michael Botticelli, wrote a memo to the heads of executive departments and agencies called Changing Federal Terminology Regarding Substance Use and Substance Use Disorders. Instead of using words like addict and alcoholic he called for person-first terminologies, such as people with alcohol or substance use disorder; words consistent with the language found in the Diagnostic and Statistical Manual of Mental Disorders. In the same year, the Associated Press recommended that news media organizations use person-first language as well, WHYY reports. While the Botticelli memorandum was intended for government agencies, there is research to support the shift toward person-first language.

Now, research coming out of the University of Pennsylvania shows that words like addict and alcoholic are associated with a strong negative bias. Lead study author, Robert D. Ashford, looked at how people responded to the above types of words. He found that average Americans were less likely to associate with addicts than they were people with a substance use disorder; what’s more, the research shows that mental health clinicians are less inclined to work with a hypothetical patient dubbed a substance abuser. Using person-first language, Ashford says, will help reduce negative bias and the stigma preventing people from treatment.

“Terms that seem to label the person — and invoke the negative attitudes toward the person rather than the disease — those are the ones that have the higher levels of bias,” said Ashford, a research assistant at the University of Pennsylvania and doctoral candidate in health policy at the University of the Sciences.

(Additional credit: Jesse Wheeler/Graphic Artist)


The research appears in the journal Drug and Alcohol Dependence.

 

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