Substance use disorders are not a weakness or a choice. They are a medical condition. People who have a substance use disorder are often looked down upon and blamed for their addiction, rather than being seen as people who have an illness and are in need of medical care.
This stigma can prevent persons from seeking help from family, friends, and even from healthcare providers. Removing the stigma around addiction is one of the first steps to addressing this problem.
According to the National Survey on Drug Use and Health, 20.5 million American adults aged 12 and older are battling a substance abuse disorder.
Alcoholism is the most common substance use disorder in the United States, with about 15.1 million reporting alcohol addiction.
Furthermore, 2.1 million Americans had a substance abuse disorder involving prescription pain relievers. From prescription pills to synthetic fentanyl, opioids come in many forms. The body does not become immediately addicted to opioids, but builds a tolerance over time, requiring increasing amounts.
Despite these staggering numbers, the stigma of addiction persists. In a 2018 study, fewer than 1 out of 5 Americans are willing to closely associate with someone suffering with drug addiction.
The stigma surrounding substance use disorders and addiction can lead to guilt and shame, causing people to hide their disorder and prevent them from getting the treatment they need.
People with substance use disorders and people in recovery are more likely to seek substance abuse treatment and maintain sobriety when they develop social connections. Isolation, discrimination and prejudice are obstacles to social inclusion.
Learn more about the science. Just like heart disease impacts the heart, addiction results in physiological changes in the brain. The causes can be extremely complex and vary by the type of addiction. Understanding how and why it occurs can help reduce the stigma surrounding it.
Talk about it. Correct others who perpetuate misconceptions about substance use disorders and mental illnesses. By discussing addiction, it helps humanize the disease and shows that recovery is possible.
Show compassion and respect. If you notice any signs of addiction, say something. People with substance use disorder need help and support, not scorn and shame.
Many words associated with addiction and substance use disorders are stigmatizing. Using these stigmatizing words can prevent people who need treatment from seeking help. By rewinding the negativity and reworking the narrative, we can start conversations that lead to healing.
| STIGMATIZING LANGUAGE |
| Addict |
| PREFERRED LANGUAGE |
| Person with a substance use disorder |
| STIGMATIZING LANGUAGE |
| Addicted to X |
| PREFERRED LANGUAGE |
| Has a X use disorder |
| STIGMATIZING LANGUAGE |
| Addiction |
| PREFERRED LANGUAGE |
| Substance use disorder |
| STIGMATIZING LANGUAGE |
| Alcoholic |
| PREFERRED LANGUAGE |
| Person suffering from alcohol addiction |
| STIGMATIZING LANGUAGE |
| Clean |
| PREFERRED LANGUAGE |
| In recovery |
| STIGMATIZING LANGUAGE |
| Clean screen |
| PREFERRED LANGUAGE |
| Substance free |
| STIGMATIZING LANGUAGE |
| Dirty |
| PREFERRED LANGUAGE |
| Actively using |
| STIGMATIZING LANGUAGE |
| Dirty screen |
| PREFERRED LANGUAGE |
| Testing positive for substance use |
| STIGMATIZING LANGUAGE |
| Drug habit |
| PREFERRED LANGUAGE |
| Regular substance use |
| STIGMATIZING LANGUAGE |
| Drug abuser |
| PREFERRED LANGUAGE |
| Person who uses drugs |
| STIGMATIZING LANGUAGE |
| Reformed addict or alcoholic |
| PREFERRED LANGUAGE |
| Person in recovery |
| STIGMATIZING LANGUAGE |
| Opioid replacement |
| PREFERRED LANGUAGE |
| Medication assisted treatment |
| STIGMATIZING LANGUAGE | PREFERRED LANGUAGE |
|---|---|
| Addict | Person with a substance use disorder |
| Addicted to X | Has a X use disorder |
| Addiction | Substance use disorder |
| Alcoholic | Person suffering from alcohol addiction |
| Clean | In recovery |
| Clean screen | Substance free |
| Dirty | Actively using |
| Dirty screen | Testing positive for substance use |
| Drug habit | Regular substance use |
| Drug abuser | Person who uses drugs |
| Reformed addict or alcoholic | Person in recovery |
| Opioid replacement | Medication assisted treatment |
Recognize addiction is a medical condition, not something that should cause shame.
Communicate with care. People are often ashamed of their addiction, which results in denial or lying. It is best to communicate with care and compassion. Choose your words carefully and avoid hurtful language.
Offer information and help to find professional resources. Find the appropriate treatment by seeking the support of a professional care team that specializes in substance use disorders.
Continue to provide support. Recovery is a journey. Offer to attend support group or counseling sessions together. If your loved one relapses, help guide them back towards their treatment plan.
Set boundaries. If they continue to refuse treatment, be loving but firm.
Remain committed. Remove alcohol and other temptations from your house and social life. Encourage other healthy activities, like exercise or a hobby that you both enjoy.
When approaching a loved one, it is important to frame the conversation from your own perspective, rather than confront with judgments or accusations about your loved one’s behavior. You can do this by using “I” statements, such as “I am worried about you,” or “I noticed that you’ve been acting different lately, and I am wondering how you are doing.”
Once the conversation has started, here are some other helpful things you can say:
“When did you first start feeling like this?”
“Do you feel like your drug use/drinking is a problem?”
“What can I do to best support you right now?”
Understand that your loved one may not be ready to seek help for their substance use. What is most important is to listen and respond in a gentle manner, using encouraging and supportive words.
Many individuals believe that all the problems created by the substance use issue will disappear once the substance use stops. However, this is likely the time when an individual experiences withdrawal symptoms.
In addition, once the individual stops using, feelings of shame and guilt, depression, or anxiety may begin to resurface. It is very important for family members and loved ones to offer support during this time to help the individual deal with these challenges. A recovery treatment program is also needed to help the individual learn more adaptive ways to deal with life’s stressors and how to avoid situations that increase the likelihood of relapse.
There are many different types of recovery programs. The programs offer the degree of immersion in counseling and structure needed at different times during the recovery process. It is important to know that while not inevitable, relapse may be a part of the long-term recovery process.
This webpage was prepared by Cornerstone under award number 1H79TI083300-01 from SAMHSA, U.S. Department of Health and Human Services. The statements, findings, conclusions, and recommendations are those of the author(s) and do not necessarily reflect the views of SAMHSA or the U.S. Department of Health and Human Services.
