April 8, 2021

Stigma – why words matter

Silhouette of lone person in hallway

What is stigma?

Stigma is any attitude or behaviour that discriminates against people and is generally based on assumptions or misconceptions.

Historically, stigma has played out its negativity against people of colour, people with sexuality or gender diversities, those with special needs or illnesses, and people who use - or have used - alcohol and other drugs (AOD).

In fact, dependence on illegal drugs has been ranked as the most stigmatised health condition globally, with alcohol dependence ranked as the fourth most stigmatised.1, 2

The damage we do

We share and spread stigma with our words, body language and actions in sometimes obvious, sometimes subtle, and always damaging ways.

Stigma can make people who use or have used alcohol and other drugs feel unwelcome and unsafe, stopping them from seeking help.3 Our language, gestures and expressions can act as triggers, reinforcing and amplifying feelings of shame and worthlessness, amongst others.

Words matters

Words have power. They can inspire, encourage and bring hope. Or they can tear down and discourage.

AOD use is a health and social issue.

By focusing on the person, rather than their use of alcohol or other drugs, and by choosing welcoming and inclusive words, you can reduce the impact of stigma.

That’s why it is so important to stay up-to-date on preferred terms relating to AOD and the people affected by it.

Here are some tips for reducing stigma in everyday conversations:

  • use person-centred language that focuses on the person, not their substance use
  • correct others who may have misconceptions about AOD use or people who use AOD
  • show support by treating people with dignity and respect
  • use non-stigmatising language that encourages people to seek help
  • don’t use stigmatising words like ‘alcoholic’ or ‘addict’ that can hurt, damaging self-image and stand in the way of recovery. Instead talk about a person with dependence
  • focus on hope. When you empathise, you begin to see how words like ‘abuse’, ‘relapse’, ‘non-compliant’, and ‘dependent’ may come across like a prison sentence: hurtful, demeaning, pessimistic and hopeless
  • be aware of negative stereotyping – many people who use AOD feel threatened by the prejudice that results from misconceptions about AOD use
  • be an active listener. Acknowledge what the person is saying – don’t brush it off
  • use body language that shows you are there for them, let them know they are not alone, and their issue is important.

Remember empathy

There are complex, valid and often painful reasons behind AOD use, such as trauma, mental illness, poor social supports, family history and early exposure to drug use. These factors all play a part in increasing a person’s risks of experiencing drug use and dependence.4

While stigma is about more than just language, it is a good starting point. Addressing stigmatising language can start the conversation and help individuals reconsider how they think about people who use or have used alcohol and other drugs.

For more information on stigma, check out the following ADF resources.

  1. Crapanzano KA, Hammarlund R, Ahmad B, Hunsinger N, Kullar R. The association between perceived stigma and substance use disorder treatment outcomes: a review. Substance Abuse and Rehabilitation. 2020:1C(12).
  2. Kelly JF, Westerhoff CM. Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. International Journal of Drug Policy. 2010;21(3):202-7.
  3. Lancaster K, Seear K, Ritter A. Reducing stigma and discrimination for people experiencing problematic alcohol and other drug use. Sydney NSW Australia; 2018.
  4. Volkow ND, Koob GF, McLellan AT. Neurobiologic Advances from the Brain Disease Model of Addiction. New England Journal of Medicine. 2016;374(4):363-71.

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