Language & Social Stigma

What is Stigma?

Drug use stigma can be defined as negative attitudes and behaviours towards people who use drugs (The Centre for Addiction and Mental Health [CAMH], 2019). Stigma attributes negative stereotypes to certain bodies, life circumstances, and practices, and leads to the devaluation of the lives of people who use substances. People who use drugs face social, structural, and internalized stigma (Government of Canada, 2019). Examples of stigma include:

  • Treating people who use drugs and their families differently

  • The portrayal of people who use drugs by the media in a negative way through stigmatizing labels and images

  • Service providers (healthcare professionals, police, EMS) expressing lack of care towards people who use drugs or not connecting them to appropriate health and social services

  • Internalized stigma that affects self-concept and self-care (Government of Canada, 2019)

How does stigma affect people who use drugs?

The lack of support and compassion for people who use drugs is one of the greatest harms of our current approach to drugs. People face profound stigma and discrimination from society as a whole and from family and friends. There is no other group of people who are treated so poorly because of a health issue. Stigma and discrimination are further compounded for groups such as pregnant and parenting women, people who are poor, and people who are impacted by colonialism and racism. Stigma is not a deterrent to drug use, it simply pushes people farther into isolation, marginalization and further harm (Shepherd & Caldwell, 2017).

Research shows that stigma hinders people who use drugs from accessing and utilizing harm reduction services such as syringe exchange programs and overall, reduces the effectiveness of harm reduction initiatives (Simmonds & Coomber, 2009). In general, stigma prevents people from accessing health and social services due to embarrassment and the fear of being judged. This results in people who use drugs not accessing the services they require and in turn, leads to poor health outcomes (Government of Canada, 2019).

How do we address stigma?

  • Public education about substance use

  • Healthcare provider education and training on substance use from a harm reduction perspective

  • Avoiding the use of stigmatizing words and labels

  • Addressing discrimination against people who use drugs and treating people with respect

  • Advocating for public health approaches to substance use that include drug decriminalization and legalization

    (CAMH, 2019; Ontario HIV Treatment Network [OHTN], 2018)

Language

The language we use has a direct and profound impact on those around us

  • Stigmatizing language contributes to health disparities by devaluing the lives of people who use drugs

  • When talking about people who use drugs, be respectful, empathetic, and use "people-first" language

 

Instead of:

  • Opioid crisis/epidemic 

  • Addicts, Junkies, Crackheads; Users, Drug abusers; Recreational drug users

  • Former drug addict, Referring to a person as being “clean”

  • Substance/drug abuse, Substance/drug misuse

Use:

  • Overdose crisis/epidemic

  • People who use drugs, People with substance use challenges/disorder, People with lived experience, People who occasionally use drugs

  • People who have used drugs, People with lived experience, People who are abstaining, Sober 

  • Substance/drug use, Problematic [drug] use, [Drug] dependence

 

References 

Giliauskas D., & Gogolishvili D. (2018, October). Interventions to reduce stigma among health care providers working with substance users. Retrieved July 28, 2019, from http://www.ohtn.on.ca/rapid-response-interventions-to-reduce-stigma-among-health-care-providers-working-with-substance-users/

Government of Canada. (2019, April 11). Government of Canada. Retrieved July 28, 2019, from https://www.canada.ca/en/health-canada/services/publications/healthy-living/stigma-why-words-matter-fact-sheet.html

Shepherd, S. & Caldwell, J. (2017). Toronto overdose action plan. Retrieved from https://www.toronto.ca/wp-content/uploads/2017/08/968f-Toronto-Overdose-Action-Plan.pdf

Simmonds, L., & Coomber, R. (2009). Injecting drug users: A stigmatised and stigmatising population. International Journal of Drug Policy, 20(2), 121-130. doi:10.1016/j.drugpo.2007.09.002

The Centre for Addiction and Mental Health [CAMH]. (2019). Stigma - Understanding the impact of prejudice and discrimination. Retrieved July 25, 2019, from https://www.camh.ca/en/health-info/guides-and-publications/stigma