Stigma Around Mental Health and Substance Misuse

Labels aren’t always bad. Labels can reflect positive characteristics, set productive expectations, and provide meaningful goals for us. However, often the labels we use to describe one another are based on unsubstantiated assumptions and stereotypes. These labels may be associated with race, gender, sexual orientation, or gender identity. They may also be the stigmatizing labels created for those struggling with alcohol use disorders, substance use disorders, or co-occurring mental health conditions. The stigma associated with those struggling with substance misuse or a mental illness may have adverse effects on them getting treatment.

In fact, using stigmatizing labels and language to talk about individuals struggling with substance use or mental health disorders can create a negative bias, perpetuate the idea that addiction is a moral failing—and not a medical condition—and prevent the individual from seeking the help they need.

Stigma, Language, and Substance Use

Research demonstrates that stigma creates obstacles for those seeking treatment for substance use disorders or mental illness and leads to negative health outcomes, giving them a treatment-adverse mindset and creating stigma-related bias among clinicians.

Almost 90% of individuals with substance use disorders and 35% with a serious mental illness don’t get treatment. While there are definitely other contributing factors to an individual’s decision not to get help—including denial, cost, and timing, among others—the stigma associated with substance misuse and addiction ranks high on the list for many.

Stigmas surrounding individuals who have substance use disorders might include inaccurate and baseless beliefs, including that these individuals are dangerous, incapable of managing treatment, or at fault for their medical condition. While these ideas likely stem from antiquated beliefs, individuals with addictions to drugs or alcohol continue to receive blame for their disease even though the first edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders identified addiction to alcohol and drugs as a mental disorder in 1952.

The ridicule and judgement doesn’t just come from society but from healthcare professionals and individuals within the justice system, too. Experiencing stigma may lead to internalizing this mindset, which can lead an individual to feel low self-worth and low self-esteem—neither of which is helpful to an individual battling a substance use disorder, an alcohol use disorder, or facing a mental illness.

However, leaders from the National Institutes of Health found that using appropriate language to describe addiction and mental illness can contribute to a decrease in stigma and provide improvement to how these individuals are treated in society and in healthcare settings.

Words—whether written or verbally communicated—have the power to influence thoughts, behavior, and change.

Examples of Stigmatizing Words

Removing some words from our vernacular can help. Some examples include:

• Addict. Instead, say an individual with a substance use disorder, which indicates that the person has a problem, not that they are the problem.
• User. A better alternative would be to say an individual who uses a substance.
• Junkie. Refer to this individual as a person who actively uses a substance.
• Alcoholic. Instead, describe this individual as a person with an alcohol use disorder.
• Drunk. A person who misuses alcohol is less stigmatizing.
• Former addict. Refer to these individuals as a person in long-term recovery.
• Reformed addict. Instead, say a person who previously used drugs or alcohol.
• Abuse. Research found that the term “abuse” is associated with negative judgements. Replace it with the word “use” or “misuse” instead.

Alleviating stigma is no simple task. In fact, so many of the administrations and organizations leading the way in addiction education and support for individuals with substance use disorders still have terms like “abuse” and “alcoholism” in their formal names.

Change, however, can begin with us. Knowing and incorporating these words into discussions about substance and alcohol use helps, as does treating individuals with substance use disorders compassionately. The same way that you would support an individual battling cancer or heart disease is the manner in which you should talk to and support an individual with a substance use disorder, encouraging them to seek treatment without passing judgement or blame.

If you or a loved one struggles with drug or alcohol addiction, reach out to American Addiction Centers (AAC) at . Talk to one of our compassionate admissions navigators—many of whom are in recovery themselves. They can answer your questions, explain your options, and get you or your loved one on the path to lasting recovery today.