If you’re still writing about “drug addicts,” “alcoholics” and “substance abuse problems,” it’s time for a refresh. Healthcare writers need to write about substance use disorders with the same support, empathy and sensitivity we use for those with cancer or heart disease: We’ve learned a lot about the disease in the last 60 years, but the way we write about it hasn’t evolved much.
Why Writing About Addiction Needs an Update
Addiction is a widespread disease: According to the Surgeon General’s Report on Alcohol, Drugs, and Health, nearly 21 million Americans are living with substance addictions. That number is more than the amount of Americans with all forms of cancer combined.
These millions of Americans — and their loved ones — need accurate and quality information about substance abuse.
In 1956, the American Medical Association (AMA) first recognized alcoholism as a disease. It wasn’t until 1987 that the AMA finally recognized all forms of addiction as a disease as well. Before that time, having an addiction was considered a moral or personal failing, not a medical diagnosis.
Challenges to Writing About Substance Use Disorder
The stigma around addiction
While other medical conditions inspire sympathy, society still regards a substance use disorder as a personal shortcoming, often due to lack of willpower. A person may initially make a conscious decision to use a substance (whether legal or not), but becoming dependent on it and developing a substance use disorder is not in their control.
The media’s portrayal of substance abuse
Another challenge is fighting the Hollywood portrayal of drug and alcohol use, where addiction is often glamorized. Television and movies frequently use addiction as a plot point — many times inaccurately.
They tend to gloss over the experience of living with a substance use disorder — or portray it as entertaining and exciting. Rarely does the entertainment industry depict the shame, embarrassment and stress a person experiences when living with or recovering from this disorder.
The need for new language
Harvard Health reports that the words “abuse” and “abuser” contribute to stigma around the disease. The DSM—5 removed references to “substance abuse” and renamed the disease “substance use disorder.”
This change was made in 2013, yet 6 years later, the United States government still hasn’t caught up. The U.S. Department of Health & Human Services has a Substance Abuse and Mental Health Services Administration (SAMHSA) and most states have their own “substance abuse agency.” Even a diligent, well-meaning writer can get tripped up with their language by visiting these websites.
So How Can We Write About Substance Abuse Disorder With Care?
Interview substance abuse experts
Don’t only rely on information from websites and publications. Talk to subject matter experts who can guide you to find the right resources and terminology.
Let them know to correct you if you use an outdated or inappropriate term during your interview. They can guide you on the terms to use in your content.
Understand That Alcoholics Anonymous’ (AA) language is not universal
Most of us are familiar with the AA introduction: “Hello. My name is Jane, and I’m an alcoholic.” AA and Narcotics Anonymous (NA) have helped millions of people recover from substance use disorders.
Many members find it empowering to label themselves as “alcoholics” or “addicts.” However, psychiatrists speculate that eventually, the language may change to, “Hello. My name is Jane, and I have an alcohol use disorder.”
Separate the person from the disease
Physicians don’t refer to people as “asthmatics” or “diabetics,” because those people are not defined by their disease. So it’s time to abolish the use of “addict” and “alcoholic” when writing about addiction.
“These words perpetuate the stigma that addiction is, in some way, the fault of the person. Calling someone a ‘substance abuser’ evokes much more judgment than saying they have a ‘substance use disorder.’ These are people — people with a family and loved ones, who are dealing with a disease they did not ask for,” says Melanie Haber, Senior Vice president of Brand & Communications for American Addiction Centers.
Be mindful with terminology
The National Press Foundation offers guidelines to use when writing about addiction, including:
- Change “abuse” to “misuse.”
- Avoid the word “clean” to describe someone who is recovering. It implies someone with a substance abuse disorder is “dirty.” Similarly, don’t refer to drug tests as “clean” or “dirty.” Instead, opt for “positive” or “negative.”
- Never use the word “junkie.”
- Don’t use the phrase “fell off the wagon,” which implies that the person brought a relapse on themselves.
Don’t forget about SEO
“Severe substance use disorder” is the proper way to refer to “addiction.” But people are unlikely to be searching that term. Because you want people to find your content — especially the people who need it most — use the alternative words occasionally when writing about addiction (even if it’s to explain why the terminology isn’t correct).
There’s enough shame and stigma surrounding substance use disorders, which can prevent people from getting the treatment they need. Use your words and content to give people and their loved ones information and support.
How to Write About Other Sensitive Healthcare Topics
In our latest eBook, we explain how to craft caring, empathetic copy for 5 tough healthcare topics:
- Mental health
- Palliative care
- Senior living
Download the “Writing About Difficult Healthcare Topics” eBook below for tips and strategies for approaching each of these subjects with sensitivity.
Additional History on Addiction vs. Substance Use Disorder
The American Psychiatric Association (APA) defines addiction as “a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences.” The brain undergoes physical changes in response to the substance, causing people to have intense, uncontrollable cravings.
The Diagnostic Statistic Manual of Mental Disorders (DSM—5) is the guidebook created by the APA to diagnose mental disorders. The manual classifies any substance addiction as a “substance use disorder,” with 3 subclassifications (mild, moderate and severe), depending on the symptoms.
Mild: Formerly called “substance abuse,” this term refers to people with hazardous behaviors (like drug use or binge drinking) without long-term or compulsive behavior.
Moderate to severe: Formerly known as “substance dependence,” this condition occurs when a person continues to use substances or engage in behaviors (such as gambling) despite severe consequences.
The National Institute on Drug Abuse and the medical community at large recognize that the brains of people with substance use disorder experience physical changes. Addiction can affect:
- Behavior control