Understanding Substance Misuse

Substance misuse is a term used to describe the use of illegal drugs and the misuse of legal drugs, including tobacco and alcohol (APHA). Substance misuse contributes to accidental death and illness. Worldwide, alcohol misuse contributes to 3.3 million deaths each year, and another 350,000 die due to other substance use (World Health Organization, 2014). Unintentional overdose is the leading cause of accidental death (Warner et al., 2011). In 2020, there was a substantial increase in substance misuse and overdose in the United States. From January to March, 19,146 people died from substance overdoses, compared to 16,682 people in the same quarter of 2019. Despite the high prevalence of substance use conditions, only 10% of affected individuals receive help for their substance use disorder. A main barrier to seeking and receiving help is stigma (Kelly et al., 2016). Stigma is defined as a mark of disgrace associated with a particular circumstance, quality, or person. Stigma can promote shame, isolation, and guilt, which then reduces the chances someone seeks treatment and stays in treatment Stigma among healthcare providers can negatively impact the quality of care that they provide. Specifically, misinformed beliefs or judgments about substance use can lead providers to unintentionally provide less compassionate, effective, and appropriate care. Using language that is strength-based and trauma informed can empower individuals to seek out help when they need it.

Why Is Language so Important?

  • Language reflects and influence our attitudes.
  • Language influences the way we view others, and subsequently how we treat them, and how others view themselves.

Examples of Destigmatizing Language

  • Destigmatizing language is compassionate and conveys an understanding of a person's circumstances and the role substances may play in coping. It is NOT judgmental or blaming. Using terms like "person with an addiction" rather than "drug addict" can increase the chances individuals reach out for help.
  • Person-first language focuses on the person rather than the illness. For example, using "person with a substance use disorder" rather than "substance abuser."
  • Destigmatizing language reflects how individuals describe themselves. For example, providers can ask about preferred names and pronouns.

Substance misuse is a cause for concern in every community. Care professionals play an important role in reducing barriers for people seeking help for substance use disorders. Being aware of biases and misunderstandings about substance use and recognizing that people start using substances for a variety of reasons, most commonly to cope with stress. Using language that is non-judgmental creates an environment where individuals feel more comfortable and supported in asking for help, which is the first step in recovery. Incorporating strength-based and destigmatizing language into care procedures can take time. Mistakes will happen. Remember to be patient and give grace as these new skills are adopted.

To learn more about substance use please consider taking our Anytime Training called Substance Use Disorders 101 (SUD 101). If you are interested in learning more about adolescent substance misuse, consider taking our Anytime Training, Adolescent Substance Use: Identifying and Responding to Misuse.

References

Kelly, J.F., Saitz, R. & Wakeman, S. (2016). Language, substance use disorders, and policy: The need to reach consensus on an "Addiction-ary." Alcoholism Treatment Quarterly, 34(1), 116-123.

Goodman, R. (2017). Contemporary trauma theory and trauma-informed care in substance use disorders: A conceptual model for integrating coping and resilience. Advances in Social Work, 18, 186-201.

Roberts, A., Rogers, J., Mason, R., Siriwardena, A.N., Hogue, T., Whitley, G.A., & Law, G.R. (2021). Alcohol and other substance use during the COVID-19 pandemic: A systematic review. Drug and Alcohol Dependence, 229 (Part A), 109150.

Warner, M., Chen L.H., Makuc, D.M., Anderson, R.N., & Miniño, A.M. (2011). Drug poisoning deaths in the United States, 1980-2008. NCHS Data Brief. (81):1-8. PMID: 22617462.

National Institute on Drug Abuse (2021, June 23). Words Matter: Preferred Language for Talking About Addiction. Niha.nih.gov. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction.

Centers for Disease Control and Prevention. (2020, December). Q & A on Latest Monthly Estimates of Drug Overdose Deaths.https://www.cdc.gov/nchs/pressroom/podcasts/2020/20201218/20201218.htm