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Stigma and Language in Drug Addiction

The language used when speaking about or referring to people who use drugs has a tremendous impact on how they view themselves and how they are viewed by others. Public opinion and media portrayals reinforce each other while contributing to and perpetuating stigma associated with drugs and drug use. No medical condition is more stigmatized than “addiction.” As shown above, public perception is that drug use, including problematic drug use, is a choice and that individuals choose not to control it, i.e. not to stop, and therefore the public generally does not allow for the presence of any mitigating factors.

Commonly encountered terms such as “junkie,” “drug abuser,” or “crackhead” are alienating, defining people who use drugs solely by their consumption of a particular substance and designating them as “others” – physically inferior or morally flawed individuals. Negative language use also extends to people in recovery who are referred

to as “clean,” implying they were previously unclean or dirty. And the term “drug abuse” can conjure associations with abhorrent behavior such as child abuse. This misguided use of language and terminology is stigmatizing for people who use drugs. And stigma results in discrimination, which can be overt or systemic. In Nigeria, people who use drugs have reported being rejected by family and friends, and finding themselves in a condition of profound social isolation, where their network is reduced solely to other people who use drugs. This makes communication with members of the main community practically impossible. Similar experiences have been documented in Tanzania. When individuals who use drugs were asked about their experiences, many reported stigma and resulting discrimination. ‘‘You become a pariah,’’ noted one, ‘‘you are in complete default of society’s norms.’’ Another said, ‘‘I lost my value as a human being.’’ One woman summarized: ‘‘Being a junkie causes you to lose all dignity.” Stigmatizing and discriminating against people who use drugs is not limited to the general public; it can directly impact clinical care.

In the US, researchers conducted a randomized study where mental health clinicians were given identical case studies about individuals in court-ordered drug treatment programs. The individual was either referred to as “a substance abuser” or “someone with a substance use disorder.” The trained mental health professionals who read about an “abuser” were more likely to believe that the individual in question was personally culpable for their situation and that punitive measures should be taken. Stigmatization therefore has a perverse double effect: the more society stigmatizes and rejects people who use drugs, the fewer opportunities for treatment will be on offer; at the same time, stigma drives individuals who need help away from those services that are available. Indeed, according to UNODC, only one in six individuals with problematic drug use receives treatment.

Stigma, discrimination and the criminalization of drug use are directly related to the violation of the human rights of people who use drugs, as documented in a 2015 report from the UN High Commissioner for Human Rights. The report gives several examples of clear human rights violations, such as the withholding of methadone or other treatments in order to extract confessions from convicted people who use drugs. Similarly, people’s right to life has been violated by extrajudicial executions and the use of the death penalty for drug-related offenses. Women are particularly discriminated against, being imprisoned more for drug-related offenses than for any other crime. Women who use drugs, whom society regards as not fit to be mothers, also face losing custody

of their children, without any evidence of neglect other than their status as an individual who uses drugs. They can also be subjected to forced or coerced sterilization, abortion, or criminal sanctions for using drugs while pregnant.

Originally appeared on

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