Ending Stigma: 'People-First' Language & Drug Use

drug use stigma

There is an endless list of words frequently deployed to describe both recreational and problematic drug users --  “druggie”, “crackhead," "addict," “junkie” -- with the language overwhelmingly derogatory and offensive.

This stigmatization of those who use drugs is a social construct, and one that has shifted over time. That is to say, condemning so-called “deviants” is heavily context dependent, not an automatic response.

As the Drug Policy Alliance notes, there is “no physical or psychiatric condition [that] is more associated with social disapproval and discrimination than substance dependence.” As the sociologist Erving Goffman wrote in the 1960s, stigmatization is an informal social control and one that seriously damages an individual's social identity.

Yet, in spite of this, the vitriol aimed at drug users lingers.

Stigmatizing language pervades all spheres, from society and medical professionals, to the media and politicians. When the latter group do admit to having tried drugs in the past, their tone is generally one of deep regret. These supposedly guilt-laden “confessions” imply that there is always a severe lack of judgement present when an illicit substance is consumed and reinforces the idea that any form of illicit drug use is fundamentally wrong. Hardly the case.

A recently published Substance Abuse article unravels the complex web of language around drug use, highlighting the detrimental impact stigma can have, particularly in the field of addiction.

The article proposes that employing “people-first” language is paramount in ensuring addiction is not seen as a “master” identity. Essentially, “people-first” language is advocating the act of describing the person, before describing their behavior or condition. Let's say, rather than referring to someone as an “addict”, it is preferable to refer to them as a “person who is addicted to drugs."

The latter description is recognizing that the individual is more than an “addict," a crucial way of alleviating the social burden imposed on those who use prohibited drugs. This imposed burden not only dehumanizes but has the more serious consequence of deterring people from seeking treatment for problematic use due to the fear of social abhorrence, as the UK Drug Policy Commission (UKDPC) outlined in their Getting Serious about Stigma report. 

Despite powerful campaigning by a number of organizations, stigmatization remains an enormous obstacle to overcome for the drug policy reform movement, not least because numerous media outlets routinely propagate it.

To name but a few, two (morally hollow) newspapers in the UK -- The Daily Mail and The Sun -- appear to take pleasure in their rancorous and inaccurate representation of drug users, their headlines reading things like:

“The shocking moment a pair of junkies slump on the floor of a public toilet after injecting themselves with a legal high” (The Daily Mail), and, “Addicts are pocketing £½BILLION in handouts” (The Sun).

This is just a snapshot of tabloid headlines laden with emotion and dubious “morality" -- neither of which are well known recipes for rationality. As the UKDPC state, this type of stigmatizing discourse serves to hinder and “undermine ... efforts to help [problematic users] tackle their condition and enable ... reintegration into society."

We know that language shapes perspectives. We know that language should be used thoughtfully, and crucially, even more so when it is being distributed on a large scale. While some of those in the political and media spheres, and beyond, lag behind, it is vital that we confront and challenge in our everyday lives the pejorative language frequently used to describe those who risk being left on the margins.