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Word Choices Affect Attitudes Toward Addiction Recovery

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A survey of health professionals found that referring to people with addictions as “substance abusers” was more likely to evoke punitive responses to drug use than those who referred to individuals with “substance-use disorders,” according to researchers at Massachusetts General Hospital (MGH).

John F. Kelly, Ph.D., associate director of MGH's Center for Addiction Medicine noted that the World Health Organization declared the term “abuser” as stigmatizing three decades ago, but the term is still commonly used to describe people with addictions to illicit drugs. Referring to recovery, Kelly said, “There's an old proverb that states, if you want something to survive and flourish, call it a flower; if you want to kill it, call it a weed.”

Kelly and colleagues surveyed more than 700 mental-health professionals attending a conference on addiction and mental illness. Half received a survey that referred to a hypothetical patient as a “substance abuser,” while the rest got a survey referring to the patient as having a “substance use disorder.” The surveys were otherwise identical.

Respondents who received the “substance abuser” version were more likely to say that the patient should be punished for failing to follow a treatment plan and to agree that the patient shouldered blame for having trouble complying with court-ordered treatment requirements.

“Our results imply that these punitive attitudes may be evoked by use of the 'abuser' term, whether individuals are conscious of it or not, and suggest that this term perpetuates that kind of thinking,” Kelly said. “From the perspective of the individual sufferers, who often feel intense self-loathing and self-blame, such terminology may add to the feelings that prevent them from seeking help.”

The study was published in the International Journal of Drug Policy.

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