Understanding Person First Language

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Written by SUNY New Paltz SSDP chapter leader Robert Hofmann

When talking about drug policy reform, activists will encounter several terms used to describe people who use drugs. These terms can show us preconceived notions of drug users held by individuals who use them. While some people use negative and neutral terms interchangeably, different phrases can conjure up different feelings and beliefs about people who use substances. It is important for drug policy reformers to use contextual terms that promote compassion and humanity towards people who use drugs in order to counteract the pervasive stigma surrounding drug use.

I learned about “person first” language from my SSDP mentor, Kat Humphries while working on a panel for SSDP2017 regarding stigma against people who inject drugs. Kat requested to change the name of the panel from “Stigma Surrounding Injection Drug Users” to “Stigma Surrounding People Who Inject Drugs”, introducing me to person first language.

On January 9th, the Office of National Drug Control Policy released a memo encouraging agencies to abandon the term “addict” and adopt person first language. (This document has become recently unavailable, most likely due to the transition of office). The compilation of research found that highly trained mental health experts were significantly more likely to recommend punitive measures for an individual referred to as “substance abuser” rather than “person with a substance use disorder”. When mental health and substance use disorder professionals harbor negative attitudes for their clients, the clients are more likely to receive poor quality of care and treatment outcomes. The shame and fear of social or economic consequence for admittance into treatment deters individuals with substance use disorders from searching for treatment or entering treatment once again. For those who still choose to seek treatment, access is incredibly limited, and many people who actively search for treatment are left with next to no help. For those who seek drug misuse programs, most wind up in AA, NA, or a similar 12 step program that sets many up for failure due to their abstinence-only approach. Even though there are many programs available for people who misuse drugs, when one fails at a certain type of program, especially repeatedly, they view themselves as a failure, further perpetuating self-negativity that entrenches dangerous behaviors. Thus, a cycle of shame, stigma, lack of effective treatment, and hopelessness forms.

This is why the term “substance abuser” is used in replacement of “person with a substance use disorder” among highly trained mental health professionals, who are trained to work with stigmatized people and understand the biases against them. If these negative perceptions are visible through the use of the term “substance abuser”, it is disheartening to think of the potential stigma added by terms like junkie or tweaker, and when these terms are used by people who don’t have mental health care training.

These studies confirm the importance of seeking out and avoiding specific terms in relation to drug use, drug misuse, and substance use disorder. It’s not simply a substitution of words to avoid potentially hurting people’s feelings, it is an acceptance of statistics showing that terminology can create differing outcomes and perceptions. Terms like “junkie”, “crackhead”, and even “addict” hinder drug policy reform and substance users by attaching an unnecessary and potentially dangerous stigma to a person who uses drugs.

Luckily, the solution to this problem of accidental stigmatization is pretty simple. Focus on replacing terms harboring attached stigma with person first language, educating peers and your SSDP chapter members about the unintended consequences of using stigmatized terms. Drug policy reform is enough of an uphill battle already; we shouldn’t add to that climb by pushing terms associated with decades of violence against those we fight for and ourselves.