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Treating people who use substances with respect improves health outcomes and helps save lives.
We encourage the use of respectful, non-stigmatizing language when describing substance use disorders, addiction and people who use drugs.
Whether it is used in a healthcare setting or in the news media, negative and stigmatizing language discredits people who use drugs and can result in discrimination. Stigmatization contributes to isolation and means people will be less likely to access services. This has a direct, detrimental impact on the health of people who use drugs.
Change the Conversation Regarding Overdose
Use people-first language. This means referring to a person before describing his or her behaviour or condition. This is important because it acknowledges that a person’s condition, illness or behaviour is not that person’s defining characteristic. “Person with a cocaine-use disorder” instead of “cocaine user” or “addict.”
Use language that reflects the medical nature of substance use disorders. There are a multitude of factors contributing to drug addiction, ranging from personal factors to social, environmental and political ones. Avoid terms that reinforce a belief that addiction is a failure of morals or personality, rather than a medical issue. “Addictive disease” and “substance use disorder” instead of “abuser” or “junkie.”
Use language that promotes recovery. This means healthcare professionals should use language that conveys optimism and supports recovery, and respects the person’s autonomy. “Opted not to” and “not in agreement with the treatment plan” instead of “unmotivated” or “non-compliant.”
Avoid slang and idioms. Slang terms and idioms have negative connotations and a significant level of stigma attached to them. While slang and idioms are rarely used in professional literature, they are also important to avoid when speaking to other colleagues or healthcare professionals. “Positive” or “negative” when referring to drug tests, instead of “dirty” or “clean.”
Compassionate Engagement Modules
The Compassionate Engagement Modules are a series of interactive case studies about stigma and discrimination experienced by People Who Use Drugs (PWUD). These modules are designed to engage PWUD and the people who provide services to them (health care providers, frontline service providers, managers, and leadership). It works best when there are both PWUD and providers together.
The Compassionate Engagement Modules provide an opportunity for PWUD and providers to learn from each other’s perspectives, develop solutions and practice compassionate care, effective communication, and self-advocacy.
How do they work?
This format of the Compassionate Engagement Modules is designed to be led by a facilitator. The facilitator will show the case study clips, then lead the group of PWUD and providers through a discussion about what happened in the case study. The group will have the option of re-enacting the case study, changing any behaviour they think can be done differently.
- Facilitator's Guide
- Methadone Scenario 1
- Treating patients with dignity and respect
- Stereotyping patients
- Managing risks to society and patients
- Methadone Scenario 2
- Treating chronic pain in opioid dependent patients
- Physicians promoting use of methadone
- Fully informing patients about methadone patient rights, responsibilities
- Carry privileges
- Methadone Scenario 3
- Treating concurrent disorders in patients
- Educating patients about the risks of polysubstance use
- Methadone Scenario 4
- Replacing opioid analgesics with methadone for treatment of pain
- Shelter Scenario 1
- Required evidence of abstinence to access services
- Searching clients’ belongings
- Confiscation of harm reduction supplies
- Shelter Scenario 2
- Prohibiting harm reduction supplies in facilities
- Client privacy
- Gossiping and professionalism
- Community Health Scenario 1
- Recording personal information of harm reduction clients
- Availability of supplies
- Community Health Scenario 2
- Forming supportive relationships with patients
- Secondary distribution of supplies
- Commenting on drug use
- Community Health Scenario 3
- Confidentiality breaches
- Hospital Scenario 1
- Flagging patient charts
- Stigmatizing language
- Appropriate triaging
- Hospital Scenario 2
- Not treating patient concerns
- One issue per visit policy
- Hospital Scenario 3
- Treatment of acute pain
In 2020, Part 2 of the Compassionate Engagement modules, titled "Compassionate Action" were created by the Peer-2-Peer project, PEEP and Cultural Safety team. Click here for details.
This document describes how stigma influences health and provides recommendations about how to use respectful language in healthcare settings and beyond.
Northern Health has a developed a number of excellent resources as part of their ''Stop Stigma. Save Lives'' Campaign.
Guidelines to using non-stigmatizing language.