Words matter when writing about addiction, and wrong words increase stigma that impedes recovery; speakers offer advice

Bishop Nash and Lyn O’Connell speaking in Ashland Nov. 15 at “Covering Substance Abuse and Recovery: A Workshop for Journalists”
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By Melissa Patrick
Kentucky Health News

ASHLAND, Ky. — The words used to describe drug addiction and those suffering from it can either perpetuate the stigma that is attached to the disease or can help people move beyond it, and journalists have a responsibility to stop using stigmatizing language.

That was the main message of the last two speakers at the Nov. 15 workshop in Ashland, Ky., “Covering Substance Abuse and Recovery: A Workshop for Journalists,” sponsored by the University of Kentucky’s Institute for Rural Journalism and Community Issues and Oak Ridge Associated Universities.

“Nobody has the power to change language like us,” said Bishop Nash, most recently the health reporter at the Herald-Dispatch in nearby Huntington, W.Va., a city that has been called the epicenter of the opioid epidemic. “That’s just how it is and I feel it in my heart to do it for my people.”

Nash said he, like many other reporters, has had to learn to write differently about addiction, but once he understood the science of the disease and why it was important to not use stigmatizing language, it has been an easy switch.

“It really requires a change of heart,” he said. “When you get your heart wrapped around this issue, you really don’t have to think about it.”

Nash gave credit to Lyn O’Connell, the associate director of community services in the division of addiction sciences in family medicine at Marshall Health in Huntington, for helping him and others in the area understand why the words journalists use to cover addiction matters.

O’Connell, who spoke first, explained that after making regular phone calls to the Herald-Dispatch, including ones to Nash, and asking them to print less stigmatizing headlines, she realized the journalists and their editors just didn’t know any better, so she compiled a set of guidelines on how to cover addiction and set out to teach them. O”Connell shared some of those guidelines at the day-long workshop.

Like other speakers at the conference, O’Connell said stigma is what keeps many people with substance use disorders from seeking treatment. She added that it also keeps lawmakers from providing adequate funding for programs to support them.

“So if they see these damaging headlines, it’s only going to perpetuate these diseases in our communities,” she said.

She encouraged journalist to use non-stigmatizing language, and offered four suggestions.

First, she said it’s important to use “people-first language.” For example, write “an individual with a substance-use disorder” instead of the more stigmatizing term “addict.” “Remember that we are talking about a human and we should put the human first in a sentence,” she said.

O’Connell also noted the importance of focusing on the medical nature of a substance use disorder. She pointed out that we don’t call people with cancer “those cancer people” and asked why would we de-humanize a person with a substance-use disorder, which is a chronic disease, and call them an addict.

She also encouraged using language that promotes recovery. For example, instead of saying “an individual with a substance-use disorder,” when appropriate say “an individual in recovery.”

It’s also important to avoid perpetuating negative stereotypes and biases through the use of slang and idioms, she said. In other words, don’t use words like junkie, addict, user, abuser, crack-head.

She also encouraged journalists to move away from writing or saying “substance abuse,” which she said has criminal under-tones. Instead, she said be medically accurate and use the term substance use disorder, which is what it is. “I think this is one of the hardest adjustments,” she said.

She offered several more suggestions, including making sure you only mention the details of a person’s addiction if it is relevant; to never say an infant is born addicted, but to instead say it was born experiencing exposure or withdrawal; and to not ever use the words “clean or dirty” to describe a drug screening, but to instead say it was positive or negative for the substance. She also said to make sure the images and photographs used in a story are accurate and are images that promote treatment and recovery.

She concluded by noting that addiction is a complex, chronic-relapsing disease that is the result of many different factors, and that most individuals in treatment have a history of trauma.

She said, “When we don’t consider the entire person in that story, we’re missing out on a lot of who that person is, and the back history.”

Nash said he initially thought all of these changes would “clog” his writing and that readers would roll their eyes and say, “Oh, the PC police are out.” But since, he said he has evolved to writing substance use disorder on first reference because that establishes it as a disease, and then refers to it as an addiction because that is the word his readers understand.

“This isn’t about being politically correct,” he said. “This about being right in the science with it.”

A person in the audience noted the struggles editors face in trying to fit so many words into a headline and said alternative, smaller words are needed that are also appropriate to use.

“That just speaks to the importance that you should not just be teaching this to reporters,” Nash said. “You’ve got to teach this to editors, you’ve got to teach this to copy desk people, and the hardest thing is that you’ve got to teach this to a lot of people who are set in their ways.”

Nash recognized that a reporters job is to report, and to not sugarcoat the news, but said there is no reason that the words they use should add to the stigma.

He said, “I believe that state and local journalists in particular have a moral imperative for the greater public good in the communities they serve.”