Stigma reduction
Language matters
The words used in consultations, referrals and notes shape whether people disclose substance use, whether they return, and whether they get the care they need.
Say this, not that
Stigmatising terms and better alternatives
Person-first language is recommended across UK and international guidance on substance use, mental health and long-term conditions.
- Avoid
Addict, junkie, alcoholic, druggie
Use insteadPerson with a substance use dependency; person who uses drugs; person with alcohol dependence
Why: Labels define a person by one part of their life and carry blame. Person-first language names the condition without replacing the person.
- Avoid
Substance abuse / abuser
Use insteadSubstance use; problematic substance use; substance use dependency
Why: 'Abuse' implies wilful wrongdoing and is associated with more punitive judgements, even among clinicians.
- Avoid
Clean / dirty (urine, or a person)
Use insteadNegative or positive test result; not currently using; using
Why: Framing bodily fluids or people as 'dirty' attaches moral contamination to a health condition.
- Avoid
Drug-seeking
Use insteadRequesting pain relief; describing unmanaged pain; seeking treatment for withdrawal
Why: The term is used as shorthand for distrust and is a documented route to undertreated pain.
- Avoid
Non-compliant, failed treatment
Use insteadTreatment did not work for them; disengaged from this service; returned to use
Why: Places responsibility on the person rather than on whether the treatment or service fitted their needs.
- Avoid
Relapsed, fell off the wagon
Use insteadReturned to use; had a recurrence
Why: Neutral wording keeps a return to use as clinical information rather than a moral event.
- Avoid
Habit
Use insteadSubstance use disorder; dependence
Why: Understates a health condition and implies it can be dropped through preference alone.
- Avoid
Addicted baby, born addicted
Use insteadBaby with neonatal abstinence syndrome / neonatal withdrawal
Why: Newborns experience withdrawal; they do not have a dependency, and the label follows the family through services.
Interactive
Test your language
Read each phrase as it might appear in notes or a handover, then reveal a less stigmatising alternative.
"The patient is a known IV drug abuser."
"Urine was dirty again this week."
"She's just drug-seeking."
"He failed detox twice."
Remember
See the person, not the label.
One respectful conversation can be the difference between someone disclosing their substance use and someone deciding never to come back.