I came across an article last week that voiced something that has very much been on my mind in the past few months: the language of drug use stigma. As those in peer communities, support services, and health care fight against the tide of fentanyl’s force, we not only see the impacts on individuals, but the overarching impact of stigma on populations. It is a constant battle to challenge the general public to see people who use drugs as people; not junkies or addicts; words which can imply throwaway for the attitude they convey.
No one is a throwaway.
How we talk about the opioid crisis can support or deny that. I’ve stopped reading the comments on Facebook news feeds that feature the overdose epidemic; I am consistently appalled by trolls with their disregard for human lives. The stigma against people who use drugs, like that against people living with HIV, is an ongoing concern, and language plays a part.
Jeremy Allingham’s Is the fentanyl situation an overdose crisis or a poisoning crisis? presents the evidence that overdose is a medically inaccurate term, for all its headline impact. Poisoning is the better term, “a technically accurate diagnostic term for what’s happening inside the body.” Allingham cites Dr. Christy Sutherland who points out that the word overdose has an implication of choice, which leads to the “they get what they deserve” mode of morality thinking. Where have I heard that morality thinking before? Ah yes: HIV.
They get what they deserve thinking has always been applied to people living with HIV. Same sex relationship? You deserve HIV, then. If it was a one-time encounter, you deserve it even more, says Morality Mind. Woman who gets HIV? She must be a slut (the slur word, for impact).
People with HIV have endlessly and energetically challenged stigma for decades from the watershed creation of the Denver Principles over 30 years ago, and language has been part of the challenge. The Denver Principles defied the label AIDS victim: “We are not victims. We are people with AIDS.” Over time, person living with HIV has largely replaced HIV+ as a respectful way to put individuals, not the diagnosis first.
Finding the common language to talk about advocacy issues is an evolving conversation. Put people first; fight stigma. The Canadian Association of People Who Use Drugs does just that, focusing on the “strengths, talents, and merits of our membership as we build a better future for people who use drugs.”
In regards to the term overdose vs poisoning, Allingham captures the thoughts of Dr. Edward Xie: “the way we talk about alcohol, a legal and socially acceptable substance, [is] proof that the word “overdose” stigmatizes drug users”, a thought Dr Sutherland echoes. Overdose is a word that is widely understood and one we are hearing far too often in the fentanyl crisis. But if it reinforces, rather than reduces stigma, it is time to expand our language and thinking.
Learn More:
Language Matters: Reduce Stigma, Combat Overdose
People First Language: Reducing Stigma in HIV Communication
Questions? Feedback? Get in touch!
Janet Madsen, Capacity Building and Knowledge Translation Coordinator,
[email protected]