Shatterproof Releases Comprehensive Addiction Language Guide

Shatterproof, the national not-for-profit organization focused on addressing the addiction crisis in the United States, has published a new comprehensive addiction guide that draws attention to stigmatizing language around addiction, offers alternative phrases, and—in a step that it feels goes beyond what similar guides have offered—provides research and explanations for why certain phrases should be used instead of others.

The language guide is part of a three-pronged Movement to End Stigma that also includes education and policy advocacy efforts.

Matthew Stefanko, director of Shatterproof’s National Stigma Initiative, tells Addiction Professional that the organization studied previous stigma-focused campaigns around topics such as marriage equality and HIV/AIDS as it crafted its evidence-based plan.

“Language has a real effect on policy attitudes, perception and treatment,” Stefanko says.

The guide was developed based on a review of academic literature and existing language guides for mental and behavioral health, and has been reviewed by the National Academy of Medicine. Besides the language guide, Shatterproof has produced a video and graphics for social media use to support the campaign.

Although other similar guides have been published, Stefanko says Shatterproof’s leaders felt the time was right for a new document that could serve both as a compilation of other resources as well as an update that includes terms not previously identified as potentially stigmatizing. Adding explanations for why certain terms are acceptable and others can be harmful was also a key component, he adds.

“For journalists and others who are trying to understand why it’s so important, we thought it was critical to say, ‘Use this word, don’t use that word, and here’s the piece of evidence from a nationwide study of physicians that showcases why you should make that switch,’” he says.

Education on stigmatizing language is equally as important for those in the addiction treatment field, and in some cases, can be even more challenging, Stefanko says.

“For the general public, they’ve heard the word ‘junkie’ in movies and TV, and it’s easy to say, ‘That movie isn’t real life. You shouldn’t use the words you heard in 'The Wire' to describe your neighbor,’ ” he says. “That’s an easy pitch.

“It’s harder when you talk to an ER doctor who says, ‘That’s what every one of my patients calls themselves. I’m just playing back what they’re saying to me.’ That can be a hard conversation. There are a few studies we cite in the language guide where people with substance use disorders are asked what they would prefer to be called. They made it clear, they say, ‘We want to be able to have the agency to describe ourselves however we want to describe ourselves, but just because we’re saying that word doesn’t mean we want other people to call us that.’ There is evidence that suggests that.”

Stefanko emphasizes that it is not Shatterproof’s aim to “dictate what someone with a substance use disorder identifies as,” but to “make it clear to those folks around them just because they’ve identified with that terminology doesn’t mean you can adopt that yourself.”