The words we use to describe substance use and people who use substances can impact our care, our attitudes, and the patients we serve.

For people who use substances, sometimes just making it to the emergency department can be challenging enough, without having to worry about the language that may be hurtful or stigmatizing.

In a recent survey of ED patients in BC, ¾ of people who used opioids felt that stigma negatively affected their care.

• “Addict” and “drug user” are terms that define a person.
•  “Substance use” describes behavior.

A “person-first” language is, therefore, preferred:

• “Person who injects drugs” or “person with a history of injection drug use” instead of “injection drug-user.”
• Use “substance use,” a neutral phrase, instead of “substance abuse or misuse,” a judgmental phrase.

Similarly, the term “recreational drug use” is probably best avoided: for some, there is nothing recreational about their substance use.

All the time.

When we address our patients, document their care, and discuss their cases with each other.

EDs are crowded spaces: colleagues, patients, their friends, and their families may easily overhear us… or read our charts.

• Lead by example, use or suggest an alternative, “person-first” language when you hear colleagues, consultants, or learners use language that may be experienced as stigmatizing or labeling
• Post BCCDC Language Matters posters in staff areas of your ED.
• Ask your patients what words they prefer to refer to their substance use.
• Encourage your staff to take IHI’s Recover Hope Campaign Pledge.
• Watch: Language matters in the ED: Our conversation with peer advocate Reija Jean.

Listen to the Language Matters (March 2021) | Full Interview from BCPSQC.

Also, jump to:

• “Language matters” can mean different things to different people. What does it mean to you?(2:31)
• Can you give us an example when language used in an emergency visit had a negative impact on you or someone you know?(3:51)
• How about a time when it had a positive impact?(6:58)
• How can emergency doctors lead by example?(10:18)
• What terms do you find preferable for referring to substance use and people who use substances?(12:04)
• If you wanted emergency medicine staff to remember just one thing from this video, what would it be?(15:07)

1. Toward the Heart– BC Centre for Disease Control

   
   

2. Language Matters, Toolkit for the Surgeon General’s Report on Addiction– National Council for Behavioral Health

   
   

3. IHI Open School Recover Hope Campaign – Change the Narrative Challenge Toolkit– Institute for Health Care Improvement.

   
   

4. Language Matters– Canadian Public Health Association

   
   

5. EM Network Substance Use Clinical Resources

   
   

6. EM Network ED Response to the Opioid Overdose CrisisResearch Program