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A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

Junkie, Addict or Person with a Substance Use Disorder?

Language in journalism

Andrea Woo

Reprinted from the "The Language We Use" issue of Visions Journal, 2018, 14 (1), p. 35

In the business of words, language matters. I recognized this as a child, when I would plow through books, stopping at beautifully crafted sentences to re-read them out of admiration. That a few words strung together could transport a reader and evoke the deepest of emotions has always stuck with me.

As an adult, I think about the power of language when I listen to politicians speak and read news stories on contentious issues such as race and inequality: How is a black criminal described compared to a white criminal? Is this immigrant “illegal” or “undocumented”? Now, in my job as a journalist who covers mental health, addiction and drug policy, I make decisions about language every day.

A debate currently playing out in the media and in the public is whether or not to use the word “addict,” a word that I myself used in my reporting until a couple of years ago. Many people I spoke with in the context of my work called themselves addicts, and the term was fairly common in both reporting and conversation. (It still is.) I didn’t find addiction to be shameful and so, by extension, I didn’t find the term “addict” to be shameful or derogatory.

But in recent years, I began hearing calls for change, from people who use drugs and from activists and academics. To call someone an addict, they pointed out, is to label that person by his or her illness rather than recognizing him or her as a person living with a medical condition. The term “addict” also endows the condition with a sense of permanency.

Careful word choice is not just about courtesy, or even perception. A report released in January 2018 by the Global Commission on Drug Policy noted that language can negatively affect health and heath care by feeding into harmful prohibitionist policies, sometimes affecting clinical care directly.1,2

As an example, the report cited a US study in which mental health clinicians were given identical case studies about people in court-ordered drug-treatment programs. People were referred to as either “a substance abuser” or “someone with a substance use disorder.” “The trained mental health professionals who read about an ‘abuser,’” the report stated, “were more likely to believe that the individual in question was personally culpable for their situation and that punitive measures should be taken.” In other words, to call someone a “substance abuser” is so quietly powerful that it can make trained medical professionals believe that the person is somehow more responsible for his or her addiction than someone referred to as “a person with a substance use disorder.”

Destigmatizing our language won’t happen immediately. “Person with a substance use disorder,” for example, is a clunky phrase that doesn’t neatly fit into headlines. Visuals are just as important; broadcast news will require some creativity to move away from the commonly used B-roll footage of stigma-reinforcing images such as discarded needles and people injecting on the streets.

With today’s resource-strapped newsrooms and few journalists with dedicated beats, it’s understandable that one might miss the ongoing dialogue about the need for evolving language. But I choose to believe that most journalists are thoughtful, compassionate people who always strive to do better and who try to be aware of trends that affect their work. We can’t be naïve about the power of strong reporting, and the power that our words have to sway public opinion and effect change.

In 2017, the American news organization Associated Press (AP) updated its style guide to recommend that journalists avoid words such as “alcoholic,” “addict,” “user” and “abuser” (unless they’re used as quotations or form part of the name of an organization).3 This is a notable change on the part of AP and will have a positive impact on how substance use issues are reported and, in turn, understood by the public.

Using effective language also requires reporting from a place of curiosity, compassion and understanding. A large part of what fuels stigma is fear of the unknown; we can dismantle that fear with education. According to the Canadian Mental Health Association, one in 5 Canadians will experience a mental health event in any given year. By age 40, about half the population will have experienced a mental health event in their life or be facing one currently.4 For those of us fortunate enough to never have experienced a mental illness or addiction, reporting on and describing what the experience is like for others can foster compassion and understanding.

Over the years, I’ve been fortunate enough to meet many wonderful people who live with mental health and addiction issues, who were kind enough to spend time with me and answer every one of my many questions: What does it feel like to have a psychotic break? When you hallucinate, whose voices do you hear and how do those voices make you feel? What does depression feel like for you? Why did you start using this drug? How does this drug make you feel? What do you need to feel better?

With these personal accounts, I was able to humanize the subject of mental health and addiction by describing the symptoms of mental illness as one would describe the symptoms of a heart attack or a broken leg, writing about them in plain language. My discussions with people with lived experience were invaluable not only for the specific stories I was working on at the time, but because they have helped me better understand the complexities of substance use and mental illness and continue to inform my journalism—and, I hope, encourage the same sort of understanding and compassion in my readers.

If you see problematic language in a news story, contact that reporter and voice your concerns. And while these deeply personal issues can be difficult to share, I urge those who are comfortable talking about them to do so, as these voices and perspectives are crucial to advance the discourse and combat stigma. 

About the author

Andrea is a Vancouver-based journalist for The Globe and Mail, with a focus on mental health, addictions and drug policy

  1. Global Commission on Drug Policy. (2017). The world drug perception problem: Countering prejudices about people who use drugs, 28.

  2. Woo, A. (2018). Report highlights the need to clean the conversation around drug use. Globe and Mail (January 9).

  3. Associated Press. (2017). The Associated Press stylebook and briefing on media law. New York: Basic Books. See also comments on

  4. Canadian Mental Health Association. (2018). Fast facts about mental illness.

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