The evolving language of substance use
The words we use to talk about drugs―or rather, substances―has changed
Language shapes how we perceive the world.
The terms we once used to describe drugs and addiction often carry stigma, misinformation, and outdated connotations. They fail to reflect modern understandings of health, science, and behaviour, and can prevent open, constructive conversations about substance use.
Particularly if you grew up during the War on Drugs era, it's important to update your language to reflect a more modern perspective. This can help you communicate with younger people in a non-judgmental way.
You don’t need to suddenly abandon all the terms you’ve used in the past. Just try to shift toward more contemporary language. It's a gradual process that will take time.
Marijuana → Cannabis
The term marijuana was used in the 20th century, but today, the word cannabis is preferred. The shift reflects an effort to move away from racially charged terminology. The word marijuana came from Mexican Spanish and was used to stigmatize Mexican immigrants, who were associated with its use. Cannabis is also seen as a more scientific, neutral term by contemporary growers and retailers, who wish to drop the stigma and integrate the substance into mainstream wellness and health conversations.
Drugs → Substances
Instead of saying drugs, the term substances is more commonly used today. The term drugs historically referred to illicit products like heroin, cocaine, and methamphetamine, and had a negative connotation, whereas the term substances encompasses a broader range, including legal substances like alcohol, nicotine, and cannabis. This shift acknowledges that not all substance use is inherently illegal or negative. It refers to any compound that can alter mood, perception, or health.
Addict → Person with a Substance Use Disorder
The word addict is increasingly replaced with person with a substance use disorder to emphasize person-first language. This shift aims to reduce stigma by focusing on the person, rather than defining them by their condition.
Drug User → Person Who Uses Drugs
Following the move towards person-first language, the term drug user is increasingly being replaced with person who uses drugs to humanize individuals and avoid reducing them to their behaviour.
Clean/Sober → In Recovery
Rather than saying someone is clean or sober, the preferred term today is in recovery. This change reflects a shift away from moralistic judgments about sobriety and focuses on the process of recovery, which can be ongoing.
Teetotaler → Alcohol-free or Substance-free
To update the term teetotaler, which originated in the 19th century during the temperance movement and carries a moralistic connotation, people now use the terms alcohol-free or substance-free. The latter phrase describes a broader abstinence—not just from alcohol, but from all substances that may alter state of mind. Additionally, alcohol-free and substance-free have a more positive tone, focusing on personal choice rather than moral rule-following.
Alcoholic → Person with Alcohol Use Disorder
Similar to the term addict, the word alcoholic has been replaced with person with alcohol use disorder or person with alcohol dependency. The language is now focused on describing the condition rather than labeling the person.
Overdose → Drug Poisoning
Increasingly, the term drug poisoning is used instead of overdose, especially in the context of opioids and synthetic drugs like fentanyl. This reflects the fact that many people may be unknowingly taking lethal doses of highly potent substances, rather than deliberately consuming large amounts.
Gateway Drug → Progression of Substance Use
The idea of a gateway drug (where one substance leads to the use of others) has evolved. Now, instead of referring to substances like cannabis as a gateway drug, professionals talk about progression of substance use. This change recognizes that multiple factors—social, psychological, and genetic—contribute to a person’s use of progressively stronger substances. It’s more complex than one substance leading to another.
Hitting Rock Bottom → Seeking Help at Any Stage
The concept of hitting rock bottom before seeking help is no longer widely used in addiction circles. Instead, the focus is on encouraging people to seek help at any stage of substance use or misuse, with the understanding that early intervention is often more effective.
War on Drugs → Drug Policy Reform
The War on Drugs, is over. To talk about how laws are changing in the aftermath, people use the term drug policy reform. This shift reflects a movement away from criminalizing drug use and towards reforming drug laws to focus on public health, harm reduction, and rehabilitation.
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