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‘Don’t Say Drug Habit,’ New Government Guidelines Suggest

An upcoming government document recommends federal officials, scientists, and contractors avoid certain words when talking about addiction.
Photo showing someone drawing fluid into a needle

The White House Office of National Drug Control Policy is releasing a document outlining suggested language for government agencies — and those they pay — to use when referring to people addicted to drugs and alcohol. “Drug abuser,” for example, should be replaced with “person with substance use disorder.” Even the idea of trying to get “clean” is discouraged; patients are instead to be said to be “in recovery.”

The recommendations are aimed at reducing stigma against individuals with addictions, Office of National Drug Control Policy Commissioner Michael Botticelli and public-health professor Howard Koh write in an essay published today in the Journal of the American Medical Association. The social stigma against people with mental-health illnesses, including addiction, remains harsh. And that can be harmful for those seeking help. “Stigma isolates people, discourages people from coming forward for treatment, and leads some clinicians, knowingly or unknowingly, to resist delivering evidence-based treatment services,” Botticelli and Koh write, citing two studies.

In their essay, the two public-health experts explain the reasoning behind some specific recommendations:

For example, the guidance recommends the following: replacing ‘drug abuser’ with ‘person with a substance use disorder,’ consistent with DSM-5 [Diagnostic and Statistical Manual of Mental Disorders]; referring to a person as ‘in recovery’ rather than being ‘clean,’ because the latter term implies that people with this disease are dirty or socially unacceptable; and avoiding use of the term ‘drug habit,’ which inaccurately portrays SUDs [substance-use disorders] as simply a matter of personal choice.

The guidelines will apply to “internal and external forms of communication, including publications, press and web materials, and funding announcements” from government agencies. In addition to government employees, the Office of National Drug Control Policy also wants contractors and scientists who receive federal funding to follow the guidelines.

Such an inclusive rule is at odds with the Office of National Drug Control Policy’s past. The office was established by the Ronald Reagan administration, as a part of America’s War on Drugs. The office’s commissioner is informally called the nation’s “drug czar,” but Botticelli doesn’t seem to have as punitive an approach to drug laws as the nickname would suggest. He himself has struggled with alcoholism in the past, and has been in long-term recovery for over 26 years, according to his official White House biography. In his career so far, he has supported distributing clean needles and naloxone in communities where people inject drugs. (Botticelli’s office declined to comment on the new guidelines until they were published.)

The policing of words has been a contentious topic in American politics lately, with many conservatives lamenting politically correct culture. Whether conservatives will oppose the new guidelines remains to be seen. Progressive drug policies are experiencing surprisingly bipartisan support at the moment.