Substance use disorder (SUD) is an umbrella term that encompasses all conditions that are characterized by problematic substance use leading to dependance and interferes with quality of life. Due to the prevalence and intensity of some substances specific conditions have been identified to assist in diagnosis and treatment, like Opioid Use Disorder (OUD), Alcohol Use Disorder (AUD), Methamphetamine Use Disorder (MUD), including the recognition of multiple SUDs cooccurring, Polysubstance Use Disorder (PUD).
Almost every person will interact with substances at some point, however, each person has an individual relationship to that substance meaning that not everyone will have the same outcome from using. A range of physical, psychological, social, and systemic factors are simultaneously at play leading a person to use, continue using, and seek help.
Substance use disorder, regardless of what substance and how use started, is a medical condition and is not a moral or ethical shortcoming.
Recognizing Substance Use
Even with a highly trained and experienced eye, you can not see if a person uses substances from a distance. Only through safe and connected conversation can a person understand another person’s substance use. However, this does not mean that there are not objective signs that can be used by a clinician to diagnosis SUD.
According to the DSM-5 , there are 11 criteria for identifying SUD:
- Using for longer or in larger amounts than intended.
- Desire to cut down or stop use.
- Preoccupation with obtaining, using, and recovering from use.
- Craving substance.
- Use impairs obligations at work, school, or home.
- Use impairs social and interpersonal challenges.
- Deviation from recreational, social, and occupational activities.
- Increased interactions with physically unsafe environments.
- Continued use despite knowledge of the risk and dangers.
- Experiencing increased tolerance.
- Experiencing withdrawal from abstinence.
A word or few can seem like a tiny part of the conversations that we have, but some words can make a space where a person may feel like they are unwelcome, or you reinforce stigma and bias in your head. Taking the small steps to change the language you use around substance use and SUD allow you to connect better and show that you care.
One of the first and easiest step to changing your language is to use person-first language. Using the structure “person who/with ______” or “people who/with_____”.
| If you would say… | Use… | Because… |
| Drug Addict User Junkie Fiend |
Person with SUD Or Person who uses drugs |
-person first language -removes negative attitudes and blame from conversation |
Beyond talking about the people in these situations, there are commonly used phrases or words surrounding substance use that also carry negative connotations.
| If you would say… | Use… | Because… |
| Abuse | -use Or -misuse |
-removes negative attitudes -misuse is the correct medical term to use |
| Dirty | About sobriety: -is currently using About drug screenings: -tested positive for … About equipment: -used -contaminated |
-clinically accurate wording -promotes environment of hope and self-improvement -removes bias and stigma |
| Clean | About sobriety: -Not using/not currently using … -in recovery About a drug screening: -tested negative for … About equipment: -new -unused -sterile |
|
| Habit | -SUD -pattern of use |
-minimalizes the severity of situation -medically accurate |
| Opioid Substitution Replacement Therapy |
-medication for opioid use disorder -opioid antagonist therapy |
-substitution has some negative connotations |