Words Matter: The Language of Behavioral Health

A third of adults in the United States do not receive help because of stigmatization even if they need it. The current language that is used now to describe substance use disorder can cause a person to feel a sense of shame. This leads individuals to hide symptoms and conditions and can cause a person to be reluctant to seek care. Thus, changing the language that people use can help reduce stigma. As Dean Lemire, a recovery advocate, explains, “Stigma is a major barrier for individuals who struggle with substance abuse.” Discrimination and stigma has also been studied within the professional fields that serve those with behavioral health conditions. Therefore, even those trained to help and serve people with behavioral health conditions may carry bias or negative perceptions unknowingly.

So, let’s take a moment to understand some of the common terms used around behavioral health and substance use that can help us understand the conditions and the best means of framing them.

What is behavioral health?

Behavioral health refers to “mental/emotional well-being and/or actions that affect wellness” and encompasses both  substance use disorders and mental health conditions. Mental health includes a person’s emotional, psychological, and social well-being, and conditions may include depression, anxiety, suicidality, and severe psychological distress with or without a specific trauma as a root cause. According to the National Institutes of Health, mental illnesses are common and can range in impact from no or mild to significantly disabling impairment. Behavioral health problems also include substance use disorders such as alcohol and other drug addiction.

Why think about behavioral health?

Every person experiences behavioral health differently, and how an individual sees himself/herself  is different when compared to another person. Hence, language matters. People inadvertently may use language to isolate somebody whether the words are intentional or not. However, when being aware of language and of the fact that people are experiencing life differently, it allows for greater sensitivity.   

What is substance use disorder?

The National Institute on Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Substance use disorder is considered a brain disease because drugs change the way the brain is structured and how it functions. When substance use disorder is framed as a brain disease, the language we use becomes more thoughtful.

For example, words like recurrence are better than using words like relapse because the latter does not imply that choice is involved. As quoted by Mark Twain, “The difference between the right word and the almost right word is the difference between lightning and the lightning bug.”

Why change the language?

Here are some notable examples of why language surrounding substance use disorder matters:

• Substance Use Disorder versus Substance Abuse: Substance use disorder is preferred over substance abuse because the latter may imply a person deserving punishment. The word “abuse” in general has a negative connotation.
• Disorder versus Addiction: Disorder is preferred to be used over addiction because addiction is a loaded word that can be used to described other behaviors such as, gambling, sugar, etc.  

Similarly, it is important to address the negative stigma around mental health. Here are a few ways to do so:

1. Talk openly about mental health.
2. Educate yourself and others about mental health.
3. Be conscious of your language.
4. See the person, not the illness.

Written by: Shannon Spurlock and Lisa Mure. Contributions to this post also from Dean Lemire.