What to call someone who uses heroin?

A first-ever study that asks people who use heroin what they want to be called finds “people first” language often best, and language suggesting misuse or dependence generally worst.

In the ongoing opioid crisis, many researchers and clinicians now use “person first” terms such as “person with substance use disorder” instead of loaded labels like “addict,” but little research has focused on the language preferences of this population. Now, a first-of-its-kind study by researchers from the Boston University School of Public Health (BUSPH) and the University of Massachusetts Medical School (UMMS), published in the journal Addiction, has found that people entering treatment for heroin use most often called themselves “addicts,” but preferred that others called them “people who use drugs.”

“In the end, researchers, clinicians, and families should not automatically use the same terms that people who use heroin call themselves, but instead ask about preferences,” says senior study author Dr. Michael Stein, professor and chair of health law, policy & management at BUSPH. “Of course, most people just want to be called by their name.”

The researchers surveyed 263 people undergoing in-patient evaluation and withdrawal symptom management at the Stanley Street Treatment and Resources program (SSTAR) in Fall River, Massachusetts. The terms that the most respondents never wanted to be called were “heroin misuser” and “heroin-dependent,” and most did not like slang terms such as “junkie.”

“Persons who use heroin often complain about interactions with healthcare providers, due at least in part to the unfortunate language providers use–which is taken, sometimes rightly, as a sign of disrespect,” Stein says. “Such antagonism can’t be good for clinical outcomes.”

“We hope this research will inform future work centering on the perspectives of individuals who use drugs, and begin to establish connections between the language that individuals use to describe themselves and treatment engagement,” says the study’s lead author, Dr. Ekaterina Pivovarova, assistant professor of psychiatry at UMMS and faculty in the Massachusetts Center of Excellence for Specialty Courts.

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