Melissa McKnight


Substance use disorder, also known by the stigmatized name “drug addiction,” is a disease that changes a person’s brain functioning and behavior.

The disease makes a person incapable of controlling the use of a medication or drug, whether legal or not. There is a strong correlation between SUD and stigma, as SUD is the most stigmatized disease in the world. The definition of stigma is a mark of disgrace associated with a particular quality.

Currently, more than 20 million people in the United States have a substance use disorder, and millions more report experimenting with illicit substances in the past month. During the 2018 Community Health Assessment, more than 47 percent of Jackson County residents reported that their life had been negatively affected by substance use – whether their own or someone else’s.

Here in Western North Carolina, we can see and feel the impacts the epidemic has on our families and community. The epidemic is evident to those who work in healthcare and any community service, the school system and child care, to anyone who reads the newspaper or watches the news, and most heartbreakingly to the families who have been directly impacted by the disease. SUD is around us all and impacts many of us individually and all of us as a society.

SUD affects people across all education and income levels, from varying types of households, and all races. SUD is a disease that does not discriminate. Research tells us that when people feel stigmatized they are less likely to seek treatment. How can we as individuals and as a community change our behaviors around substance use stigma? It starts with how we talk. Language matters.

Here are a few tips from the N.C. Department of Health and Human Services’ Stop the Stigma Campaign to help change our language: 

• The word “abuse” connotes violence and criminality and does not fit with a view of SUD as a health condition. SUD is a diagnosable condition that has become significantly problematic in a person’s life. Instead of: drug/substance abuse, try substance use disorder, or drug/substance misuse.

• Person-first language affirms people’s individuality and dignity. It promotes the message that a person is more than just their addiction. Note that how a person chooses to identify is up to them and they should not be corrected if they choose to use different language. Instead of addict, abuser, junkie, druggie, try person who uses drugs, person with a SUD, or person using substances problematically.

• The term “dirty” is often used to describe syringes that have been used or to describe positive drug screens. People who are no longer using drugs are often referred to as “clean.” However, the clean/dirty dichotomy creates a false narrative that people who use substances are unclean. Instead of clean/dirty, try sterile/used syringes, positive/negative drug test, person in recovery/person with problematic substance use.

For more information on reducing stigma, The Recovery Research Institution “Addiction-ary” can provide ideas on terms that are less stigmatizing. With less stigma, individuals with SUD are more likely to seek help, stay in treatment and achieve long-term remission.

We can all work together to stop treating individual’s with SUD as a disgrace, and instead treating them as a person first. To get involved, contact Janelle Messer at 587-8238 or

Melissa McKnight is deputy director for the Jackson County Department of Public Health.