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Clinical Question
What terminology is preferred by patients who are being treated for substance use disorder?
Bottom line
Words shape our reality. People starting methadone treatment prefer being referred to as "person with an addiction" or "person with a substance use disorder," prefer to describe their presenting problem as an "addiction," and prefer being called a "client." Low-rated preferences include the disparaging terms “junkie” and “druggie,” being labeled as having the euphemistic "drug misuse" or "substance misuse" disorders, and being referred to as a "service user" or "customer." 1b-
Reference
Study design: Cross-sectional
Funding: Foundation
Setting: Outpatient (specialty)
Synopsis
The investigators surveyed 450 English-speaking adults enrolled in a single northeast United States institution for methadone treatment. The participants filled out a paper survey on their first visit. Using a 7-point Likert-like scale, using a score of 6 or 7 to indicate agreement, the highest-rated terms for the presenting problem were "addiction," "substance use," and "substance abuse," though the preference occurred less often in non-White–identifying participants. Least-preferred terms were "drug misuse," "substance misuse," and "substance-related disorders," though only 16% to 20% of patients disagreed or strongly disagreed with these terms. Regarding personal descriptors, "person with an addiction" or "person with a substance use disorder" or "substance-dependent person" were preferred, though participants who were partial to 12-step programs preferred "addict" as a term. The most disagreeable terms were "junkie" and "druggie," which were least preferred by 73% of participants. Participants preferred “client” (83% agreement) to “patient,” with “consumer,” “service user,” and “customer” being least preferred. There was no difference in responses by sex.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Terminologie
Bon à savoir la préférence des clients anglophones mais il serait très important de savoir la préférence des clients francophones
Impact assessment
Excellent
Don’t forget “Words shape our reality.”
As stated above under the “bottom line” - words shape our reality. Yet in medicine the trend these days is to use the Orwellian “newspeak” or euphemisms to soften or confuse patients and practitioners alike.
Interesting that the patients/clients themselves prefer the term addictions or addict over the more pc substance misuse. As an addiction specialist it has certainly been my experience that people seeking care are realistic. They want the straight goods e.g., hard truths delivered with empathy and care.
Addiction
Relevant but common sense
ADDICTION AND SUBSTANCE USE
HELPFUL