The substance use crisis is now deadlier than ever: Over 107,600 people fatally overdosed in 2021, the highest number of such deaths recorded for a single year, according to the Centers for Disease Control.
In response to this urgent public health crisis, journalists across the United States have explored myriad stories related to substance use disorder (SUD). As we reviewed this news coverage for the past year, we noticed that certain words appeared repeatedly.
As we share these Top 10 words, we hope to advance the understanding of SUD so that together, we can continue to forge solutions.
1. Addiction
Addiction is a disease, and yet – an individual struggling with addiction is more than just their illness. The term “addict” has lost favor in the behavioral health community, and in its place is person-centric language that recognizes the value of the individual. Today, the preferred terms are “substance use disorder” and “a person with substance use disorder,” referring to a complex condition defined by the uncontrolled use of alcohol and/or drugs despite harmful consequences, such as health problems, disability or failure to meet responsibilities.
This change occurred because certain words can come off as negative, shameful and judgmental; can perpetuate the negative stigma around SUD; and discourage individuals from seeking treatment. By reframing substance use disorder as a health issue, we also show respect to those struggling with it.
2. Opioid crisis
Across the United States and for more than two decades, more and more people every year misuse prescription and illicit opioid drugs. In 2021, 80,816 people died as a result of opioid overdose.
The increase in fatalities began in the 1990s, with overdoses involving opioid painkillers, followed by waves of deaths due to illicit opioids such as heroin and, more recently, fentanyl.
3. Fentanyl
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine, making it one of the most dangerous accelerants of the opioid crisis in 2022.
4. Settlement
Multiple lawsuits have been filed in recent years involving drug manufacturers, distributors and retailers, due to claims that their business practices fueled the opioid crisis.
One such lawsuit involved manufacturer Johnson & Johnson and the “big three” distributors McKesson, AmerisourceBergen and CardinalHealth. In February 2022, these companies finalized a $26 billion opioid settlement agreement to address their liabilities in over 3,000 opioid crisis-related suits nationwide.
5. Patients
Many people falsely believe that people with SUD deliberately make destructive choices, a belief that can lead them to being treated as misfits and criminals rather than patients with a chronic, treatable health condition.
This is part of the reason why only 18% of people with SUD receive treatment.
6. Mental health
SUD often coexists with other mental health conditions, including generalized anxiety, panic disorder, PTSD, ADHD, depression and bipolar disorder. Those with SUD are more vulnerable to mental disorders, and vice versa.
For example, over 60 percent of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness. This statistic reinforces the importance of people having convenient access to mental health services, SUD screening and SUD treatment.
7. Community
SUD touches the person struggling with the condition as well as those close to the individual and the community at large.
Direct consequences of SUD include motor vehicle crashes, injuries, social and legal problems, impaired health, overdose, deaths, and babies born with drug withdrawal and fetal alcohol spectrum disorders. Meanwhile, indirect impacts include higher healthcare costs, the spread of infectious diseases, drug-related crime, interpersonal violence, unintended pregnancy and family hardships.
8. Medication-Assisted Treatment
Medication-Assisted Treatment (MAT) denotes the use of prescribed medications, in combination with other therapies, to treat SUD. MAT is primarily used to treat opioid-related SUD by normalizing brain chemistry, blocking the euphoric effects of drugs and relieving physiological cravings. Current thinking suggests that a better term to describe this type of treatment is “Medication for Opioid Use Disorder (MOUD).”
9. Support
During treatment and recovery from SUD, support comes in many forms. Peer Recovery Support Specialists, who have personal experiences with SUD, provide non-judgmental assistance that complements therapy and other forms of treatment.
Peer support has been shown to improve the quality of life of those with SUD; boost engagement and satisfaction with treatment services; increase treatment retention; improve overall health; lower emergency room visits and in-patient hospitalizations; reduce the overall cost of services; and lessen substance use and relapse rates.
10. Recovery
Addiction experts agree that there is more to recovery than just abstaining from substances.
While no standard definition of “recovery” exists, several organizations have created working definitions. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) working definition of recovery is “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” The Betty Ford Institute describes it as “a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship.” [14]
By demystifying these Top 10 terms and by destigmatizing SUD, all of us – from individual patients to society as a whole – stand to benefit.
