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Alcohol and Substance Use
Please also reference:
- The National Institute on Alcohol Abuse and Alcoholism’s page When It Comes to Reducing Alcohol-Related Stigma, Words Matter
- The National Institute on Drug Abuse’s page Words Matter – Terms to Use and Avoid When Talking About Addiction
Alcohol misuse vs. alcohol abuse
Use alcohol misuse instead of alcohol abuse when referring broadly to drinking in a manner, situation, amount, or frequency that could cause harm to the person who is engaging in drinking or to those around them.
Alcohol overdose vs. alcohol poisoning
Use alcohol overdose instead of alcohol poisoning, which is not an accurate term. Poisoning implies death due to toxicity. Alcohol kills by direct neuropharmacological effects on the brainstem when someone drinks too much (i.e., when they overdose).
Alcohol use disorder vs. alcoholism Updated
Use the term alcohol use disorder (AUD) rather than alcoholism or alcohol abuse. This is a divergence from AP style. Alcohol use disorder aligns with the medical community and federal government’s initiatives to raise awareness that compulsive substance use is a complex brain disorder rather than a moral failing or personality flaw.
Addiction is not a diagnostic term although it is an acceptable synonym for moderate or severe substance or alcohol use disorder. NIAAA uses addiction to refer to the severe sub-classification of AUD. Alcohol addiction is a chronic relapsing disorder associated with compulsive alcohol drinking, the loss of control over intake, and the emergence of a negative emotional state when alcohol is no longer available.
For more in-depth information on the criteria for alcohol use disorder, see the National Institute of Alcohol Abuse and Alcoholism’s page Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.
Alcohol-associated hepatitis, alcohol-associated cirrhosis, and alcohol-associated pancreatitis
Use the terms above instead of alcoholic hepatitis, alcoholic cirrhosis, and alcoholic pancreatitis. While the substitution of alcoholic with alcohol-associated has not been adopted widely for these health conditions, changing the language may help to reduce stigma for people diagnosed with these health conditions.
Alcohol-associated liver disease
Use alcohol-associated liver disease (ALD) instead of alcoholic liver disease. Use of alcoholic as an adjective may perpetuate stigma for people with ALD and other alcohol-related health conditions. Alcohol-associated liver disease has been adopted officially in the field of alcohol research.
Baby with neonatal opioid withdrawal syndrome, neonatal abstinence syndrome vs. born addicted Updated
Use baby with neonatal opioid withdrawal syndrome (NOWS) or baby with neonatal abstinence syndrome (NAS), depending on the context, instead of born addicted or addicted baby. Babies cannot be born with addiction because addiction is a behavioral disorder—they are simply born manifesting a withdrawal syndrome. Use clinically accurate, non-stigmatizing language the same way you would for other medical conditions.
NOWS refers to a baby experiencing withdrawal symptoms from in-utero exposure to opioids.
NAS refers to a baby experiencing withdrawal symptoms from in-utero exposure to substances like cocaine, psychiatric medications, or those substances and opioids.
Fetal alcohol spectrum disorders
The term fetal alcohol spectrum disorders (FASD) refers to the wide range of physical, behavioral, and cognitive impairments that occur due to alcohol exposure before birth (also known as prenatal alcohol exposure).
Focus on the fetus and pregnancy, rather than the mother, as this reduces stigma. For example, use alcohol-exposed pregnancy vs. mother/person who drinks during pregnancy.
Medications to treat opioid use disorders vs. medication-assisted treatment
The widely used term medication-assisted treatment (MAT) stigmatizes the pharmacotherapies as less than adequate and distinct from medications for other medical conditions. Use medications for opioid use disorder, or MOUD, instead of MAT.
Person in recovery, person in remission
Use person in recovery or person in recovery from alcohol/substance use disorder instead of recovering alcoholic/addict. Note personal definitions of recovery vary and not all people in remission from alcohol or substance use disorder identify as in recovery.
Person with a substance use disorder, person who uses drugs Updated
Use person with a substance use disorder (SUD) instead of addict, user, junkie, or drug abuser. A person can have multiple substance use disorders to different substances (alcohol, stimulants, opioids, etc.). Be thoughtful about when to use a plural version of this term versus the singular disorder.
Person who uses drugs or person who uses substances are other acceptable terms for people who may be otherwise be called a user, but do not have an SUD.
Person with alcohol use disorder vs. alcoholic Updated
Use person with alcohol use disorder instead of alcoholic to reduce stigma. Stigma is a significant barrier in many people’s willingness to seek help for alcohol and other substance use problems and can affect how they are treated in all aspects of life, including availability and quality of care.
Some individuals choose to personally use alcoholic to describe themselves as part of their recovery program, e.g., Alcoholics Anonymous. Writers can differentiate between writing a personal story and creating general health content.
Person with an opioid use disorder or person with opioid addiction
Use person with an opioid use disorder (abbreviated to OUD) or person with opioid addiction instead of addict, user, junkie, or drug abuser. In general, use the term opioid and not narcotic.
Return to use, recurrence vs. relapsed
Use the terms return to use, return to drinking, or recurrence instead of relapse when referring to someone who has returned to alcohol or drug use, or a recurrence of substance/alcohol use disorder symptoms.
Substance use disorder, addiction vs. habit Updated
Substance use disorders are chronic, treatable medical conditions from which people can recover. They are defined in part by continued substance use despite negative outcomes. Substance use disorders may be diagnosed as mild, moderate, or severe based on whether a person meets defined diagnostic criteria.
Addiction is not a formal diagnosis, and the term is used in many ways. Some people use the term to describe some substance use disorders, especially more serious presentations.
Use substance use disorder (SUD) or drug addiction instead of habit to avoid trivializing this medical condition. This is a divergence from AP style.
Testing positive (on a drug screen)
Use testing positive when referring to a drug screen, rather than dirty, or failing a drug test. Use neutral, medically accurate terminology. Also do not use clean to describe negative test results or abstinence from drug use.
Treatment center vs. rehab
Use treatment center instead of rehab or detox center. The latter terms carry cultural stigmas and misconceptions.
Use, misuse vs. abuse Updated
When referring to illicit drugs, refer to their use instead of abuse. The term misuse can describe nonmedical use of substances that have legitimate medical uses when taken as directed, such as cough syrup or prescription medications. Misuse can also describe adult intake of legal substances, like alcohol (or, in some states, cannabis), in ways that may negatively affect health and safety. See also: alcohol misuse vs alcohol abuse.
This page last reviewed on November 14, 2023