TABLE 1.

Recommended Terminology Regarding Substance Use

Say This:	Not This:	Here’s Why:
Terminology regarding substance use
Substance use disorder; [insert specific substance: opioid, cocaine, alcohol, etc] use disorder  Addiction	Drug abuse/dependence Substance abuse/dependence	The diagnostic terms “substance abuse” and “substance dependence” described in the DSM-IV have been combined in the DSM-V into “substance use disorder.” “Abuse” and “dependence” should only be used in specific reference to DSM-IV or earlier criteria or when using ICD-10 nomenclature, which still use the term “dependence;” “addiction” may also be used in conjunction with a severe substance use disorder.
Substance use  Hazardous substance use  Unhealthy substance use  Problematic substance use	Substance abuse Drug habit Vice	Substance use exists on a continuum, not all of which constitutes a diagnosable substance use disorder; therefore, these terms describe substance use that risks health consequences or is in excess of current safe use guidelines, without necessarily referencing or meeting criteria for a substance use disorder; it is more precise in describing health hazard than simply “misuse.” Of note, any substance use in adolescents is considered unhealthy.
Nonmedical prescription opioid use  Nonmedical prescription drug use  Nonmedical prescription medication use	Prescription opioid abuse Prescription drug abuse	Refers to using opioids or other prescription drugs in a way other than as prescribed or by a person to whom they were not prescribed.
Intoxicated or in withdrawal Using	Strung out, tweaking, high, drunk (and other colloquial substance-specific terms) Getting high	Uses medically accurate language to describe the state of intoxication or withdrawal from a substance. Less stigmatizing way to describe the act of using a substance to reach intoxication.
Drinking	Getting drunk
Terminology regarding persons
Person with a substance use disorder  Person who uses [insert specific substance: opioid, cocaine, alcohol, etc]	Substance/drug abuser, addict, junkie, druggie, stoner, alcoholic, drunk (and other colloquial substance-specific terms) Drug user, heroin user, drinker, crackhead, pothead, drug-seeking (and other colloquial substance-specific terms)	Uses person-first language, as individuals are not defined solely by their substance use. If unsure of whether the individual has a diagnosed disorder, then the description of “a person who uses [insert specific substance]” is most appropriate.
Person who injects drugs (PWID)  Treatment was not effective  Patient in need of more support/higher level of treatment	Injection drug user Patient who failed treatment Noncompliant, nonadherent	Referring to the treatment not meeting the needs of the patient or the patient needing a higher level of treatment, rather than the patient failing.
Person with multiple recurrences  Person with multiple treatment admissions	Frequent flyer Recidivist	Less stigmatizing way to denote someone with recurrence of substance use disorder, rather than referencing it as a criminal offense or a relapse, which is associated with the connotation of more blame.
Infant/baby with neonatal withdrawal syndrome  Infant/baby born substance-exposed  Infant/baby with physiologic dependence/withdrawal  Concerned loved one	Addicted baby Born addicted Drug endangered Neonatal abstinence syndrome baby or NAS baby Crack baby Enabler	Substance use disorders, characterized by repeated use despite harmful consequences, cannot be diagnosed in an infant; an infant can develop physiologic dependence to a substance such as opioids, for which the medical term is neonatal opioid withdrawal syndrome or neonatal withdrawal. Less stigmatizing way to describe a loved one who supports someone with a substance use disorder and at times may protect them from the negative consequences of their substance use.
Terminology regarding treatment
Treatment, pharmacotherapy  Medication for addiction treatment (MAT)  Medication for opioid use disorder (MOUD)	Medication-assisted treatment (MAT) Opioid substitution therapy Opioid replacement therapy	Medication is treatment and should not be referenced as “assisting” some other treatment, or as simply substituting one opioid for another; if use of acronym “MAT” is desired, recommend using it to refer to term “medication for addiction treatment.”
In early remission  In sustained remission  In recovery  Entered recovery  Stopped using substances  Engaged in treatment	Clean Got clean	People with a history of substance use who are not currently using are deemed “in remission” or “in recovery,” more neutral words than “clean” which implies that people actively using substances are “dirty.”
Negative versus positive test result [Insert substance] detected	Clean versus dirty test/urine	Refer to the actual results of the toxicology test, rather than “clean” and “dirty,” which imply judgment.

ICD-10, International Classification of Diseases and Related Health Problems, 10th Edition.