Equity, Diversity, and Inclusion (EDI), Other, Special Populations
The words we use to describe substance use and people who use substances can impact our care, our attitudes, and the patients we serve.
For people who use substances, sometimes just making it to the emergency department can be challenging enough, without having to worry about the language that may be hurtful or stigmatizing.
In a recent survey of ED patients in BC, ¾ of people who used opioids felt that stigma negatively affected their care.
What kind of language matters?
- “Addict” and “drug user” are terms that define a person.
- “Substance use” describes behavior.
A “person-first” language is, therefore, preferred:
- “Person who injects drugs” or “person with a history of injection drug use” instead of “injection drug-user.”
- Use “substance use,” a neutral phrase, instead of “substance abuse or misuse,” a judgmental phrase.
Similarly, the term “recreational drug use” is probably best avoided: for some, there is nothing recreational about their substance use.
When does language matter?
All the time.
When we address our patients, document their care, and discuss their cases with each other.
EDs are crowded spaces: colleagues, patients, their friends, and their families may easily overhear us… or read our charts.
What can you do?
- Lead by example, use or suggest an alternative, “person-first” language when you hear colleagues, consultants, or learners use language that may be experienced as stigmatizing or labeling
- Post BCCDC Language Matters posters in staff areas of your ED.
- Ask your patients what words they prefer to refer to their substance use.
- Encourage your staff to take IHI’s Recover Hope Campaign Pledge.
- Watch: Language matters in the ED: Our conversation with peer advocate Reija Jean.
Also, jump to:
- “Language matters” can mean different things to different people. What does it mean to you?(2:31)
- Can you give us an example when language used in an emergency visit had a negative impact on you or someone you know?(3:51)
- How about a time when it had a positive impact?(6:58)
- How can emergency doctors lead by example?(10:18)
- What terms do you find preferable for referring to substance use and people who use substances?(12:04)
- If you wanted emergency medicine staff to remember just one thing from this video, what would it be?(15:07)
OTHER RELEVANT INFORMATION
Toward the Heart– BC Centre for Disease Control
Language Matters, Toolkit for the Surgeon General’s Report on Addiction– National Council for Behavioral Health
IHI Open School Recover Hope Campaign – Change the Narrative Challenge Toolkit– Institute for Health Care Improvement.
Language Matters– Canadian Public Health Association
EM Network Substance Use Clinical Resources
EM Network ED Response to the Opioid Overdose CrisisResearch Program
The purpose of this document is to provide health care professionals with key facts and recommendations for the diagnosis and treatment of patients in the emergency department. This summary was produced by the BC Emergency Medicine Network and uses the best available knowledge at the time of publication. However, healthcare professionals should continue to use their own judgment and take into consideration context, resources and other relevant factors. The BC Emergency Medicine Network is not liable for any damages, claims, liabilities, costs or obligations arising from the use of this document including loss or damages arising from any claims made by a third party. The BC Emergency Medicine Network also assumes no responsibility or liability for changes made to this document without its consent.
Last Updated Dec 23, 2021
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