Authored by: Andrew Kestler, Britt-Heidi Bailey, & Reija Jean (Peer Advocate & Vice-President BCAPOM), with support from the BC Patient Safety & Quality Council & the LOUD in ED Collaborative.

What does “language matters” mean?

The words we use to describe substance use and people who use substances can impact our care, our attitudes, and most importantly 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 language that may add insult to injury.

We, as emergency department staff, have likely all at one time used language that could stigmatize people who use substances, even if that was not our intention. In a recent survey of ED patients in BC, ¾ of people who used opioids felt that stigma negatively affected their care.

Which language matters?

Addict and drug user are terms that tend to define a person. Would you want to be defined only by your substance use? Might you not prefer labels like mother, daughter, physician, community activist, or musician? For that reason, person-first language is preferred: As an example, “person who injects drugs” or “person with history of injection drug use” instead of “injection drug-user.”

Other terms, such as “substance abuse or misuse” imply a certain degree of judgment when “substance use” would do just fine. Similarly, the term “recreational drug use” is probably best avoided. Many of our patients would say there is nothing recreational about their substance use.

When does language matter?

All the time: When we address our patients, when we chart, when we discuss a case. EDs are crowded spaces: colleagues, patients, their friends, and their families may easily overhear us when we least expect it.

What can you do?

• Post BCCDC Language Matters posters in staff areas of your ED
• Suggest alternative, person-first language when you hear learners or colleagues use language that may be experienced as stigmatizing or labelling
• Ask your patients what language 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

Language Matters (March 2021) | Full Interview from BCPSQC. Jump to:

• Q1. “Language matters” can mean different things to different people. What does it mean to you? (2:31)
• Q2. 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)
• Q3. How about a time when it had a positive impact? (6:58)
• Q4. How can emergency doctors lead by example? (10:18)
• Q5. What terms do you find preferable for referring to substance use and people who use substances? (12:04)
• Q6. If you wanted emergency medicine staff to remember just one thing from this video, what would it be? (15:07)

Related Resources

• 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 Crisis Research Program