Words matter: Guiding principles for combatting drug-related stigma in academic writing

Could some academic language conventions inadvertently lead to discrimination?

And how do academic writers follow ethical conventions – such as de-identifying trial participants – without risking dehumanising the same people their research is seeking to help?

To assist academic writers grappling with these challenges, a team of editors at the International Journal of Drug Policy has developed guidelines to help writers avoid perpetuating stigma, while also combating it, when writing about substance use.

“Academic research is often reproduced authoritatively in public and media discourse, and enacted to justify policy, treatment and other practices, so the influence of language on perceptions and behaviours can have life-altering consequences,” says Mr Ramez Bathish, the lead author of the paper and a Research Officer in Turning Point’s Clinical and Social Research Team. 

According to Mr Bathish, using people-first, strengths-based and inclusive language and processes mindfully and with care can break down stigma and build more equitable values, policies and practices.

Guiding principles for breaking down stigma

“Language is always evolving,” explains Mr Bathish. “There is no simple recipe to making the ‘right’ language choice.”

Instead, the paper’s authors have offered a set of principles to help academic writers make inclusive and respectful word choices.

1. Use people-first language

According to the guidelines, people should be framed as whole people first and foremost, both narratively and in terminology.

“However, presenting research participants solely as ‘people who use drugs’ when their substance use is not relevant to the point being made can have homogenising and stigmatising connotations, especially when sustained across a manuscript,” Mr Bathish explains.

“Consider terms like ‘people ’or ‘participants’ in the first instance, and only frame people in relation to behaviours and characteristics when relevant,” he says.

2. Use empowering and strengths-based language

Strengths-based language – which focuses on a person's abilities rather than challenges – can influence the way they are seen and treated by others.

“Use of empowering and strengths-based language demonstrates respect for people’s capacities, skills and knowledge, and challenges the negative stereotypes that are too often found in descriptions of people who use drugs,” Mr Bathish explains.

The authors also suggest using active voice to describe research participants’ actions to highlight their agency.

3. Avoid jargon and slang

“While some kinds of jargon can be unavoidable, we also encourage writers to consider whether jargon, including acronyms, is necessary,” says Mr Bathish.

According to Mr Bathish, acronyms can be confusing and make it difficult for readers to understand what is being said.

4. Be specific and avoid generalisations

Over-generalising may inadvertently contribute to stigma, the authors warn. Instead, they suggest writers choose specific and precise words. 

“This reduces the chance of conflating people with diverse experiences and erasing or silencing key differences that may be critical to interpreting research findings,” Mr Bathish says.

5. Use inclusive language

Drug-related stigma often overlaps with discrimination based on race, gender or mental health conditions.

The authors recommend choosing neutral, respectful terminology to break down stigma.

“Unless relevant, we recommend writers avoid using descriptions that refer to personal attributes, such as age, gender, race, ethnicity, culture, sexual orientation, disability, or health condition,” Mr Bathish says.

When applying the above principles, consider these approaches:

Involve participants and consider the effects of each word choice

The editorial suggests that research teams consider putting strategies in place to consult meaningfully with research participants and other stakeholders and respect their language preferences.

This might involve developing a plan for managing stigmatising language in research outputs at the start of the project.

“Ideally, people with relevant lived and living experience will be consulted in the early stages of project design, and their preferences respected throughout,” Mr Bathish says.

The guidelines also encourage writers to consider the potential effects of their language by asking: 

• “How do these narrative and language choices frame the subject of these communications?”
• “What does this communication say about those who might be understood to be similar to the subject?”
• “How might this communication be interpreted by those outside the community of the speaker?”

Be mindful of the power of your language choices

Because of the evolving nature of language, Mr Bathish encourages academic writers to employ the guiding principles “holistically, collaboratively and with care”.

“Be mindful of the potential power and effects of your language choices,” he says.

Access the paper here for an outline of:

• the power of words in driving stigma and discrimination
• why language matters, and why care is so important when writing about substance use
• resources to guide language choices and combat stigma