Commentary: How we talk about opioid crisis affects what we do about it

Mark Marchand, March 10, 2020, Times-Union of Albany

Junkie. Dirty. User. Addict. These words stand in the way of further progress against one of the most formidable challenges we face.

The opioid crisis is in the crosshairs of scientists, medical researchers, and health care providers looking to solve a dilemma that sees more than 100 people dying daily from opioid-related overdoses. Progress is being made.

A growing number of researchers are now focusing their attention on an issue they say stands in the way of proven treatment and helpful public policy: It’s the words used to describe the problem. Scientists studying the language used by news media outlets and the public arrive at one result: stigma. Pejorative words and phrases, they say, fuel perceptions that block efforts to reduce the shame associated with those affected by the crisis.

One such researcher is Emma Beth McGinty of Johns Hopkins University, who has spent the past decade studying the issue. Her research on news media coverage and public statements/opinions has surfaced two persistent myths: 59% of the public believes there is no effective treatment and 56% believe those suffering from addiction are dangerous. McGinty says published research indicates neither is true. Her research and that of others was published in the New England Journal of Medicine and other peer-reviewed journals.

Those perceptions, she says, are rooted in early 20th-century beliefs that people suffering from severe mental illness and addiction were violent and incurable. Despite the development of effective anti-psychotic medicines and treatment programs, false perceptions persist, fueled by news reports and depictions in pop culture.

Those beliefs, she says, run counter to empirical research.

Two of the more serious problems that surfaced in her research are: The stigma fuels a majority belief in punitive actions (jail time) to battle the crisis and the belief that addiction is associated with a “moral failing.” The latter belief, McGinty says, hurts proven drug treatment programs for addiction because “most think you’re replacing one addiction with another.”

Other research supports McGinty. Harvard’s Robert J. Blendon and John M. Benson analyzed 2016 and 2017 data from national polls. They reported in the New England Journal of Medicine that less than half the public believes there is an effective treatment for prescription painkiller addiction. More than a third believe there is no effective treatment and 17% say they simply don’t know. (The Food and Drug Administration has approved three medications for use in treatment programs: methadone, buprenorphine and naltrexone.)

Blendon and Benson conclude, “There is a clear need for the medical and scientific communities to educate the public about the issues surrounding the potential effectiveness of treatment.”

University of Pennsylvania doctoral candidate Robert Ashford looked at words and phrases. His 2018 paper “Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias” tested language choice with nearly 1,300 subjects. He found that “substance abuser” and “opioid addict” were most strongly associated with a negative bias. Terms such as “person with a substance use disorder” and “person with an opioid use disorder” led to more positive perceptions. Ashford told me that while others have already suggested cessation of use of the negative terms, “the current results provide further empirical evidence that the terms should indeed be removed from the lexicon and replaced with the more positively associated terms.”

Even this newspaper is at the forefront of positive change in how the topic is covered. Reporters use the phrase scientists suggest: “opioid use disorder.”

McGinty sees hope in results of recent research on news reporting about medication treatment for opioid use disorder. “The best stories are those that are more engaging and focus on individuals and their struggle, showing them in the full trajectory of treatment and following them all the way to recovery and resumption of normal life activity. They had a medical problem, they received treatment, they got better.”

Mark Marchand is a writer and an adjunct instructor in the journalism program at the University at Albany.

Here’s a direct link to the article on the Times-Union website.