Key Terms and Best Practices in Road Safety
Key Terms and Best Practices in Substance Use
Key Terms and Best Practices in Road Safety
1. Focus on: People when describing road crashes.
Headlines focused on the object (vehicles), rather than the subjects (people) are common in road crash reporting. This is dehumanizing: It leaves out people and their actions from the story of the crash, distancing the readers from the situation.
By humanizing the event through language that speaks about people, we acknowledge the responsibility of people on the road. For example, a headline that reads “Cyclist dies after being hit by a truck driver,” is more relatable to readers, who are often themselves drivers, than the headline “Cyclist dies after being hit by a truck.” The latter would be equivalent to a headline that says, for example, “Bullet kills shopkeeper during robbery” instead of “Gunman kills shopkeeper during robbery.”
2. Avoid: Speculation when describing traffic crashes.
Sticking to the facts and avoiding speculation is best when reporting on or describing a traffic crash.
It can be tempting to jump to a conclusion about the cause of a road crash, or to report speculation from bystanders or others. However, identifying the exact causes of these events requires a comprehensive investigation, which takes time and resources. The World Health Organization has prioritized four risk factors that contribute significantly to most road crashes, injuries and deaths, according to research. These are: speeding; driving under the influence of alcohol; lack of or incorrect use of helmets; and lack of or incorrect use of seat-belts. Check with your local officials to see if they have identified the cause of a crash, with these top risk factors in mind.
3. Terms to Use: “Crash” or “collision”
Term to Avoid: “Accident”
Road traffic crashes, injuries and deaths are almost always preventable. Using the word “accident” conveys an undue sense of inevitability and leads the audience to interpret these events as unavoidable or the result of “bad luck” or “destiny.” It also suggests nothing can be done—even though effective policy solutions are available.
4. Terms to Use: “Drink driving,” “driving while impaired,” or “driving under the influence”
Term to Avoid: “Drunk Driving”
The term drunk driving implies risk only at very high blood alcohol levels, or when a person is visibly impaired. Driving while having recently consumed some alcohol, when impaired by alcohol or when a person’s blood alcohol level is above the limit set by law are all harmful behaviors. You do not need to be “drunk” to be impaired while driving.
Key Terms and Best Practices in Substance Use
1. Avoid one-dimensional or stereotypical imagery and stories, and dramatic or harrowing imagery when describing substance use.
It is important when sharing lived experiences that the complexity of substance use, and the surrounding policies and socio-political context, is considered. Incorporate positive images that reflect hope, strength and resilience. Use images of different demographic groups.
There is a spectrum of drug use, its antecedents and its outcomes. However, media coverage of substance use has historically been sensationalized, portraying overly simplified, monolithic identities for people who use drugs—for example, self-destructive, violent and impoverished, or innocent, unsuspecting victims. Visual media has also been used, sometimes inadvertently and with good intentions, to further stigmatize people who use drugs and prop up a stereotypical image of a person who uses drugs. This type of imagery does not consider the existence of people who use substances and have healthy, productive lives, or that the poor health can be a result of exclusionary drug policies, including housing restrictions that have resulted in street living, exposure to violence, and contentious interactions with law enforcement.
2. Avoid racialized narratives and the victim/bad guy dichotomy.
Media stories often perpetuate a false dichotomy, with specific types of people (e.g., a white, suburban young person) who uses or overdoses on substances portrayed as “victims” and the person who supplies or sells substances as the “bad guy.” Other commonly vilified roles related to drug use include women of color, particularly pregnant women and mothers, and people with any history of criminal justice involvement.
The victim/bad guy dichotomy has also historically been racialized, which can be seen in the evolution of the drug policy narrative that has shifted from vilifying drug use in “urban” areas since the 1980s, to calls for a more compassionate approach toward drug use today as overdose within white, suburban and small-town areas have become more prevalent and visible.
A commonly used comparison of substance use disorder is diabetes. People with diabetes may need insulin treatment to manage their conditions, in ways not unlike opioid agonist treatment. Furthermore, people with diabetes are more often treated with a supportive, care-coordinated approach and are not penalized for deviating from dietary, behavioral or medication directives.
3. Avoid using overly dramatic language when referencing substance use.
Using language such as “bigger,” “newer” or “scarier” when referring to emerging drug threats can be perceived as inauthentic by people who use those substances. Also avoid dramatic verbs such as “suffers from” and “afflicted with” or overly glorifying people who have achieved abstinence (e.g., by using words like “heroes”). It further compounds stigma by conveying the message that anyone who uses such a “terrible” substance is stupid, dangerous or illogical.
4. Provide historical and structural context to jarring statistics or stories, so that the reader understands the root of a problem rather than placing blame on individuals.
When describing public health issues, focus on specific people and use person-first language (e.g., people who use drugs and people who are homeless or unhoused) rather than on structures (e.g., housing policies, employment opportunities) and systems (e.g., racism), that have perpetuated inequitable situations in the first place.
5. “Substance use” vs. “Substance use disorder.”
Medical criteria for “substance use disorder” include the continued use of a substance despite substantial negative health and social impacts, and several criteria describing the person’s actions in managing their drug consumption and other life activities. Not all substance use equates to a disorder, and many people consume substances in a manner that would not be diagnosed as a medical disorder. Equating any and all drug use to a drug-related “disorder” suggests that anyone who uses a substance needs clinical treatment, which is not true, and obfuscates the fact that in many cases of overdose the elevated risk has been caused chiefly by punitive responses related to drug policies—such as incarceration, eviction, employment loss, family removal, etc.— rather than by a “disorder.”
6. Term to Use: “Opioid agonist treatment”
Term to Avoid: “Medication-assisted treatment”
The term “medication-assisted treatment” implies that opioid agonist treatment is not a legitimate treatment on its own, suggesting that medication only “assists” other therapies. In reality, opioid agonist medications like methadone and buprenorphine (Suboxone) are highly effective for treating opioid use disorder and reducing overdose risk. Naltrexone, an opioid antagonist, is less effective and requires full detoxification, increasing overdose risk.
“Opioid agonist” treatment should not be stigmatized as “replacing one addiction with another,” but recognized as a proven, evidence-based approach to treating opioid use disorder. Avoid terms like “opioid substitution” or “replacement,” as they reinforce negative stereotypes. Be specific when referring to agonist or antagonist treatments to ensure accuracy and reduce stigma.
7. Terms to Use: “Person in recovery” or “person in long-term recovery”
Terms to Avoid: “Staying sober” or “completed detox/rehab”
“Person in recovery” or “person in long-term recovery” are commonly accepted terms to describe a person who is managing their substance use within their self-defined parameters of health and wellness. The terms “pathways” or “roads” to recovery is useful in recognizing the different means to recovery. Success should focus on the reduction and management of disease and illness, fulfilling social roles (family, work, etc.), and staying alive.
Avoid equating success and recovery to abstinence. Also avoid referring to how long a person has been “staying sober” or that they have “completed detox/rehab,” where the sense of completion suggests that treatment is over and that any future relapse is a personal failure. Relapse should never be equated to failure.
Success in recovery should focus on managing the condition and meeting personal goals, not on abstinence alone. Terms that contrast between “using” and “not using” can perpetuate stigma, even when used with positive intentions. Instead, emphasize that maintenance treatment, including long-term pharmacotherapy, is a valid and effective approach.
8. Terms to Use: “Person with substance use disorder” or “person who uses substances”
Terms to Avoid: “Drug user” or “drug addict”
Language plays a critical role in reducing stigma around substance use. While terms like “druggie” or “junkie” are overtly harmful, even seemingly neutral terms like “drug user” or “addict” can be damaging by reducing a person to a single characteristic. Instead, use people-first language to recognize the person beyond their substance use.
It’s also important to acknowledge that many people with substance use disorders may refer to themselves as “addicts” as part of reclaiming stigmatizing language or reflecting their lived experience. While respecting their choice, communication should aim to uphold the highest standard by using language that humanizes and respects all people, emphasizing the whole person rather than their condition.
9. Terms to Use: “Safe consumption spaces” or “syringe access programs”
Terms to Avoid: “Safe injection site” (when referring to harm reduction programs)
When possible, use the specific language of the harm reduction program being referenced. Common terms include “safe consumption spaces” and “syringe access programs,” which promote safer use and improve the health and well-being of people who use substances.
Avoid terms like “safe injection site,” which focuses narrowly on one type of drug use and evokes negative imagery. Harm reduction encompasses a wide range of services aimed at reducing harms and deaths, while supporting human rights and self-determination through non-judgmental, compassionate care.
In addition, avoid stigmatizing language. For example, “used” or “unused” are better terms than “clean” or “dirty” when referring to needles. Terms like “needle exchange” can also reinforce outdated ideas of limited access, while open models have a greater public health impact. Careful, respectful language can help counter the stigma often associated with harm reduction programs.
10. Terms to Use: “Substance use disorder,” “substance use issues” or “substance use condition”
Terms to Avoid: “Drug habit” or “drug abuse”
“Substance use disorder,” “substance use issues” or “substance use condition” are all acceptable and have often been used interchangeably. Avoid using the acronym “SUD,” except if needed in a very technical document with a narrow audience. Terms like “drug habit” or “drug abuse” imply that substance use involves a moral choice. “Abuse” is also associated with dysfunction as well as the dichotomy of “victim” and “abuser,” similar to contexts of “domestic abuse” or “sexual abuse.”
The Diagnostic and Statistical Manual of Mental Disorders uses the term “substance use disorder” to replace several other outdated alternatives (e.g., “dependence” or “addiction”) that tend to communicate stigma and moral judgment about substance use.
As noted above, be careful to not conflate “substance use” with “substance use disorder.” There is a spectrum of substance use, and all use may not be unhealthy. Substance use disorder is appropriate to situations where a clinical diagnosis has been made.
11. Avoid using the term “vape.”
The term “vape” or “vaping” generally refers to using an electronic cigarette or other device. However, these are industry-coined marketing terms specifically designed to portray the products as harmless by linking them to water vapor—when in fact what they emit is aerosolized chemicals. Liquid chemical components in these products are heated to the point of vaporization and users inhale an aerosol composed of a complex array of chemicals, which can include nicotine, solvent carriers like propylene glycol, ethylene glycol and glycerol, tobacco-specific nitrosamines, volatile organic compounds, flavors, tobacco alkaloids and metals.
Either put the terms in quotes or explain the issue when using the term.
12. Terms to Use: Person-first language such as “person with alcohol use disorder,” “person with alcohol dependency,” “person who drinks (or consumes) alcohol” or “people who drink (or consume) alcohol.”
Terms to Avoid: “Addict,” “alcoholic” or “alcohol user”
“Addict,” “alcoholic” or “alcohol user” are terms that often invoke a negative attitude toward the person rather than the person’s behavior. These terms create stigma and shame. It is important to separate the person from the disease. Avoid words like drug or alcohol “abuse,” “misuse,” “addiction” or “problem.” Similarly, instead of “non-user,” use “a person who does not drink (or consume) alcohol.” Refer to “alcohol consumption” rather than “alcohol use.”