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Michigan OPEN


Stigma affects everyone. Stigma toward people with substance use disorders can be a significant barrier to receiving appropriate care. Learn what stigma and explore why your words matter as well as the mental health and additional resources provided. Be sure to check out our educational resources and evidence behind our stigma initiative.

What is Stigma?

Stigma affects everyone. Ending the stigma toward people experiencing addiction is more important now than ever, as the rates of substance use disorder and mental health concerns have risen dramatically during the COVID-19 pandemic.1 Social distancing measures have introduced additional barriers to receiving care for substance use and mental health concerns.

What does “stigma” mean?  

A stigma is a negative assumption about a person, or a group of people, based on a specific belief or behavior.2 A stigma can affect how someone is treated by society. Patients with opioid use disorder, or OUD, are often stigmatized, despite OUD being a medical disease that patients do not choose to have. Stigma may also be compounded by other types of bias, such racial, gender, religious, age, and economic biases, further worsening experience and access to care. 

How does stigma affect healthcare? 

Due to the stigma surrounding opioid use, there are negative assumptions about patients with opioid use disorder.2 Consequently, it can be difficult for people, including healthcare workers, to recognize OUD as a medical condition that requires treatment just like high blood pressure, heart disease, or diabetes. It is important for healthcare providers to recognize risk factors for OUD and symptoms of OUD so patients can receive appropriate medical treatment.  

Did you know OUD is a disease?

OUD is a chronic medical disease that is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and requires ongoing medical treatment from a physician.3,4 There are genetic and environmental risks to developing OUD, just like with heart disease, cancer, and diabetes. Similarly, OUD, like many other medical conditions, can be treated with medications, therapies, and lifestyle changes.  

What can we do to reduce the stigma related to opioid use?  

  • Be kind and compassionate toward patients with OUD. OUD is just like any other chronic medical disease requiring lifelong treatment. 
  • If you have OUD, be kind and compassionate toward yourself. 
  • Do your part to reduce stigma toward OUD: 
        • Be an advocate and use language to minimize stigma
        • Use the right words to minimize stigma
        • Provide support and encouragement 
        • Be empathetic 
        • Learn more about OUD 

Addiction Language Guide – Shatterproof

Comprehensive addiction language guide to reduce use of stigmatizing language.


Words Matter!

How we talk about opioid misuse and substance use can add to the stigma surrounding OUD.5,6 It’s important to use language that emphasizes that OUD is a medical disease, not a life choice.4 While there are many examples of words to use and words to avoid when talking about OUD, here are some common words and phrases to consider:

Use these words:  

  • Opioid use disorder (OUD) 
  • Substance use disorder (SUD) 
  • Negative test 
  • Positive test 
  • Substance-free test 
  • Opioid misuse 
  • Substance use 
  • Patient with opioid use disorder 
  • Recovering patient

Avoid these words:  

  • Clean 
  • Dirty 
  • Drug user 
  • Addict 
  • Junkie 
  • Former addict 
  • Reformed addict  
  • Drug abuse 
  • Habit


Check out Shatterproof’s Addiction Language Guide and Words Matter VideoLearn more about how to approach patients who may be at risk for SUD, screening tools, provider-patient conversation starters, and other SUD care resources on OPEN’s SUD Care Coordination website.


OPEN + Shatterproof

OPEN is dedicated to reducing stigma in our community, focusing on the health care setting. Addressing stigma is a critical aspect of each OPEN initiative. OPEN is excited to collaborate with Shatterproof, a leading stigma reduction nonprofit, in delivering programming that spreads awareness to the importance of patient-centered care and person-first language.

The partnership between OPEN and Shatterproof aims to start conversations on the issue of structural stigma and provides stigma-reduction resources and programming to health care professionals.


OPEN is continuously working behind the scenes to provide the very best care. We are striving to change the trajectory of the opioid epidemic.

We are excited to announce we have taken the Superior Health Quality Alliance Shine a Light on Stigma pledge to support efforts to change the stigma around substance use disorder by encouraging person-first and person-centered language. We are committed to removing the stigma around addiction to increase respect for and dignity of persons with substance use disorder improve care for them—and the families who love them. Join us! Stand up against SUD stigma and receive your pledge certificate.


We will support staff and those we serve by being open to conversations about substance use and stigma. We will seek counsel from people with lived experience and utilize their stories and feedback to help drive meaningful improvements to reduce stigma in our communities and organization. We will strive to respond in supportive, non-judgmental, culturally responsive, and welcoming ways at every stage.


We will treat people who have substance use disorders with dignity and respect. We believe that the words we use in talking about substance use disorders are critical to eliminating stigma and supporting people with substance use disorders to get the treatment they need. We will discuss substance use disorder as a chronic illness, not a moral failing, and ensure that this is reflected in all improvement activities, policies and practices.


We will encourage staff to support one another through peer-to-peer coaching to build a healthy workplace culture. We will invest time and resources in training staff and those we serve in stigma reduction. We will share what we have learned and will do all we can to Shine a Light on Stigma!


Mental Health Resources




  1. Wu, T., Jia, X., Shi, H., Niu, J., Yin, X., Xie, J., & Wang, X. (2021). Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Affective Disorders, 281, 91-98.
  2. Tsai, A.C., Kiang, M.V., Barnett, M.L., Beletsky, L., Keyes, K.M., McGinty, E.E., Smith, L.R., Strathdee, S.A., Wakeman, S.E., & Venkataramani, A.S. (2019). Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Medicine, 16(11), 1-18.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  4. Murphy, B. (2018, September 13). 4 factors that add to stigma surrounding opioid-use disorder. American Medical Association.
  5. National Institutes of Health. (2021, November 29). Words matter – Terms to use and avoid when talking about addiction. National Institute on Drug Abuse: Advancing Addiction Science.
  6. Northwest Portland Area Indian Health Board. (n.d.). Words matter when we talk about addiction. Tribal Opioid Response: Healing our Nations Together.
  7. Torres-Lockhart, K.E., Lu, T.Y., Weimer, M.B., Stein, M.R., & Cunningham, C.O. (2022). Clinical management of opioid withdrawal. Addiction, 117, 2540-2550.