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The Medical Minute: Stay positive when talking with people with substance use disorders

Physicians and other health care professionals who treat the growing number of people living with substance use disorder often hear the same thing from their patients: why didn’t they talk to someone about their problem sooner?

Their instincts are right, said Dr. Aleksandra Zgierska, a professor in the departments of Family and Community Medicine, Anesthesiology and Perioperative Medicine, and Public Health Sciences at Penn State College of Medicine. A conversation with a family member or someone they love can be the catalyst for someone struggling with addiction to get the care they need, she said.

If you’re among those hoping to help, that conversation might seem daunting enough. But when picking your words, choose them carefully, she said.

“Change can start with just a conversation,” said Zgierska, who serves as associate director of the Penn State Addiction Center for Translation and as an advisory board member of the Penn State Consortium for Substance Use and Addiction. “But that conversation can’t be antagonistic. People are not motivated to change based on negative emotions.” Instead, family members and friends should try to be supportive and non-judgmental, because negativity can make things worse.

“Society often treats addiction as shameful or a weakness of character,” she said. “The stigma is pervasive. That situation has to change.”

Be positive

“Use of illicit drugs not only affects physical health, but also mental and social health,” said Brad Linn, assistant professor in the departments of Family and Community Medicine, Neural and Behavioral Sciences, and Psychiatry and Behavioral Health in the College of Medicine. “As a result, it affects relationships.”

Linn advocates for using cognitive behavioral therapy to help substance use patients. Based on the concept that thoughts and behaviors are linked, the approach has proven to be both effective and efficient in treating patients with substance use disorders, he said.

Like Zgierska, Linn suggests family members and friends show support and suppress negativity. “They must say things like ‘I love you and I care about you and I want to see you well,’” he said. His research, in fact, has shown that reducing negative emotions can help bring about the behavioral changes necessary for recovery.

Families should act quickly to help direct those with substance use disorders to clinics and recovery-oriented organizations, Linn said. Work-based employee assistance programs may also provide a route for treatment.

Families must recognize recovery takes time, he added. “It’s possible your loved one will have a relapse,” he said. “It’s important not to see that as a failure, but to recognize that the person is on a long recovery journey and continue to offer love and support.”

Choose the right words

Zgierska suggests jettisoning terms like “addict.” “That implies the person is defined by their struggle with substance use. Referring to them as a person with substance use disorder underscores the fact they exist outside their disease.”

Other words that exacerbate negativity around the illness include “clean,” for someone who no longer uses substances, or “dirty” for someone who does, Zgierska said.

Other words to avoid, according to the National Institute on Drug Abuse:

  • User
  • Substance or drug abuser
  • Junkie
  • Alcoholic
  • Drunk
  • Former addict
  • Reformed addict

It’s not just those words used in articles and popular culture that can hurt, Zgierska said. Their use in the home can have a similar effect.

“Let’s communicate, in the right way. I have had patients who say, ‘My parents never talked to me. They didn’t care,’” she said. “And the family says in response, ‘We cared a lot. We just didn’t know what to do or say.’”

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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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