Quite rightly there is a current focus on stigmatising language. Use of language frames the way we think. Non-judgemental, people-first language is important to reduce stigma but it is equally important that we consider the subtle use of language that disempowers, judges and marginalises the people who use our services.
These are some of the common argument we hear to justify the de-funding of residential services:
There is no demand for rehab
We frequently hear the reason for reduced detox and rehab access is that people don’t want it. This simply isn’t true. We frequently speak to people desperate for rehab, we are told they have had to ‘fight’ and ‘beg’ to even be considered for a placement. We know the lack of demand is due to lack of awareness, and that is understandable - why would frontline treatment staff make people aware of a treatment option that isn’t funded?
The ‘no demand’ argument places the blame firmly on the people seeking treatment. It sounds like a simple statement, it passes in conversation as if it offers some form of insight, but it is just blatant victim blaming.
Rehab is too expensive
People with multiple needs (homelessness, mental health and substance-use) require more comprehensive treatment, this is true in almost all forms of healthcare, therefore rehab costs more than less-comprehensive treatment. The ‘too expensive’ argument is nothing more than a moral judgement and the subtle implication is that some people are worth more than others.
We can’t put everyone in rehab
This is one we hear often, and often where there is no suggestion that rehab is for everyone. Behind it is a classic use of passive language that creates an image of people waiting to be put somewhere, like pieces on a chess board.
Rehab is not right for some people
The UK clinical drug treatment guidelines make it clear who rehab is most likely to be suitable for. This statement deflects from the reality of rehab being underutilised by subtly implying that the treatment on offer would be ineffective for those who miss out anyway.
Rehab providers should do more to market their services to funders
A seemingly innocuous statement, but behind it is the implication that the defunding of detox and rehab is always someone else’s problem and not a systemic issue.
All these statements feed a narrative that addiction is fixed, that there is a type, that addiction is a choice, that people can’t or don’t want to get better, that people are passive and helpless. The combined message that these arguments offer is “it’s your fault that you are not well and you are not worthy of help”.
If we are to improve treatment access for people with multiple health and social disadvantages we need to confront this subtle stigma-driven language.