“People Who Use Drugs”—Slow Your Roll on Person-First Language Like This

In recent years, harm reductionists have pushed to call drug users “people who use drugs” as opposed to “drug abusers,” “substance abusers,” or “drug addicts,” among other labels that hold considerable negative connotations. “People who use drugs,” or PWUD for short, is an example of person-first language, a self-explanatory convention that places people before things — things often viewed as holding people back, such as being physically disabled or having schizophrenia.

I worry that the use of “PWUD” among harm reductionists is excessive and paradoxically detrimental to our shared cause of helping people who use drugs. “People who use drugs” is often associated with political correctness and used in place of other, better-suited phrases like “drug user.”

And, Yes, I Do Have Skin in the Game

I like to call myself a “long-term, often-problematic drug user.” Having used drugs nearly every day for ten years, I’ve been kicked out of college and arrested thrice for my drug use, not to mention guilty of otherwise fitting the bill of the “junkie” or “druggie” stereotype countless times.

I also grew up around a super-problematic drug user of a mother for nine-plus years. She’s been arrested in front of all my middle school classmates for DUI, put me around generally-bad people — just a bunch of bullshit kids shouldn’t have to deal with.

Being Overly Politically Correct Hurts Us

Here in rural Tennessee, people are especially averse to anything that’s been singed by superfluous political correctness. This isn’t geographically specific, though — aversion to political correctness is common among nearly all largely-right-leaning people regardless of location. I should mention that even some left-leaning people aren’t fans of PC, either.

Largely-right-leaning politicians and stakeholders across Tennessee, for example, have supported prevention coalitions, often-exclusionary 12-step programs, and outdated, non-evidence-based rehabs. Yeah, they help some, but they fall short.

How can we best break through to those who are most likely averse to harm reduction? I don’t have the answer, unfortunately. However, one thing I do know is that we should avoid doing anything that can be viewed as overly and unnecessarily politically correct.

What is being overly politically correct, at least as far as drugs or drug users are concerned? I think avoiding “drug abuse,” “substance abuse,” and “addict” — at least when used excessively or as the first option to define what I like to call a “long-term, often-problematic drug user” or their behavior — isn’t overly politically correct; on the other hand, I think exclusively using the identifier “people/person who use/uses drugs” and never using other terms to refer to drug users, for example, could be seen as excessive and unnecessary.

It’s Not About the Number of Words

Choosing “drug user” over “person who uses drugs” isn’t at all about word count. It’s not that I can’t be bothered to type two extra words. This reasoning is nothing short of silly.

It’s about distancing ourselves from things potentially viewed as overly politically correct.

Let’s face it — “person who uses drugs” or, for example, “person experiencing homelessness who uses drugs” are clunky phrases. I’ve noticed that some harm reductionists never refer to drug users as just that — drug users. This leaves their writing and rhetoric prone to being clunky, difficult to read, and lacking good flow.

I prefer “drug user” — remember, I’m both a long-term and active drug user, so I very much have skin in the game — over PWUD, but I understand most harm reductionists want to avoid “drug user.” For those who prefer to use PWUD, please try to use at least a 25-75 blend of “drug user” to PWUD (“at least a 25-75 blend” means a 26-74 blend or better). I think “drug user” is the next-best option after PWUD in terms of identifiers that hold relatively few negative connotations.

For the record, I think — strictly from a literary, grammatical standpoint — that “drug user” is generally superior to “people/person who use/uses drugs.”

Associating Other Social Equity Efforts or Otherwise-Left-Leaning Ideas With Helping Drug Users

Many people who consider themselves harm reductionists view “harm reduction” as equal parts:

  • Helping drug users.
  • Advancing not-necessarily-drug-user-related social equity efforts (e.g., pro-LGBT, pro-sex worker causes).

Back when harm reduction was first applied on a major scale in the mid-1980s — which focused on the reduction of HIV transmission, which happened to be particularly likely among gay men who injected drugs — practitioners were forced to address the intersectionality between gay men, injection drug users, and HIV transmission. Based on its background, it makes sense that many harm reductionists view “harm reduction” as one-half helping drug users and one-half advancing auxiliary social equity efforts.

Also, considering the fact — although I have no hard evidence to support this, you’d be hard-pressed to argue otherwise — that most harm reductionists are largely-left-leaning people, it’s easy to understand why so many harm reduction supporters are also supporters of social justice interests in general.

Here’s my issue with associating (1) helping drug users with (2) social equity efforts or other largely-left-leaning ideas that aren’t directly related to drug use: Doing so detracts from our shared goal of helping people who use drugs.

First off, in rural Tennessee, most residents are averse to things like pro-LGBT or pro-sex worker efforts. Whether we actively promote these agendas in our harm reduction-related programming or simply mix our pro-drug sentiments with pro-LGBT or pro-sex worker ideas on social media for others to see, I think we make it less likely for Tennesseans to hop on board the SS Let’s Help Drug Users. They’ll be less willing to adopt harm reduction-positive ideas and, even if they do adopt such views, they’re less likely to become active, across-the-board supporters.

Second, according to the Harm Reduction Coalition’s (HRC) and the Drug Policy Alliance’s (DPA) definitions of harm reduction, helping drug users comes first. The DPA is equally dedicated to fighting “racialized drug policies,” which helps drug users at large — for example, even though I’m White, since I’m poor, I can’t afford to bail out of jail once arrested or hire a private attorney, both of which makes me more likely to unnecessarily plead guilty to charges and otherwise not defend myself like others who can afford to post bail following arrest or secure private legal representation.

Combating race-driven drug laws is undeniably directly related to helping drug users. Pro-LGBT efforts, for example, aren’t directly related to helping drug users. I recognize that, for example, we may need to adopt different strategies to help transgender people who use drugs, though modifying our approaches to help drug userstransgender drug users are, of course, part of the greater drug-using community — falls short of fully-fledged pro-LGBT efforts. The same holds true for pro-sex worker efforts, as drug use and sex work can very well overlap — and often do; however, advocating for sex workers in non-drug-related capacities should not be considered “harm reduction” because doing so doesn’t directly help drug users like me.

For the record, I’m bisexual and was an online-based sex worker for about four years. I reference pro-LGBT and pro-sex worker efforts here because I have skin in these proverbial games.

If I Wasn’t Already Clear

According to the HRC’s and DPA’s definitions of “harm reduction,” helping drug users is the primary objective of harm reduction. And, of course, this article is discussing harm reduction as it directly relates to drugs — not anything else, such as sex work.

Helping drug users, at least per what two of the world’s leading harm reduction-related organizations think — the Harm Reduction Coalition and the Drug Policy Alliance, if you don’t remember — should be the number-one goal of harm reductionists. If this isn’t your goal, what you’re doing might not be best defined as “harm reduction.”

What do we do as harm reductionists? Things that are directly related to helping people who use drugs. We should avoid doing things that hurt drug users.

In places like rural Tennessee, where I live, people aren’t big on anything that’s pro-LGBT or pro-sex worker in nature. Also, residents of the Volunteer State aren’t already hip to harm reduction; obviously, they don’t support harm reduction-positive ideas, as they’re not even familiar with them.

How can we best appeal to the average Tennessean as harm reductionists? I think associating harm reduction with auxiliary social justice efforts or other largely-left-leaning sentiments can materially slow and geld our goal of helping drug users.

How Social Media Use Potentially Turns Off Newbies

Harm reduction is currently most supported by largely-left-leaning people, at least here in the modern United States. Largely-left-leaning people are almost always responsible for what’s considered by some to be “excessive political correctness.” Again, most Tennesseans aren’t fond of anything even remotely considered excessively or unnecessarily politically correct.

I was introduced to harm reduction online — specifically, on Reddit’s r/Opiates subreddit. In places without harm reduction infrastructure like rural Tennessee, most people who find interest in harm reduction will continue to be introduced to the idea via the World Wide Web.

How will largely-right-leaning or otherwise-not-largely-left-leaning people who haven’t yet been exposed to harm reduction welcome the idea of helping drug users — “harm reduction,” in other words — react upon being initially exposed to harm reduction when referenced in a way that’s seen as excessively politically correct?

Probably not well, at least not as well as if that exposure weren’t influenced by political correctness.

What Am I Getting At?

I worry that some potential supporters of harm reduction-positive ideas, efforts, and programs — even harm reduction resources, such as educational brochures — may be turned off by what they perceive as unnecessary, excessive, inappropriate political correctness.

Using “people who use drugs,” again, isn’t being politically correct, I don’t think; however, outright refusing to use terms like “drug user,” “addict,” or “drug abuse” — even though I think “drug abuse” shouldn’t be used outside of referring to excessive consumption of psychoactive drugs that unarguably constitutes “abuse” — may be considered overtly politically correct.

Associating harm reduction with things that are considered overly politically correct could inhibit adoption of harm reduction-positive ideas.

Does this serve as a well-defined, go-to guide for how not to be viewed as excessively politically correct? Hell no.

I think it’s most appropriate for each of us, as harm reductionists, to exercise discretion in doing things that may earn us an unwanted reputation.

3 thoughts on ““People Who Use Drugs”—Slow Your Roll on Person-First Language Like This”

  1. Why are you trying to candy coat the drug attick. Those people are drug users. It’s a fact. They are a negative impact on family friends children and society. Should we reconsider calling a child molester something nicer so their feelings are not hurt. Come on. This is the stupidest thing I have ever heard. Those people are drug addicts!! They need to stop being selfish and get off their pity pots and man up. NO SYMPATHY HERE FOR THOSE PEOPLE!


    1. Don’t get it twisted, Susan. I know people who inject illegal drugs that are 20x the person you will ever be.


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