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AAP announces recommendation of using non-stigmatizing terminology for substance use policy


Rachel H. Alinsky, MD, MPH, FAAP, spoke with Contemporary Pediatrics® about her newly released AAP policy statement advocating for the use of medically accurate, person-first terminology when discussing substance use.

The American Academy of Pediatrics recently published a policy statement urging pediatricians to abandon stigmatizing language in favor of medically accurate, person-first terminology.

The policy statement, titled, “Recommended Terminology for Substance Use Disorder in the Care of Children, Adolescents, Young Adults, and Families,” outlined suggested language for pediatricians, media, policy makers, governmental agencies, and AAP peer-reviewed publications.

Rachel H. Alinsky, MD, MPH, FAAP, lead author of the policy statement, spoke with Contemporary Pediatrics® about some easy language switches, making patients feel unjudged, and creating a friendly and open health care environment for both young patients and their families. Alinsky is an assistant professor of pediatrics at Johns Hopkins University School of Medicine with a focus on addiction medicine and adolescent medicine, Baltimore, Maryland.

One language change that Alinsky highlighted was the change from labels such as ‘drug abuser’ and ‘substance abuse’ to ‘substance use’ and ‘substance use disorder.’ Using person-first language is also helpful when broaching this subject. For example, using ‘the patient has a substance abuse disorder’ vs ‘drug addict.’

She noted that another change she advocates for is not using the terminology ‘addicted baby.’ In a phone conversation with Contemporary Pediatrics®, she explained that babies cannot be born addicted. Addiction, she said, “is the maladaptive behavior that surrounds dependency.” Because of this distinction, Alinsky suggests refraining from the term and instead using ‘infant born substance exposed.’

She implores that the use of these outdated terms creates an air of judgement and mistrust with patients, something she said is only going to make interest in treatment more difficult. “When society uses derogatory terms such as ‘substance abuse’ and ‘drug abuser,’ it creates perceptions that people with substance use disorders do not deserve help or treatment,” she explained in a separate press release announcing the policy statement. “Instead of labeling people with these terms, we should be first recognizing the individual as a person and using medically accurate language such as ‘a person with a substance use disorder.’”

Pediatricians are in a unique position to help implement these changes, according to Alinsky, as many patients first experiment with drugs and alcohol in their adolescent years.

“Pediatricians know the power of words and are in an excellent position as role models, clinicians, and researchers to replace harmful language with terms that respect the dignity of people who have substance use disorders,” she said.

In addition to individual pediatricians embracing non-stigmatizing terminology, she highlighted the need for professional institutions and entities to encourage authors submitting manuscripts or other materials for publication to use medically accurate and respectful person-first language.


American academy of Pediatrics Recommends Non-Stigmatizing Terminology for Substance Use in Policy Statement. American Academy of Pediatrics. Press release. Published May 23, 2022. Accessed May 23, 2022.

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