Merge pull request #2769 from department-of-veterans-affairs/megzehn-…

…updating-health-content

Create-destigmatizing-language-page.md

src/_content-style-guide/health-content/destigmatizing-language-in-substance-use.md

@@ -0,0 +1,173 @@
+---
+layout: content-style-guide
+permalink: /content-style-guide/health-content/destigmatizing-language-in-substance-use
+has-parent: /content-style-guide/health-content/
+title: Destigmatizing language in substance use
+intro-text: "When writing about substance use and substance use disorder, the words we use matter. This is true both in content for Veterans as well as in our treatment plans, policies, and other documents."
+---
+
+Research shows that stigmatizing language can make it harder for people with substance use disorder to seek treatment. It can also negatively shape the perspectives of the people providing treatment in a way that negatively impacts the care they provide.
+
+At VA, we use language that reflects how we provide treatment and support to Veterans with substance use disorders:
+
+- We recognize people as human beings first and not as defined by their problems or conditions.
+- We know that people have problems but are not themselves the problem.
+- We show support and understanding for people who have substance use problems, rather than negativity, punishing attitudes, or blame.
+- We recognize substance use disorder as a serious condition and not a choice or “habit.”
+
+## Substance use: Language to use and avoid
+
+**Use:** Alcohol, drug, or substance use disorder; alcohol, drug, or substance use addiction  
+**Avoid:** Alcohol, drug, or substance abuse; alcohol, drug, or substance dependence
+
+**Use:** Person with a substance use disorder; person with a substance addiction; person who uses drugs, substances, or medications other than as prescribed  
+**Avoid:** Addict; addicted; alcohol, drug, or substance user; alcohol, drug, or substance abuser
+
+**Use:** Person with alcohol use disorder; person who engages in unhealthy drinking  
+**Avoid:** Alcoholic; drunk
+
+**Use:** Not currently using drugs, substances, or medications other than as prescribed  
+**Avoid:** Clean
+
+**Use:** Currently using drugs, substances, or medications other than as prescribed  
+**Avoid:** Dirty
+
+**Use:** Person in recovery or remission from alcohol, drug, or substance use disorder  
+**Avoid:** Ex-, former, recovering, or reformed addict or alcoholic
+
+**Use:** Person with a severe substance use disorder  
+**Avoid**: Hardcore
+
+**Use**: Person who is currently injecting drugs or substances  
+**Avoid:** Injection, injecting, or IV drug user
+
+**Use:** Person with stimulant use disorder; person who engages in unhealthy use of stimulants  
+**Avoid:** Meth head
+
+## Supply of substances: Language to use and avoid
+
+**Use:** Person who traffics or sells drugs, substances, or medications other than as prescribed  
+**Avoid:** Dealer
+
+**Use:** Extensive involvement in the unlawful sale of drugs, substances, or medications other than as prescribed  
+**Avoid:** Hardcore
+
+## Drugs and substances: Language to use and avoid
+
+**Use:** Potential for a substance to lead to addiction or unhealthy use  
+**Avoid:** Abuse potential; potential for abuse
+
+**Use:** Substances that can lead to addiction or unhealthy use  
+**Avoid:** Drugs of abuse
+
+**Use:** Non-medical use of prescription medication; using medication other than as prescribed  
+**Avoid:** Prescription drug abuse
+
+**Use:** Cannabis  
+**Avoid:** Marijuana
+
+**Use:** Syringes; injection equipment  
+**Avoid:** Works; rigs
+
+**Use:** Sterile, unused, or not previously used (when referring to syringes or injection equipment)  
+**Avoid:** Clean
+
+**Use:** Unsterile, used, or previously used (when referring to syringes or injection equipment)  
+**Avoid:** Dirty
+
+## Toxicology: Language to use and avoid
+
+**Use:** Provide a sample for drug or toxicology testing  
+**Avoid:** Drop
+
+**Use:** Tested positive for substances  
+**Avoid:** Dirty; fail; pop
+
+**Use:** Tested negative for substances  
+**Avoid:** Clean; pass
+
+## Treatment: Language to use and avoid
+
+**Use:** Alcohol use disorder  
+**Avoid:** Alcoholism
+
+**Use:** Person doesn’t agree with others’ perspectives of their substance use; person perceives their substance use differently than how others perceive it  
+**Avoid:** Denial
+
+**Use:** Unsuccessful course of treatment; didn’t benefit from treatment  
+**Avoid:** Fail
+
+**Use:** Substance use disorder; substance addiction  
+**Avoid:** Habit
+
+**Use:** A recurrence of alcohol, drug, or substance use  
+**Avoid:** Lapse; slip
+
+**Use:** Medication for opioid use disorder MOUD); medication for alcohol use disorder (MAUD); medication or pharmacotherapy for substance use disorder  
+**Avoid:** Medication-assisted treatment (MAT); maintenance; maintenance treatment; methadone maintenance; replacement treatment; opioid substitution
+
+**Use:** Person has chosen not to complete the recommended treatment (or other course of action); person has decided not to complete the recommended treatment (or other course of action)  
+**Avoid:** Non-compliance
+
+**Use:** Recurrence of symptoms of substance use following remission  
+**Avoid:** Relapse
+
+**Use:** Experiencing discord or friction in the therapeutic relationship; unsure about treatment  
+**Avoid:** Resistant
+
+## Criminal justice system (or criminal legal system): Language to use and avoid
+
+**Note:** We acknowledge the movement toward replacing references to the “justice system” with references to the “legal system.” We’re including both terms at this time and may update this information in the future as consensus arises.
+
+**Use:** Person with justice system involvement; person with legal system involvement  
+**Avoid:** Convict; criminal; delinquent; offender
+
+**Use:** Person who was formerly involved in the justice (or legal) system  
+**Avoid:** Ex-con; ex-convict; ex-offender
+
+**Use:** Person who pled guilty to, or was judged guilty of, a felony offense; person officially declared guilty of a felony offense in a court of law  
+**Avoid**: Felon
+
+**Use:** Undocumented immigrant; person who doesn’t have documentation of U.S. residency  
+**Avoid:** Illegal; illegal immigrant
+
+**Use:** Person who is incarcerated  
+**Avoid:** Inmate
+
+**Use:** Person in detention, jail, or prison  
+**Avoid:** Prisoner
+
+## Other related topics and situations: Language to use and avoid
+
+**Use:** Person experiencing severe poverty, homelessness, housing insecurity or instability; person who is unhoused  
+**Avoid:** Derelict; transient
+
+**Use:** Under-resourced neighborhood; neighborhood with a high rate of poverty; marginalized community  
+**Avoid:** High-poverty (in reference to a place or community)
+
+**Use:** Lower-income or marginalized metropolitan neighborhood or community  
+**Avoid:** Inner-city
+
+**Use:** Difficulty in seeing a means to recovery; in a challenging situation  
+**Avoid:** Hopeless
+
+**Use:** A harmful challenge affecting many people  
+**Avoid:** Scourge
+
+## Resources
+
+We encourage you to use these resources for more guidance:
+
+[The Recovery Research Institute’s “Addictionary®” (RRI website)](https://www.recoveryanswers.org/addiction-ary/)
+
+[The National Institutes on Drug Abuse’s “Words matter – Terms to use and avoid when talking about addiction” guide (NIDA website)](https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction)
+
+**Additional references we consulted to create this guidance:**
+
+[The 2017 Executive Order on changing federal terminology regarding substance use and substance use disorders (Obama Whitehouse Archives website, PDF)](https://obamawhitehouse.archives.gov/sites/whitehouse.gov/files/images/Memo%20-%20Changing%20Federal%20Terminology%20Regrading%20Substance%20Use%20and%20Substance%20Use%20Disorders.pdf)
+
+The Drug Enforcement Administration’s community outreach and prevention support style guide (link not yet available).
+
+Broyles, L. M., Binswanger, I. A., Jenkins, J. A., Finnell, D. S., Faseru, B., Cavaiola, A., Pugatch, M., & Gordon, A. J. (2014). Confronting inadvertent stigma and pejorative language in addiction scholarship: a recognition and response. _Substance abuse_, _35_(3), 217–221. <https://doi.org/10.1080/08897077.2014.930372>
+
+Tran, N. T., Baggio, S., Dawson, A., O'Moore, É., Williams, B., Bedell, P., Simon, O., Scholten, W., Getaz, L., & Wolff, H. (2018). Words matter: a call for humanizing and respectful language to describe people who experience incarceration. _BMC international health and human rights_, _18_(1), 41. <https://doi.org/10.1186/s12914-018-0180-4>

src/_content-style-guide/health-content.md → src/_content-style-guide/health-content/index.md

@@ -1,15 +1,15 @@
 ---
-layout: default
+layout: content-style-guide
+permalink: /content-style-guide/health-content/
 title: Health content
+intro-text: "Health content should be accurate, accessible, and actionable to help Veterans make decisions about their health and health care benefits. In VA health content, we avoid overly clinical language and write in a person-to-person, empathetic, and conversational voice."
+sub-pages:
+  - sub-page: Destigmatizing language in substance use
 ---
 
-# Health content
-
-Health content should be accurate, accessible, and actionable to help Veterans make decisions about their health and health care benefits. In VA health content, we avoid overly clinical language and write in a person-to-person, empathetic, and conversational voice.
-
 ## Use plain language alternatives for medical terms—or explain terms in context
 
-Use a plain language approach instead of medical jargon. If they need to know a specific medical term that a health care provider may use, include the term and explain it in context with plain language.
+Use a plain language approach instead of medical jargon. If Veterans need to know a specific medical term that a health care provider may use, include the term and explain it in context with plain language.
 
 ### Use everyday words when you can
 
@@ -150,7 +150,7 @@ Our National Center for PTSD is the world’s leader in PTSD research, education
 
 You can also call our tobacco quitline at 855-QUIT-VET (855-784-8838). Or sign up for our SmokefreeVET text messaging program.
 
-[Sign for SmokefreeVET text messaging](http://smokefree.gov/VET)
+[Sign up for SmokefreeVET text messaging](http://smokefree.gov/VET)
 
 [Find more resources to help you quit smoking](https://veterans.smokefree.gov)
 
@@ -162,7 +162,7 @@ For more tools and resources to help you adopt a healthy lifestyle, meet your he
 
 ## Make risk—and risk reduction—easier to understand
 
-Many Veterans may have a higher risk of certain conditions based on their service history. When writing about risk, make the numbers as clear and simple as possible. And always follow statements about risk with action steps your audience can take to protect their health
+Many Veterans may have a higher risk of certain conditions based on their service history. When writing about risk, make the numbers as clear and simple as possible. And always follow statements about risk with action steps your audience can take to protect their health.
 
 ### Do the math for your audience
 
@@ -232,5 +232,3 @@ Use these resources as well to help guide your health education content:
 [Health literacy online: A guide for simplifying the user experience (Office of Disease Prevention and Health Promotion website)](https://health.gov/healthliteracyonline/)  
 
 [The SHARE Approach—Communicating Numbers to Your Patients: A Reference Guide for Health Care Providers (Agency for Healthcare Research and Quality website)](https://www.ahrq.gov/health-literacy/professional-training/shared-decision/tool/resource-5.html)
-
-