The language journalists use must be precise, must be fair and above all, do no harm. In reporting on addiction for the last several decades, the media — both print and broadcast — have used language dealing with the disease that breaks all of those rules, leaving those who are experiencing addiction in their lives to face additional stigma and discrimination, and communities ill-informed on how to solve the problems substance misuse creates.

West Virginia University’s Ashton Marra, a career journalist-turned-professor, and WVU psychology department doctoral graduate Jonathan Stoltman, the director of the Opioid Policy Institute, founded Reporting on Addiction to research how the media can change the narrative about addiction, thus changing outcomes for both individuals and communities. They’ve used their research to create resources for professional and student journalists and are training them in ways to tell more contextual stories about addiction that incorporate the latest medical science. 

Marra says the old model of treating addiction like a crime must end. She talks to journalists about the purpose of their stories.  

“Why are you covering this crime? Who did that impact? Nobody. It did nothing but shame someone at one of the worst moments of their life; at the worst moment in their disease, we have now shamed them for a crime that literally impacted no one,” Marra said. “I know that's not always the case, but a lot of times it is a crime that impacted literally no one else. And putting their mugshot up and talking about their arrest doesn't help anyone. It didn't help my community, it didn't help anyone.” 

Marra likens the evolution of the language surrounding addiction to how journalists once discussed climate change as a “both sides” topic. Now that reporting has caught up with the science, “we as a world of people understand that there are not two sides to climate change. It just is.

“ There are not two sides to addiction, it is a disease, not a moral failing, ”

— Ashton Marra

And in that point lies the change she and Stoltman want journalists to make — addiction is a chronic disease, not a crime. 

“Helping the community, which is a journalist's role, is informing the community about it as a medical condition,” Stoltman said. “Because the medical science has been there for decades at this point, but the community doesn't think about it that way. And a large reason for that is because the media also doesn't present or think about it that way.” 

Changing the narrative to use language that treats addiction as the brain disease it is can help reduce stigma and break down barriers to treatment and services that will not only reduce discrimination, but ultimately can save lives — Marra notes “it really is that big.” 

Marra and Stoltman began Reporting on Addiction, now a nonprofit, in response to a national news story that posited West Virginia and Appalachia as devastated by the opioid crisis and the resident population not seeming to care. While a response to the story was the first priority, Stoltman wanted to do something substantially larger. They’ve created a one-page style guide for journalists, generally based on new Associated Press guidelines and other academic research, about reducing stigma and discrimination.  

They’ve also created research-based curriculum for journalism students that was piloted in five journalism schools in the fall of 2022, including WVU’s Reed College of Media. They’ve also presented their research to several professional newsrooms, worked with more than 30 reporters one-on-one and shared their guide at more than half a dozen national research conferences. The two also have had a behind-the-scenes support role in several news stories, including on NBC’s “The Today Show” and in Vanity Fair and the Wall Street Journal.  

But even with national coverage, the road ahead to change the narrative is long. 

“An important element of the work we are doing is structuring this in a way that we don't expect it to be done tomorrow. We don't expect to just come up with this one-page style guide that you're going to see and pass that around and everything's going to be fine and everything's going to get better overnight,” Stoltman cautions. “Part of the reason that we are investing so much of our time into working with student newspapers and training journalism instructors with model curriculum that they can use in their classrooms is because we know it's going to be long term before we really start to see significant change.” 

Best Practices and Recommendations for Ethical Reporting on Addiction

The following recommendations are based on a combination of the current AP Stylebook guidelines and research, including national focus groups with medical experts, people with lived experience, activists and media members.

* Indicates recommendations that align with AP Stylebook’s current guidelines.

Avoid:

Instead:

Terms like “abuse”, “problem” or “recreational use.” *  Use the terms “drug use” or “substance use.” *
Terms like “addict” or “junkie.” * Use person-first language that centers their disease, e.g. “a person with a substance use disorder” or “a person who uses drugs.”
Terms like “problem”, “disease”, “illness” or “disorder” to describe addiction. Use chronically-relapsing brain disease is preferred; however, brain disease can be an adequate replacement.
Terms like “addicted babies” and “crack babies.” * Use “baby born to a mother who used drugs while pregnant.” Babies cannot be born with an addiction because it is a behavioral disorder.
Reductive narratives illustrated through phrases like “after they recovered”, “kicked their addiction” or any other phrase that implies a “cure” for addiction. Include context that helps your audience understand substance use disorders as lifelong medical conditions in which relapse is common. Addiction science is advancing, but there is currently no cure.
Using quotes or opinions, especially for the sake of “balance,” that are not based on scientific, medical evidence. Evaluate the news value of including a nonevidence- based opinion. If it is necessary to include false statements, provide your audience with the context of that scientific fact immediately following.
Using images (especially stock images) of drugs, drug paraphernalia, or someone actively using drugs. Use photos of the physical facilities, communities and programs you are covering, of your sources, or of the experts you spoke with. Ask for permission before including or taking images to respect that clinics serve people who value their privacy.