Last week, the National Records of Scotland announced plans to stop using ‘drug misuse deaths’ in its reporting and use ‘drug use’ instead. We welcome this move away from stigmatising language. However, we would have preferred a return to the term ‘drug-related deaths’. Here’s why…
The words we use to describe drug-related deaths matter. They shape public understanding, influence media reporting and affect how people who use drugs, and families who lose loved ones, are perceived.
Last year, our Chief Executive, Kirsten Horsburgh, raised our concerns around the language used in Scotland’s official reporting with the National Mission Oversight Group, a group set up to provide challenge, scrutiny and advice to the Scottish Government and wider sector.
We felt that the terminology used in the National Records of Scotland’s (NRS) reporting on drug-related deaths was stigmatising and harmful. It used ‘drug misuse’ – a term that shifts attention away from the realities of poverty, trauma, deprivation and lack of opportunity that underpin problematic drug use.
The National Mission Oversight Group wrote to the NRS to express these concerns, and the NRS subsequently opened a consultation on its use of language. We worked with our members – including people with living and lived experience – to respond to that consultation.
Read about how we conducted our consultation and views from our members
The majority of our members said their preferred term was ‘drug-related death’, with one member explaining: “Drug misuse reminds us of the Misuse of Drugs Act, sounds like an offence or we have committed a crime by dying. Poisoning still doesn’t sound right as it sounds like intentional, who would take poison? ‘Drug-related’ seems the best option and doesn’t over complicate things.”
We urged the NRS to return to ‘drug-related deaths’, the term it used before introducing ‘drug misuse’. Following our consultation with our members, we advised we were also comfortable with ‘drug overdose death’, ‘drug use death’ and ‘drug death’.
So, the NRS announcement that it will move from ‘drug misuse deaths’ to ‘drug use deaths’ should feel like a win. ‘Drug use’ was one of the terms we said we were ok with, and it is given as an alternative term for ‘drug misuse’ in our 2020 publication, ‘Moving Beyond Person-First Language’.
‘Drug use’ is a clear improvement. It removes the judgement carried by the word ‘misuse’ and represents an important step forward in reducing stigma. However, we continue to believe that ‘drug-related deaths’ is the most appropriate term. While seemingly subtle, describing these as ‘drug use deaths’ can still suggest that an individual’s drug use is the defining cause of death, rather than recognising the complex interplay of social, structural and health factors, alongside policy and practice decisions, that often contribute to these preventable deaths.
The NRS has explained that it selected ‘drug use deaths’ over ‘drug-related deaths’ to avoid confusion with terminology used elsewhere in the UK. In Northern Ireland, for example, ‘drug-related deaths’ is used to refer to a broader definition of drug poisoning deaths. The NRS also notes that the Advisory Council on the Misuse of Drugs (ACMD) has established a working group to review the current UK definition of a ‘drug misuse death’, which could lead to changes in terminology across the UK. We hope this review provides an opportunity to adopt language that better reflects both the evidence and the experiences of people affected by drug-related deaths.
Language in the drugs field has long been contested, and different people will have different responses to particular words. We are pleased that the NRS listened to concerns about the term ‘drug misuse’, and we recognise that ‘drug use deaths’ represents a significant improvement. However, we remain of the view that ‘drug-related deaths’ better reflects the wider context in which these deaths occur and Scotland’s commitment to a public health approach. For these reasons, we will continue to use the term ‘drug-related deaths’ in our work.