Stories about substance use and addiction can be among the thorniest that health and science reporters encounter. This topic carries a long history of marginalizing the people most directly affected. In addition, deeply ingrained societal misconceptions about substance use make it difficult to separate fact from fiction. And a tangle of political and legal issues adds another layer of complexity to navigate. For all these reasons and more, it’s easy for reporters covering such stories to make avoidable missteps. By leaning too heavily on tragic or grisly narratives or buying into simplistic and damaging myths, stories can perpetuate the stigma surrounding substance use and downplay the real possibility of treatment and recovery.
Journalists can help reverse this pattern. Good reporting on substance use and addiction is both accurate and sensitive, includes sources with lived experience without compounding their trauma, points out scientific limitations, explores how intersecting issues such as mental health and poverty are at play, and, when possible, frames stories around solutions and hope. Here are some tips to keep in mind as you work to sharpen your coverage in this area.
1. Use precise, humanizing language.
Topics in the area of substance use and addiction come with a laundry list of terms. Avoid conflating related words and instead use the most precise terms possible. For example, the term “substance use” describes the behavior of using substances, such as alcohol or cocaine. “Substance use disorder” is a mental health condition. (Someone can use substances without having a substance use disorder.) And “addiction” in this case is a severe, chronic form of substance use disorder. (This infographic from the Recovery Research Institute breaks down mild, moderate, and severe substance use disorders.)
Use language that also reflects the dignity and humanity of the people affected by the issues you’re covering. “Focus on people being human beings, because that automatically brings empathy and accountability into your storytelling,” says Ashton Marra, executive editor at the nonprofit news outlet 100 Days in Appalachia. For example, many experts recommend using person-first language, such as “person with substance use disorder” or “person with addiction” instead of terms like “user” or “addict.” Also avoid the outdated, stigmatizing term “substance abuse,” which associates too closely with causing harm to others.
Similarly, avoid leaning on stigmatizing tropes that portray substance use in simplistic or clichéd ways, such as descriptions of a person with addiction “hitting rock bottom,” “pulling themselves up by their bootstraps,” or “being given a second chance.” If your story involves relapses, avoid phrases like “falling off the wagon,” and others that imply a personal failure. Instead, frame relapses as a common part of the recovery process.
As you select quotes, pay careful attention to the language a source uses. If it might be harmful to others, consider paraphrasing instead. Working with a sensitivity reader can also help improve your story’s framing and language.
2. Include sources who use substances.
People who use substances or who have substance use disorders are “subject experts in their own community and their own experiences,” says Doug Johnson, a climate reporter for The Weather Network. Previously a freelance science journalist, Johnson, who’s based in Canada, has covered substance use and harm reduction for Undark and Filter, a nonprofit outlet dedicated to compassionate coverage of these topics. Including sources with on-the-ground knowledge can add depth and nuance to your stories. For example, in his 2019 Undark story about how researchers are mining drug forums for solutions, Johnson included Ryan Le Blanc, a drug forum moderator whose own recovery was informed by posts about reducing the risks of substance use and quitting altogether. By featuring Le Blanc alongside researchers and clinicians, Johnson both humanized his story and gave an insider’s view on how online forums may be supporting harm reduction.
Seeking sources with this type of lived experience is more than just a courtesy; it ensures that you’re reflecting the reality of specific communities instead of just parachuting in for a good quote. To avoid tokenism, focus on building relationships with sources and don’t be afraid of them challenging your understanding of an issue. And as you incorporate a source’s personal account of substance use into your story, make sure to avoid stigmatizing framing.
3. Use trauma-informed reporting skills.
When interviewing sources with a history of substance use or addiction (or their family members or caregivers), be mindful of their mental health. They may be experiencing multiple layers of stressors, such as violence, unemployment, housing insecurity, isolation, or chronic pain or other medical issues.
Use extra sensitivity and compassion as you interact with these sources to avoid causing further harm or distress. In asking for an interview, be straightforward about what topics you plan to cover and state explicitly that their name and quotes might appear in your story. Consider sharing questions ahead of an interview. This gives your sources “space to think through what they’re willing to share and what they’re not willing to share,” Marra says.
The interview itself might dig up past trauma. “This doesn’t mean you shouldn’t do these interviews,” says journalist and author Maia Szalavitz, who specializes in covering the neuroscience of addiction. “It just means you have to be trauma-sensitive and not push.” As you talk with a source, watch carefully for signs that they’re struggling, such as crying, agitation, or shutting down. And be ready to back off of a particular topic, offer your source a break, or even suggest stopping the interview and finishing it another time.
If your source is actively using substances at the time of an interview, remember that they might be disinhibited. Offer multiple interviews to clarify their comments, and if they ask to take something off the record later, consider honoring that request, says Szalavitz, who has written several books on these topics, including Undoing Drugs: How Harm Reduction Is Changing the Future of Drugs and Addiction.
4. Consider offering anonymity.
Though journalists tend to avoid using anonymous sources when possible, allowing a reluctant source to withhold their name may help them feel more comfortable and protect them from possible fallout. Being identified in a story may compromise a source’s safety, and the information they share could be used to discriminate against them later. Even if a source wishes to use their name, make these risks clear. At the same time, don’t decide anonymity is what’s best on behalf of your source;it’s ultimately their choice.
5. Select images carefully.
Make sure the images accompanying your story don’t descend into fear-mongering or reinforce inaccurate or dehumanizing stereotypes. For example, images containing syringes, bottles of medicine, and needles injecting substances into arms might activate drug cravings for people in recovery and are often exaggerated or unrealistic. Similarly, images depicting suffering, such as poor living conditions or the crying children of a person with a substance use disorder, can be exploitative and perpetuate stigma. For many stories, you could replace images like these with ones that highlight the humanity of your sources without sanitizing the truth. If possible, focus your lens on everyday moments: a source walking their dog, playing with their child, or sitting on their front porch, for example.
6. Watch out for myths.
The topic of substance use and addiction is rife with misconceptions, often fueled by historical mistreatment of people who use substances. Make sure your own biases and assumptions aren’t seeping into your reporting, and question any blanket statements you encounter. For example, sources or other media stories may wrongly claim that harm-reduction practices, such as sterile-syringe access, don’t work or that medication-assisted treatment isn’t a legitimate form of recovery, Szalavitz says. Scrutinize tips you receive about certain substances, too. (No, police officers aren’t overdosing by touching fentanyl.) Instead of taking a claim at face value, look for data or other supporting evidence and get reliable experts to weigh in.
7. Highlight scientific limitations.
If you’re covering a specific study, be wary of overstating its findings. All scientific studies, including those centered on substance use and addiction, have limitations. Researchers in this area might be working amid challenges such as small sample sizes, participants lost to follow-up, or institutional and governmental restrictions on how they conduct their studies, especially if they study controlled substances. For example, scientists exploring the effects of cannabis have to obtain the drug through highly regulated channels; they can’t study the same substances available to the public. Limitations like these affect how generalizable a study’s results are beyond the lab. As you interview scientists, ask them to outline the barriers that impact their work and include this background in your stories about new findings.
8. Put your story in context.
Don’t report your story in a vacuum. Think about the deeper issues that might underlie a trend you want to cover. Most topics related to substance use intersect with a wide range of other issues that are worth exploring:
- Consider the political and legal backdrops of your issue: Are activists and policymakers engaged in a drug-decriminalization battle that relates to your story? Is your story about naloxone use or access to other harm-reduction practices rooted in policy debates?
- Think about how other medical and sociological factors, such as mental health, poverty, child welfare, unemployment, and housing insecurity, might tie into your story.
- Ask sources whether issues of social justice, such as systemic racism and historical marginalization of specific communities, are at play.
- Consider the geographic context of your story. Laws governing controlled substances and access to treatment vary from state to state in the U.S., and from one country to another.
9. Adopt a solutions angle.
Too often, stories about substance use take on a hopeless or tragic tone. “We need to move past just talking about the problem and start talking about what those solutions are,” says Jonathan Stoltman, co-director of Reporting on Addiction and director of the Opioid Policy Institute. Try seeking a solutions-oriented angle for your story, if possible. Instead of just reporting on rising overdose rates in a community, for example, cover resources and supports available to people there. And if you find that access to care is limited, that can be your story. The Solutions Journalism Network covers several examples of stories centering on harm-reduction efforts and creative solutions.
Rachel Crowell is a freelance math and science journalist and editor whose work has appeared in Quanta Magazine, Scientific American, Science News, Science News Explores, APS News, Nature Careers, and more. Follow them on Twitter @writesRCrowell.
