“Correct Use Doesn’t Equal Abuse” Is A Problematic Statement And I Need You To Stop Saying It.

Taylor Nichols, MD
4 min readMar 5, 2023

No, you aren’t better than people with opioid use disorder. Instead, you’re perpetuating the stigma that harms you. Let me explain.

As a matter of grammar, the statement “correct use does not equal abuse” is unfalsifiably true.

Ok, so then how can a true statement also be problematic?

Enter, stigma.

A person may use such a statement as a form of self-advocacy. For example, this statement may come from a patient with chronic pain trying to make the argument that they deserve ethical and appropriate treatment with pain medications including opioids because they are person who has a history of using their drugs “correctly” and not “abusing” them.

On the surface, that’s a reasonable position. A patient with chronic pain might utilize this position to try to reassure a clinician that they aren’t going to take more than the prescribed amount of medications or otherwise “abuse” their medications such as to “get high.” That is a form of self advocacy to seek the ethical and appropriate care that they need and feel is appropriate for the management of their chronic medical conditions and pain.

But let’s dig into that a bit more. If a person holds a position in which a division is created, then the impact of that statement is to also hold that the opposite is true. So what does the opposite of this position look like?

The counter-statement would be that a patient who “abuses” drugs is by this definition not someone who uses them “correctly” — presumably, not as prescribed or in an unpredictable manner. Someone who might use a drug like an opioid medication in a non-prescribed or unpredictable manner could just be someone trying to “party” and “get high.” Sure, that’s a plausible scenario. They could also be someone with an opioid use disorder, who also has a chronic medical condition with an addiction to opioids. Not everyone who uses opioid drugs to “party” or “get high” has an opioid use disorder. In fact, most likely if they do, they are not yet aware of their chronic medical condition because once in the active use phase of addiction…

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Taylor Nichols, MD

Humanist. Emergency Medicine and AddictiEmergency + Addiction Medicine | Health policy and advocacy | Health tech and innovation