I've been thinking of this for awhile, I want to ban the word 'clean' from drug services, granted it's only a word so you might think I'm just being picky, but words like this carry both a lot of power and a wide range of meanings.
Right I'm going to leave the stigma stuff for later on in the article, first lets concentrate on why I'm writing this article in the first place 'clean needles'.
We've all been guilty of it (yes, me as well) "make sure you've got clean needles" or "do you always use clean kit?". It all seems perfectly fine, after all we know what we mean don't we.
The only problem is, the word 'clean' means many things.
I clean the dishes, I clean my hands, I even (occaisionally) clean my car. At no point are these sterile. If we continue to use the term clean when talking about equipment then we are going to have this confusion of language.
Instead we should be using (and getting people to use) terms like 'new', 'unused', 'sealed' or 'sterile'.
It's rare for me to have a day at work without at least one person telling me that they're 'Clean' or that they want to get 'Clean'. Although I'm happy for them that they have got to a stage where they are either seeking or entering 'Recovery' (another word loaded with it's own hidden meanings, arguments and history) the fact that they use stigmatising language like this is something that needs challenging.
The term 'Clean' is of course a wonderfully positive image, however the implication is that anything not clean is 'dirty'. In this context that means that people on some level are still seeing other drug users as dirty, or if they lapse/relapse they'll see themselves as dirty. It's bad enough that tabloid media and a large chunk of the public stigmatise drug users, lets not add to this ourselves.
Is all stigma bad
As I'm sure many of you know there is a body of thought, mainly headed by people like Neil McKegany who seem to think stigma is something that can be a positive influence to change (See Neil McKegany's article on this topic). The main points are that stigma may prevent people from starting to use drugs, and that people using them will be more likely to stop if people think they're scum.
Stigma is something that can lead to hate crimes and assaults on drug users (something I've seen in the areas I've worked in. But it's also something that can keep people feeling worthless within society. The UKDCP Stigma report states in it's conclusion:
.... need to challenge the entrenched and widespread assumption that users are solely culpable for their condition by educating people, including health professionals and the media, about the causes and nature of addiction. While some aspects of the state of drug addiction are disease-like, others are inherently social and psychological. The root 12 causes of addiction are perhaps best understood as a complex nexus of genetic and environmental risk factors that develop over time. This interacts with the social, psychological and physiological impacts of the addiction itself to produce individuals who are frequently socially excluded, with precarious or non-existent employment, housing and relationships.
We need to stop adding to the stigma, we need to stop using the word 'Clean'.
Abstract of a randomised study showing there is a difference in the way workers see people depending on the language used.
Nigel Brunsdon is the owner of Injecting Advice.com. He's been working in harm reduction since the 1990's, although he's previously a frontline needle programme worker he now spends most of his time developing online resources for drugs workers and users.