New London — Instead of calling people drug addicts or junkies, refer to them as patients with opioid use disorder. Instead of saying people are clean — because if they're clean now, what did that make them before? — say they're in remission.

This is guidance from Jennifer Muggeo, who commented, "If I could tattoo that on my face without looking funny, I would. I really can't overemphasize the importance of using care when we speak."

Muggeo, a supervisor at Ledge Light Health District, said that irresponsible language around opioids "drives the stigma, which leads to guilt and shame, which exacerbates the risk of death."

Stigma reduction is a focus of work at Ledge Light, along with educating on how insurance rules may create barriers for treatment; ensuring access to naloxone, which counters the effects of opioids; and coordinating access to treatment and support services.

Muggeo was addressing a group of about 25 Connecticut College students, many of whom are in neuroscience professor Dr. Ruth Grahn's psychopharmacology class and are considering careers in the medical field.

Muggeo and Grahn were the featured speakers at a conversation on opioids and stigma at the college on Wednesday evening. The event is one of several uses of a $10,000 grant this year from the Connecticut Healthy Campus Initiative, along with handing out lockboxes for people to secure their medication and offering training on the overdose-reversal drug naloxone.

From CC Curtiss' perspective as well-being and health promotion director at the college, the event's engagement of potential future clinicians will help with prevention. That's something that's also important to Carol Jones, director of harm reduction at the Alliance for Living, who is in her 32nd year of remission from opioid use disorder.

"I know people who are in the (medical) field who still feel, 'Oh, just toughen up, you can do this,'" she said. "They really believe it's a moral failure or a lack of willpower."

Grahn explained the scientific basis for why this is not true: For the brain's reward system to work well, it must be coordinated with the decision-making system of the brain, but when drugs cause the reward system to exceed its limits, "the decision-making process goes awry."

Expanding on this, Muggeo spoke of efforts to increase awareness that substance use disorder is a disease. The issue is that compared to other organs that carry diseases, people have the misconception they can just will their brains to be different.

"We use the word 'diseases' and pat ourselves on the back and feel good about that, but we still expect something different from those patients than patients with asthma or diabetes," she said. "We still expect that they are going to will themselves out of this."

Muggeo also is trying to combat misconceptions around use of medications, like methadone and buprenorphine, to treat opioid use disorder. She clarified that taking medication doesn't mean you're going from taking one opioid every day to another, and there's no medical reason someone needs to taper off medication.

Grahn noted that while medication does have an opioid component, it gets absorbed slowly — unlike heroin — and doesn't produce a high.

Muggeo acknowledges that some people don't want to stop using, in which case Ledge Light will make sure they know about naloxone, the dangerous prevalence of the powerful synthetic opioid fentanyl, and the importance of not using alone.

"We really educate people that are using how to use safer, how to use in a way that they do less harm to themselves, how to have clean injection equipment," Jones added. "We have no judgment, we have no expectations, we just want people to know that they matter, and they matter to us."

This was a perspective that Erin Martin, a senior at Connecticut College, appreciated. She is hoping to become a nurse practitioner.

Martin is in Grahn's psychopharmacology class, as is Ariele Buxbaum Grice, who commented that a lot of people "are just totally blind to" the statistical evidence pointing to effective treatment strategies. She feels college students can be blind to these issues because of their privilege and because they're living in "this little bubble of higher education."

Buxbaum Grice is thinking she wants to be a researcher and is therefore particularly interested in the neurobiological basis of opioid use disorder. She said the conversation also made her re-evaluate some of the language she uses.

e.moser@theday.com