Inherent in the way we talk about things is how we think of those same things. When we use words like “clean” we necessarily imply that the opposite is “dirty.” Substance use disorder continues to be a highly stigmatized medical condition despite the many advancements in neurobiology and a fuller understanding of social and environmental determinants of health. In spite of these many advancements, people with a substance use disorder continue to report high rates of discrimination from medical providers, denial of services from government entities, and continued targeting by law enforcement. The ramifications of stigma in care environments are manifold and further compound the opioid crisis. During this workshop participants explored personal biases related to drug use and the way that these emerge in language, the ramifications of stigma against people who use drugs, and how to create an affirming environment that will enhance care for people who use drugs.