The Words We Choose Matter
By choosing language that is not stigmatizing, we can begin to dismantle the negative stereotype associated with opioid addiction.
Adobe Acrobat Viewer is required to view Adobe Acrobat (PDF) files. If you don't have Acrobat Viewer already installed, click here to download it now.Changing the stigma associated with opioid addiction treatment will benefit everyone. It will allow patients to more easily regain their self esteem, allow politicians to appropriate funding, allow doctors to treat without disapproval of their peers, let the public understand this is a medical condition as real as any other.
One way to combat the stigma is with the words used to describe the condition and treatments associated with it.
"...In discussing substance use disorders, words can be powerful when used to inform, clarify, encourage, support, enlighten, and unify. On the other hand, stigmatizing words often discourage, isolate, misinform, shame, and embarrass. Recognizing the power of words, this guide is designed to raise awareness around language and offer alternatives to stigmatizing terminology associated with substance use disorders. It is offered primarily as a resource to those who work within the field of prevention, treatment, and recovery support..."
Excerpt from "Substance Use Disorders: A Guide to the Use of Language" Prepared by TASC, Inc. under contract for the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (DHHS), last rev. 4.12.04
Drug War terms have been very effective at creating the stigma and demonizing drugs and the people who use them. It is unrealistic to expect that these words can now create an opposite image in the minds of the public. To change the perception of the disease of addiction we must eliminate the slang terms and replace them with medical terms or other appropriate respectful language. Fortunately this is something we can all do, and have an impact on the stigma and discrimination endured by the people suffering from this condition. Below are some words and suggested alternatives.
Will the entire recovery community be willing to adjust language that has been the tradition for years? Probably not, but will people just entering this phase of their lives, with effects of stigma and discrimination still fresh in their minds, consider their use of language, hopefully. Even if only some people replace stigmatizing terms with medical or otherwise respectable language, it will help reduce stigma and make addiction treatment more accessible in the future.
Even if you don't agree with some of the alternative words, please find at least one you can change or one not on the list. Any way you can help decrease stigma will help.
The 01-24-2006 USA Today article shows how non-stigmatizing phrasing and descriptors can medicalize and add credibility to the condition.
In contrast this article published 01-23-2006 on CitizensVoice.com sets a different tone by using the word "addict" 8 times in a short article (no one quoted in the article used that word, only the reporter).
For more reading on "The language of Addiction Medicine" see:
The American Academy of Pain Medicine, American Pain Society, American Society of Addiction Medicine - consensus document - February 2001, http://www.painmed.org/pdf/definition.pdf
The Rhetoric of Recovery Advocacy: An Essay On the Power of Language by William L. White
Edwin A. Salsitz, MD., FASAM articulates on Addiction Medicine vocabulary
"Substance Use Disorders: A Guide to the Use of Language" Prepared by TASC, Inc. under contract for the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services (DHHS), last rev. 4.12.04
The Essence of Drug Addiction- By Alan I. Leshner, Ph.D., Former Director, National Institute of Drug Abuse, National Institutes of Health http://www.naabt.org/tl/The_Essence_of_Addiction.pdf
The Words We Choose Matter. Topic from our Online Community.
Important Definitions
Some of the problems and misunderstandings come from ambiguous definitions of many of the common terms used in addiction medicine. In 2001, The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine recognized the following definitions of Addiction, Physical Dependence and Tolerance and recommend their use. (see source article: http://www.ampainsoc.org/advocacy/opioids2.htm )
Addiction: Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Physical Dependence: (Please note: Not "dependence" by itself.) Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
Tolerance: Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.
"In recovery"
This may be appropriate when speaking to people within the recovery community, but less so when speaking outside those circles.
In 2004 801 adults were asked, "When you hear the word 'recovery', as in 'This person is in recovery from an addiction,' what does 'recovery' mean?"
Only 22% answered that it meant that the person is no longer using addictive substances. The rest receive the wrong message every time that phrase is used. According to this research as we promote people being "in recovery" 3 out of 4 people are thinking we are promoting something entirely different. This is a clear case of "for ever 1 step forward we take 3 steps back" The recovery community has used the phrase 'in recovery" for 50+ years and even after all that time only 1 out of 4 understand the meaning. It may be time to reexamine the language. After all, the point of language is to convey meaning, what good is it to insist on using terms most people don't understand?
In recovery" is well understood within the circles of the recovery community and used there it is effective, but just as companies have their own "shop talk" and adjust their internal language to make it understandable to the public so should the recovery community, if it wants to effectively convey its message.
Alternatives to "recovering addict" and "in recovery" are "addiction survivor" and "addiction is in remission". Who is more likely to be accepted by the public or in a neighborhood, or gain support of lawmakers, or covered by insurance plans a "recovering addict" or an "addiction survivor"?
PDF Version of "The Words We Choose Matter"
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