The Language of Addiction

Language is one of the things that defines who we are. We are of some nationality, Immigrant or Refuge or Local, we are of certain gender pronoun, race we identify with, a profession, we are Fathers, Mothers, Sons, Uncles, Friends, Relinquishees (one of my many identifiers)… and so on. What we are not—or shouldn’t be—is our misfortune, our health status, or lack of choice, things we might’ve not had control over. We can, of course, call ourselves whatever we like, however we want to identify so: Victims, Sufferers… Crazy—when referring to mental-health—or Addicts, Alcoholics.  BUT, we must be continually mindful that words are powerful and do shape how we see ourselves and how others see us.

Some of those words, such as Addict, are so closely intertwined with stigma that they might not serve us a lot of good—there are people who will put us in the “Bad Person” category if we utter those words.  There will be people who will consider us less-than, pity-worthy, morally unfit, and so on. It’s fine with me if you want to use the word that you feel comfortable with (the way I feel comfortable with Relinquishee), but please don’t treat the word as a kind of repentance or a shortcut to help others learn some kind of an absolute truth about you. Most people remember the negative so you might be an Addict before you are a Doctor, a Schizophrenic before you are a Mother.  I think it’s important to fight for the words that describe you. And if you do chose the word such as Addict out of defiance (or Drunk or Junkie), that is your business, but if you’re doing it because others are doing it or because you think you have to, think about it – because those kinds of words own you and, once they do, it’s hard to shake them off.

As for “addiction” itself, in my opinion, the word is ok to use as it’s a clinical and appropriate term defined by the American Society of Addiction Medicine (ASAM). Here’s the beginning of its short-form definition: “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.”

Now, do people consider this kind of information when they label someone an Addict? Probably not. And it’s labels like that that lead to stigma (which in itself is a complex issue as there’s stigma about people with addiction, or stigma about 12 steps, stigma about treatment, stigma about recovery, and so on.)

When it comes to someone who has an addiction my preferred term is: “Person with Substance Use Disorder”/”Person with Alcohol Use Disorder”/ Person with Opiate Use Disorder” etc., rather than Addict. Rather than Bipolar, I’d use “Person With Mental Health Disorder/ Person with Bipolar Disorder.”

I’m also not a fan of the term “Clean”—we are all clean. Opposite of Clean is Dirty and you’re not a Dirty Person just because you are a person who is still active (as in using) in your addiction.

Even as an Addiction Professional, I am not completely certain that addiction is a “disease.” It might be, but there seems to be much more to it, including a learned component that is not addressed by using the term “disease.”   So I try not to characterize it as such.  “Condition” is ok. I prefer “disorder.”  And this is consistent with the DSM V categories of addiction and mental health diagnoses.

Sometimes, people who try to convince others around them that they are not Bad because they are Persons with Addiction like to compare what they have to diseases such as Diabetes or Cancer. Addiction, Diabetes, or Cancer can all fit under the umbrella of Lifestyle Diseases—those that are due to certain things we do in life that harm our bodies and minds. In that way, someone with (and notice how easily we use the word “with” in this instance) cancer is no different that someone with (a harder “with” to accept) alcoholism. After all, people with cancer don’t get into cars drunk with their children, don’t destroy marriages and careers, don’t throw dishes against the wall, don’t have their babies taken away… But if we play the Blame Game, we could say, well, if this person ate less sugar, didn’t smoke, didn’t work in an office filled with asbestos, did breast exams sooner, etc., we could blame them for …—you get the point. It would be awful to blame someone for dying of cancer. Do you remember when HIV/AIDS first became known? We initially treated that disease as some kind of a divine punishment for homosexuality (or drug use); people with the virus lived in shame, and then died in shame, some of them perhaps convinced that it was who they were that made them deserve those painful deaths.

Nobody wants to be sick or have a health issue that might kill them. Nobody wants to go through trauma, have depression, experience a loss of identity, or inherit a certain genetic makeup.  Nobody wants to self-medicate to cope, and nobody sets out to one day become dependent on heroine or Jack Daniels. As children, we want to be Doctors, Presidents, we want to play sports professionally, go into space.  We all want to live. We all want to be healthy.  We all want to be the words that are good, that make us feel good, that make others look at us with respect. We all get language—or do we, really? We can always try harder. If we use “addiction” as information about a disorder that a person deals with, rather than labeling this person by the disorder, we could generate more compassion and understanding. For now, stigma—in all its forms—obscures this information, the language gets muddled.

 

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