Weather has been on the mind of many people lately. In the Northeast US, a storm hit that was labeled as a “Bomb Cyclone.” The name alone conjures up fear of destruction and terror. There wasn’t much difference between it and a more typical blizzard that we experience in the northeast, followed up by extreme cold weather and a drop in atmospheric pressure (which I doubt most humans notice in their day-to-day). But the name, “Bomb Cyclone” established it as something that felt much more devious and terrible, and wound up the imaginations and anxieties people everywhere.
The words that we choose matter. Whether it’s Bomb Cyclone or “junkie” or “alcoholic,” the words that we choose matter because we have histories with them, and they have associations that color our experience with them. In the world of substance abuse, some of the labels that we as a society have created, words like alcoholic or addict (the personal label), have over time taken on diagnostic characteristics (there is no diagnosis for alcoholism, but that doesn’t stop people from referring to it as a mental health disorder). And these words are not in our diagnostic catalog in part because of the negative associations that have been associated with these labels over time.
We often hear about beliefs about “addicts” that have extreme sticking power. “Addicts lie.” “Addicts can’t be trusted.” “Addicts are powerless to their addiction.” These “-isms” are blanket statements that are not true about every person who struggles with substance use disorders. And for many other people, the -ism helps to perpetuate the myth; if someone who has struggled with substance use is expected to lie and is going to be judged negatively for struggling to make behavior change, then they are more likely to lie about times when they are struggling. Lying isn’t a personality trait of addiction, its a symptom of a larger societal issue.
And that larger issue is the stigma that is connected to our choice of words when we are talking about substance use disorders. The choice to continue to use labels that have negative connotations is the choice to perpetuate the stigma that there is something “wrong” with people who are struggling with substances. It is the choice to “other” them in a way that makes it more difficult for them to get the help that they need, and to create unnecessary barriers for that help to be available. While there are many people who choose to assign themselves these labels saying that the label helps them to maintain positive behavior changes, for countless other people, the insistence on using these labels keeps them from identifying with the need to make a change (if I don’t identify with the label “alcoholic” or “addict,” then I am less likely to change my behaviors around substances or to seek help to change them). How do we get rid of the negative stigma that is so prevalent?
We change the conversation. We substitute out words that are stigmatizing and associated with negatives and we replace them with words that are filled with hope and understanding. We use scientific diagnoses rather than labels. We talk about people rather than specific traits that they have. (Side note: even major publications who are writing about addiction and treatment and are trying to get helpful information out to the masses use labels such as addict to describe substance users. This is like calling someone who is obese fat. The only place this kind of label is allowed is when they are writing about substance users.)
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There is hope for people who are struggling with substance use. In a recent study, 75% of people who qualify for alcohol use disorders in one year don’t qualify in the next, meaning that they have changed their drinking to reduce their symptoms enough that they no longer have the diagnosis of substance use disorder. Things can change, and they do every day. We, as a society and a community should be encouraging those changes by choosing words that encourage hope and engender change. In this way, we can shift the tone of the conversation around substance use and hopefully help more people find the treatment that they need and make the changes that they want.
Making more thoughtful choices about how we speak about substance use and those who are struggling with substance use and abuse can be the difference between helping people make positive change and keeping them stigmatized.