Our previous post explained how the language related to substance use disorders is undergoing an evolution.
Not long ago, the official terminology in the DSM forced an association between the disease of addiction and the misleading notion of “drug abuse.” People with substance use disorders were more easily marginalized, both by society and the medical establishment. Recent efforts have succeeded in changing the conversation by giving the vocabulary a much-needed update. Organizations like the American Psychiatric Association have made a concerted effort to acknowledge the negative labels that terms like abuser, addict, or alcoholic can give to a person seeking treatment. It’s incumbent that we critically consider the words we use when addressing the concerns of addiction.
The following list of selected terms comes from the National Alliance of Advocates for Buprenorphine Treatment.
Although the “Guide to the Use of Language” was published in 2004, it remains relevant today. The “words to avoid” have not vanished from the public lexicon. There are still stigmas associated with addiction that are perpetuated by judgmental and inaccurate terms.
Another category of terms, the Words to Use with Caution, are equally worthy of investigation. Individuals with substance use disorders and their loved ones have likely heard these terms before. When these words and phrases are used, they should be carefully explained and given the proper context.
- Chronic Disease
When it works: It’s useful because it identifies alcohol and drug disease not as an acute condition, but one that requires continued management, just like other chronic conditions such as heart disease and hypertension.
Caveat: Some view the term “chronic” as enabling, one that justifies failure and presumes a negative end result.
When it works: This is a common term to refer to individuals who are receiving any type
of intervention, treatment, or recovery support services. The word client appears often appears on clinical paperwork and is used in clinical settings.
Caveat: Always referring to a person as a client can be dehumanizing, especially in face-to-face interactions. Remember that clients are patients, and they are also people.
When it works: It’s a recognized term to describe the recurrence of symptoms and behaviors of substance use disorders following a period of remission.
Caveats: The term has negative connotations because it often has projected a tone of moral judgment. Some recommend the term recurrence for its alignment with the nature of other chronic illnesses.
- Treatment Works
When it works: The term may be useful if referring to a single episode or period of intervention and services. The term emanates from the fact that studies have shown that treatment, whether a single episode or multiple episodes, often results in demonstrated improvements beyond reduced alcohol or drug use, including changes in functional areas such as employment, health, etc.
Caveats: The problem with the term is that it implies that treatment is a onetime event, when in it is only part of the long-term process of recovery. In addition, the term also suggests that treatment is something that happens to the individual, instead of the reality of the patient learning to manage their illness. Alternative terminology highlights the reality of recovery.
- Chronic Disease
To read more about the most up-to-date developments on the language of addiction, please visit this page published by the White House Office of National Drug Control Policy: https://www.whitehouse.gov/ondcp/