By Jessica Hulsey Nickel
Language matters for people seeking help in the battle against addiction
The Centers for Disease Control and Prevention (CDC) reported that over 67,367 persons last year died from drug overdoses. Drug overdose deaths are now more than from car crashes, equal to 17 times the deaths on 9/11.
Growing up, I heard many people call my dad the “a” word — an addict. In reality, he was a brilliant man and the father of two girls. He played guitar, could fix anything that ran on electricity, and had a debilitating medical condition called a substance use disorder — a heroin addiction. He died much too young at the age of 48.
When addiction hits your family, it’s like being hit head-on by a Mack Truck. It’s sleepless nights filled with worry, it’s desperate Googling, it’s dead-end streets, it’s isolation. And for those that have lost someone — a son, a daughter, a mom, a dad — it’s unimaginable pain. But unlike the support that erupts when other medical issues hit our neighbors — say cancer or Alzheimer’s — where are the offers for help, the casserole dishes, the warm cookies, “thinking of you” cards and potluck fundraisers?
Our own biases and foul language contribute to this isolation. When words are used inappropriately to describe individuals with a substance use disorder, it not only negatively skews cultural perceptions of their disease, but also feeds into the stigma that can stop people from seeking help, can stop people from going next door with that casserole dish. Using “addict” to describe someone struggling with a substance use disorder ignores the science and discredits the individual.
Much of the terminology used to describe addiction is disparaging — suggesting that addiction is a result of moral/personal failings, or that individuals choose to be addicted, or suffer a lack of willpower. As we know, addiction is a medical issue, and can be compounded by patient behavior just like many other illnesses, from type ll diabetes to heart disease and lung cancer.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), released in 2013, replaced the categories of substance “abuse” and “dependence” with a single classification of “substance use disorder.” We need to align our dinner table terms with the science and the doctors.
When referring to people who have a substance use disorder or any medical condition, it is best to use “person-first language” — emphasizing the person before the disorder. For example, using the phrase: “individual with a substance use disorder,” is starkly different than labeling someone an “addict” or “junkie,” both of which are stigmatizing terms that falsely represent addiction as an identity instead of a disease.
In short, don’t call my dad the “a” word.
Terms like “clean” or “dirty” should be reserved for describing the dishes in your dishwasher, not people. Don’t use them to describe an individual’s current state of substance use; you can use more accurate language, such as “not currently using substances,” or “a person who is currently using substances.”
Paying attention to the language that we use about addiction can help us make significant strides toward removing a major barrier to people asking for help and helps cultivate a more realistic concept of the disease. Words can do demonstrable damage to a person in or seeking recovery. Or, words can offer hope.
With better language we can tackle stigma; with less stigma we can make sure the 21 million families currently struggling with addiction find the treatment and support they need.
Jessica began working in prevention at 15 years old through an anti-drug coalition in southern California. The next chapters included an appointment by President Bill Clinton to serve on the Drug-Free Communities Commission, serving as a legislative aid in the U.S. House of Representatives, and work to pass and fund the Second Chance Act to help individuals returning home from prison and jail. In 2015, Jessica founded the Addiction Policy Forum to help families and patients struggling with the disease of addiction. Frustrated by the lack of progress in improving outcomes for those individuals and families struggling, she started the nonprofit with $13,000 from her own savings account and long hours at the dining room table. Read more about Jessica Hulsey Nickel.