When it comes to addiction, language serves as a powerful force. It shapes people’s perceptions, influences policies, and impacts lives. The last couple of decades have seen an evolution in commonly used addiction terms as well as the language surrounding addiction. This evolution reflects broader shifts in societal attitudes and understanding of substance abuse as a disease.
Moving away from stigmatizing addiction terms that imply a moral failing on the part of the addict toward a compassionate, person-first language alters how we talk about addiction. It also plays a pivotal role in creating empathy and promoting recovery. No less an authority than the Associated Press changed their language around addiction in 2017, avoiding addiction terms like abuse, problem, addict, and abuser whenever possible.
Knowing the Historical Context
To comprehend the evolution of the language around addiction, it’s helpful to know its historical context. From roughly the late 19th century to the late 20th century, addiction was largely perceived through a moralistic lens.
Not surprisingly, addiction terms were laden with judgment. Terms like “junkie,” “addict,” “drunk,” “boozehound,” “crackhead,” and even “substance abuser” were thrown around all the time, perpetuating harmful stereotypes and overlooking addiction’s complex nature. Such language framed addiction as a matter of choice or individual character, rather than recognizing it as a multifaceted health issue with biological, psychological, and social dimensions about which we’re still learning.
The Shift Towards Person-First Language
Over time, as our collective biological and psychological understanding of addiction deepened, so too did our language. People began to recognize addiction as a chronic brain disorder characterized by compulsive drug seeking and drug use despite negative consequences.
This paradigm shift prompted a move towards more empathetic, person-first language that acknowledges the humanity of people struggling with addiction. Person-first language strives to emphasize the individual before the condition, implying empathy and the reduction of harmful stigma.
What is Stigma?
Stigma is a word that dates back to the 1500s, and means “a mark of disgrace or infamy.” The word stigma stems from the ancient practice of branding criminals and slaves.
However, in its modern sense, stigma is the discrimination against an identifiable group of people. Stigma about people with substance use disorders can include inaccurate or unfounded thoughts, like they are dangerous or somehow lesser for living with an addiction. Not only are these unfounded thoughts and attitudes harmful to those living with a substance use disorder, they reduce the public’s understanding of addiction as a multilayered and complex condition.
From Stigma to Compassion: A Mini Glossary
 “Drug addict” to “Person with a substance use disorder.” Terms like “junkie” dehumanize people and reduce them to their addiction. “Person with a substance use disorder,” on the other hand, literally places the person first, negating the chance of the substance use disorder defining them.
“Clean” to “In recovery.” The term “clean” implies that using substances is “dirty,” which adds unnecessary stigma. “In recovery” focuses on the positive journey of healing and growth.
“Drug habit” to “substance use disorder.” The term “drug habit” trivializes the severity and complexity of addiction. “Substance use disorder” emphasizes the medical nature of addiction, which encourages empathy and understanding.
“Replacement therapy” to “Medication-assisted treatment.” By describing treatments for opioid dependence like Methadone, Suboxone, and Vivitrol as “replacements” minimizes the validity of these treatments and implies that the individual is still actively using drugs. Keep in mind, addiction is an uncontrollable compulsive behavior. The primary goal of treatment is to stop this behavior. With medication-assisted treatment as part of a comprehensive treatment plan that offers behavioral counseling and group support, the addictive behavior is stopped, not replaced.
The Power of Language to Promote Healing
Language is not merely a tool for communication. It is a powerful force that shapes attitudes, perceptions, and behaviors. By adopting compassionate, person-first language, we collectively forge a culture of empathy and understanding around addiction.
Shifting our language in this way is crucial in reducing stigma. It promotes access to treatment and supports individuals and communities ravaged by addiction. Moreover, it aligns with the principles of trauma-informed care, recognizing the deep impact of trauma on individuals and emphasizing safety, trust, and empowerment.
By challenging and rethink our addiction terms, we allow people living with addiction to more comfortably seek treatment. We also allow lawmakers to appropriate funding and doctors to deliver better treatment. We also encourage insurers to increase coverage of evidence-based treatment, and help the public understand that addiction is a medical condition that should be treated as such.
The evolution of addiction language reflects our growing understanding of addiction as a complex health issue. In moving away from stigmatizing terms that imply judgment, we are affirming the human dignity of individuals living with addiction. This change isn’t just about semantics. It’s about creating a more inclusive society for everyone.
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