Erase “addict” from your vocabulary

The words you use to describe other people matter. We teach this to children, but most adults aren’t accustomed to checking in with language to understand how words, their meaning, and their weight change over time. Unfortunately, the language surrounding addiction has not centered around the well-being of the person with the addiction. The terms many of us are accustomed to using — “addict” and “drug problem” — are fraught and blamey. New word, folks: blamey. Get into it.

You can change your language when talking about addiction in general terms, but it’s particularly important to do so when you’re talking about people who have a drug addiction. Doing so reduces stigma and helps dissipate some of the shame around addiction, which can make it easier to open up and seek help.

We consulted Dr. Nzinga A. Harrison, an addiction medicine expert, for her take on the terms below. Keep in mind that these terms, like addiction and treatment itself, are not one-size-fits-all. There are many opinions on this subject and some people prefer to use other words, but we feel like this is a good place to start.

• Instead of “drug problem,” use “substance use disorder,” “opioid use disorder,” or ”addiction.” Why? The problem is the disease created by the substance. The person doesn’t have a “problem” with drugs; rather, they have a chronic illness that warrants medical descriptors.
• Instead of “addict,” use “person with a substance use disorder.” Why? Addiction is a disease. And guess what, folks? A person is more than their disease, no matter what the disease may be.
• Instead of “clean” or “dirty” to describe if someone is using a substance, just say “using” or “not using.” Why? There’s no need to add additional loaded language to the status of someone’s substance use. Just use the actual words.
• Instead of “replacement therapy” when discussing methadone or buprenorphine, use “Medication Assisted Treatment.” Why? The implication that a person is replacing one addictive substance for another is simply not how this treatment works. Methadone and buprenorphine are medications that help manage a disease. Insinuating that there is anything negative about using them to treat that disease is harmful. Think of them as medications that you would use to treat other chronic conditions, like diabetes or high blood pressure.
• Recovery or Remission? They’re sometimes used synonymously, but they are, in fact, different. According to Dr. Harrison, “Remission is a medical term that means the symptoms of SUD [substance use disorder] have fallen below the diagnostic threshold for at least 3 months. Recovery is a life-long whole-person process that has to do not only with absence of drug use but also general health and well-being, physical health, mental health, social health, connectedness, stability and life meaning. Remission is for the illness. Recovery is for the person’s life. While remission can happen in as short as three months per diagnostic criteria, recovery is a much longer, multidimensional process.”

All of this is what’s known as “people-first language.” Here is a great description from a National Institutes of Health paper:

“People-first language literally puts the words referring to the individual before words describing his/her behaviors or conditions. This practice helps highlight the fact that an individual’s condition, illness, or behavior is “only one aspect of who the person is, not the defining characteristic.” In the realm of addiction, terms such as “alcoholics,” “addicts,” and even the more generic “users” are terms that group, characterize, and label people by their illness, and in so doing, linguistically erase individual differences in experience.

To a large extent, these terms also presume a homogeneity in experience, character, and motivation that depersonalizes the people to whom the terms are applied. Instead, referring to the person first, e.g., “person with a cocaine use disorder,” “adolescent with an addiction,” or “individuals engaged in risky use of substances,” reinforces the affected individual’s identity as a person first and foremost.”

Bottom line: Think before you speak. In the long run, the effort is worth it.

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