Language Matters—Words like 'Abuse' and 'Addict' Are Stigmatizing

By Zachary Siegel 02/09/16

US Drug Czar Michael Botticelli is trying to change the language surrounding addiction in order to reduce the stigma.

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Language Matters—Words like 'Abuse' and 'Addict' Are Stigmatizing
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“Junkie” is a historical word. In the early 20th century, people who did heroin were referred to as junkies because they would collect scrap metal, copper wire, and other junk, to pawn or sell to pay for their drugs. Bubbles from David Simon’s The Wire was junkie incarnate, wheel-barrowing garbage all over the city, scrounging for dollars. But over the years the word became an insult, degrading the behavior of drug users. 

The Boston Globe recently surveyed advocates and researchers, uncovering the meaning of the language we use to describe addiction. The consensus is that the current lexicon of addiction needs a dramatic makeover. 

In a meeting of Narcotics Anonymous, one is more than likely to introduce herself as “Hi, my name is so and so and I’m an addict.” Even the word "addict," let alone "junkie," leads to problematic labeling, according to leading researchers and advocates. 

“This person is much more than one illness,” Dr. Kevin P. Hill, an addiction psychiatrist at McLean Hospital, told the Globe. To announce oneself as an “addict” is to be defined by a condition, which more and more people find hopelessly stigmatizing. People addicted to drugs are many more things than simply addicts. They are mothers and fathers, brothers and sisters, friends. In this case, he is your reporter. 

“The biggest thing we trade in is hope,” Dr. Barbara Herbert, of the American Society of Addiction Medicine, told the Boston Globe. “Our biggest enemy is hopelessness. That’s why I think language matters a lot.” 

Indeed, language is the vehicle through which we identify ourselves in the world, making it a powerful force in our self-construction. Which is why US Drug Czar Michael Botticelli is working to excise stigmatizing language from all federal communication regarding addiction and drug use. "Research shows that the language we use to describe [addiction] can either perpetuate or overcome the stereotypes, prejudice and lack of empathy that keep people from getting treatment they need," Botticelli once told The Huffington Post

More recently, he told the Globe, “For a long time, we’ve known that language plays a huge role in how we think about people and how people think about themselves.” 

It’s not only self-identifiers such as addict that have become problematic, but also diagnostic labeling, both formal and informal. Substance abuse, for instance, leads to labeling people as “abusers.” That’s not a friendly identifier. It carries a negative valence. Informally, people use the word “clean” to designate one who is currently not using drugs. The antithesis of clean, of course, is dirty, which implies those who are currently using are uncleanly. This is stigmatizing the use of drugs, which should be looked at as nothing other than a natural occurrence in the world. It’s neutral to simply call it what it is: drug use. 

The Substance Abuse and Mental Health Services Administration (SAMHSA) has teamed up with the National Academies of Science to study words that promote stigma and what legitimate alternatives might be. 

“If we want more people to seek treatment and we want public policymakers to make treatment available, changing the lexicon is going to be really important,” Tom Coderre, from SAMHSA told the Globe.

“Words have to change so attitudes change,” said Botticelli. 

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.