Rethinking Language

How We Refer to Addiction Makes an Impact

I lived in Germany as an exchange student when I was in high school in the late 1980s.

My dad had a business connection with a distributor in Germany. The man arranged with my family to have his daughter live with us in Minnesota to learn English and begin to understand American culture. When her time living in the States was up, I decided to go and live with their family.
Already an active alcoholic already (but not realizing it at the time), the prospect of being able to buy beer or liquor in a grocery store as a seventeen-year-old intrigued me. I suppose I was interested in the culture and the language as well; however, if I’m honest, my motives for seizing the opportunity were anything but pure.

I lived there for nearly a year and a half. Not surprisingly, I hit my drinking hard and I drove way too fast on the Autobahn—I think I got my guest father’s Mercedes up to 220 kph once. However, the adventure was one I wouldn’t trade, and was overall formative for me. I’m glad I went.

Learning German was difficult though. The only preparation I had was two years of high-school German in Minnesota, which was wholly inadequate.

Beyond learning the daily vocabulary that I needed to function, there was also the Umgangssprache (everyday speech). Since I wanted to fit in, I made an extra effort to learn this slang.

One word I remember was geil. At first, I thought it simply meant cool or "rad." (Hey, this was the '80s!) I started to use the word frequently when I wanted to exclaim that I thought something was great. Around other kids my age, this worked fine.


Around adults, they’d look at me with shock and raise their eyebrows.

One day, Hans, my guest father, took me aside and told me I shouldn’t be using the word geil so freely. I asked him why, but he never gave me an answer. Eventually I learned from other kids that the word geil has a sexual connotation.

I remember thinking: What a stupid word to use for ‘cool!’ But that’s the nature of language; it’s free-flowing, and a meaning a word has with a certain audience can mean something completely different with another.

Being public with addiction

I’ve done a lot of thinking recently about how I refer to my addiction publicly.

I’m a freelance writer and a public speaker. I do my best to piece together words to effectively convey the meaning I want you to comprehend. With writing, it’s much more an art form than a science. It’s tricky—the picture I want you to envision often isn’t the one that you ultimately paint on the canvas in your head.

The spoken word is often just as slippery.

Nowhere is the imprecise nature of language more apparent than when people in recovery use the term disease to refer to addiction.

First, let me be clear: I completely agree with the disease model of addiction. The science is clear—bona fide alcoholics and addicts react differently to mind-altering chemicals than other people do. Addiction is also a progressive disease affecting not only the mind, but also the body. The genetic data is also widely available, although individual researchers have interpreted that data differently.

Add to the fact that addicts and alcoholics often need medical attention to recover, and the use of the word also throws insurance coverage into the complicated mix. The hard advocacy work that the Hazelden Betty Ford Foundation does deals with that very issue. The real kicker here is that people’s lives are at stake. The need for clarity and understanding around words used to describe addiction, has never been greater than right now.

The problem arises with the varied reactions people have with the word disease.

Much like the carefree way I tossed the word geil around when I lived in Germany, referring to my malady as a disease often depends on the audience receiving it. With some people "in the rooms," or with families who understand the rich traditions of a Twelve Step community, the word is a given. However, with the general public, its reception is far more unpredictable.

Picture for a moment a woman entering your favorite supermarket. You see her hunched over. She struggles to push the grocery cart. Maybe you’ve seen her before, and you turn to me and ask, “What’s wrong with her?”

“Oh, her—she has a disease.”

Immediately your mind goes to what sort of disease she possibly could have. Maybe you make a mental note to Google her symptoms when you get home.

Now picture something else: you see a man driving his car erratically. He swerves his vehicle left, then right, and eventually ends up in a ditch, the hood of his car smashed with steam rising from the engine.

“Holy crap! What’s wrong with that dude?”

“Oh, him? He has a disease.”

You see the problem.

In everyday speech, disease doesn’t seem to work when referring to the outward signs of addiction. Therein lies the conundrum with diseases affecting the mind—our everyday language doesn’t allow us to view the brain as an organ, or, at least as one that is just as susceptible to normal or abnormal functioning as any other organ in the body.

Stigma alive and well

When I speak publicly to audiences who may not have an understanding of what addiction really is, I avoid using the term disease altogether. I do this, not because I deny the scientific data, but because it can elicit such knee-jerk reactions that people will turn off whatever else I want to say.

I don’t believe I’m over-reaching or that I’m misguided with this strategy. I contend there are other ways we can get across the same concept without tainting people’s perception of the issue. Advocates need to pursue educating the public about addiction. I only suggest that we think about the words we use with the goal of getting help for people who need it.

One suggested term is induced mental illness. I used this in my book Sobriety: A Graphic Novel, a Hazelden Publishing resource for youth and young adults that shares Twelve Step recovery through the power of comics. Induced mental illness is accurate in that—without adding mind-altering chemicals to a person’s life—the addiction would lay dormant. Adding drugs or alcohol to one who is susceptible, it is without question that the disease will manifest itself as a mental illness. At least that’s true for what I remember about how I behaved back in the day.

However, I think that term has the drawback of being too complicated for some people—induced mental illness can easily glaze people’s eyes over if you don’t explain it properly.

Another word I’ve heard people use is condition. It’s simple and direct, although a bit generic. And disorder carries its own baggage; it communicates that addicts are degenerates, and people easily see addiction as a moral failure, which it is not.

Chemically dependent has a history of usage. However, addiction medicine no longer uses the term. Besides, it’s not completely accurate; it denotes that the dependence is ongoing, which for most abstinent people, it’s not. Today, the medical community (and DSM 5) uses substance use disorder. But for communicating with the public, it’s not a very friendly expression—it sounds too “doctor speak” and brings in the word disorder besides.

Which brings us back to the word disease—why not just use that word, try to educate and change the understanding, and hope for the best?

That’s certainly a possibility, but one of which I hope public speakers and advocates would opt against. The masses, many who have yet to fully understand addiction, seem to be allergic to the term, and I think we’re better off using different words.

What I’ve opted for is using condition when I describe my addiction and recovery. It’s quick and easy and doesn’t carry much baggage. When I spell out what addiction is, I use induced mental illness, and make it clear for readers or an audience exactly what that term means for me.

And then I tell my story—of the wreckage I wrought and the recovery process that saved me—which is perhaps the best witness we can give to anyone so they can empathize and understand. People deserve professional, medically indicated, treatment for their brain disease, no matter how it manifests itself in their lives.

Dan Maurer, author of Sobriety: A Graphic NovelDaniel D. Maurer is a freelance writer and speaker openly living in recovery. He is the author of Sobriety: A Graphic Novel and Faraway: A Suburban Boy’s Story as a Victim of Sex Trafficking. Daniel keeps the blog Transformation is Real and produces a podcast created in cooperation with the Hazelden Betty Ford Foundation. On April 1-3, 2016, he will lead a retreat with the artist Joan Swenson encouraging participants to grow their recovery through art and words. Daniel lives with his family in St. Paul, Minnesota.

The contents and opinions of this article are the author’s and do not necessarily reflect the views of the Hazelden Betty Ford Foundation.

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