Sticks, Stones AND Words May Harm Us

Why we must change our vernacular

It was the first adage many of us learned as youngsters:

 “Sticks and stones may break my bones, but words will never hurt me.”

Unfortunately, it’s not true when it comes to the words and phrases we use in describing addiction, treatment and recovery. Our language harms us, as well as our advocacy efforts. And more often than not, it’s our own fault.

Here is my list of harmful words and phrases, not necessarily in order of egregiousness:

“Substance abuse” or "substance abusers"

“Chemical dependency”

“Disease” or “disease concept”

“Addicts and alcoholics”





Now let me explain why we must change the vernacular.

If you’re like me, we never abused substances. We loved them. And unlike child, domestic, animal or sexual abuse, addiction to substances is not a problem-driven behavior. As professionals, we sell ourselves short and mislabel our patients and clients by calling them “substance abusers” and describing what we do as “substance abuse treatment.” As advocates whose goal is to explain our problem to others (politicians, the media, our neighbors), calling it “abuse” does nothing to smash the stigma that says our problem is nothing more than willful misbehavior, not an illness.

Which brings me to the next grouping of words on the list; it is time once and for all to stop calling it “chemical dependency.” That terminology was birthed in Minnesota in the 1950s but never really took hold beyond the upper Midwest and today is confusing to anyone who doesn’t understand what we mean. We’re never dependent on chemicals like ethylene glycol (antifreeze), sodium hypochlorite (bleach) or phosphates (dishwasher detergent). Keep it clear and simple, and explain that we are dependent on “alcohol and other drugs” – with an emphasis, by the way, on “other.” Alcohol is a drug too, the most used and misused in the world. 

A long time ago when the experts, among them Dr. E.M. Jellinek, were trying to understand and explain addiction, they talked about the “disease concept.” A new concept it was, back then. Those days are long gone. It isn’t a concept anymore. It is time to drop it. And while it is often described as a disease (which it is), I don’t use that noun any longer. Why? Because the public still grapples with equating addiction with common diseases like Lyme disease, typhus or the latest, Zika. So I’ve substituted “illness.” And it seems to work. Even naysayers, or those reluctant to embrace addiction for what it is, can usually agree that people who have it are indeed sick or ill with what we now label a “substance use disorder.”

And who has this illness? Well, we often call ourselves “addicts and alcoholics.” I suppose that’s okay, if that’s how you want to describe yourself. But the negative connotations around those words, especially when discussing a group of people living in a sober house or rallying for recovery at the statehouse, can infer that they are still under the influence. Or not getting better. Addicts and alcoholics are as much “victims” of their illness as are people fighting cancer, hypertension or depression, among others.

This is why I’m not keen on the word “recovering” to describe who or what we are. A few years ago a nationwide survey found that the general public equates “recovering” with something short of not being completely well, or still using even! For most of us in a certain program of wellness, we know what it means to say, “My name is William and I am recovering.” But in public these days I’ve started to describe myself as somebody who has “recovered from the desperate condition of too much drinking and drugging and is now in ‘remission’ from my illness. The general audience understands what I’m saying. Oh yeah, and by the way: I don’t recover or stay that way all by myself.  For me, the key is “mutual help,’ not “self-help.” I don’t know too many people who do it alone.

And what is “sobriety?” It’s a word I try to avoid uttering in public because over the course of my long journey professionally and privately, my definition and perspective have evolved. I know a man whose drinking caused him to quit 49 years ago, and he hasn’t had a taste of alcohol since. He smokes, which means he daily ingests nicotine, a drug that is addicting. Is he less or more sober than a young woman in St. Paul overcoming opiate dependence whose treatment includes buprenorphine? I don’t know if they're sober. But I’m certain they are as committed to finding and embracing their own accommodation with recovery as anyone else who wants to get better. In public, when I am explaining recovery to politicians, doctors or members of a Rotary Club, I always emphasize that there’s more to it than just abstinence or “sobriety.”

It’s taken me 20 years of speaking on behalf of Hazelden Betty Ford to master how to tell my story of addiction, redemption and recovery in a language others understand. Often audiences respond that my story, like the thousands who have come before me or will follow, is a “miracle.” Not exactly, I’m quick to point out, because it isn’t that easy or simple. I recovered from my serious illness because I got professional treatment more than once. From experts who are highly trained and experienced. At a facility licensed to operate within standards set and monitored by government agencies. 

If there is a miracle to it all, it’s that I’ve learned to speak a new language that is helping to change the terms of the debate for the sake of those who still suffer. The best part is that I don’t speak it alone.

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