Words Matter: How to Talk about Addiction

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Neurologist and Addiction Medicine Specialist Dr. Russell Surasky Provides Tips on How to Avoid Stigmatizing

Dr. Russell Surasky

Removing the stigma from addiction would help everyone.

Addiction is a disease – a devastating disease that lays waste to families and entire communities. It is a complex, chronic illness that changes the structure and functioning of the brain and puts its sufferers at risk of relapse for a lifetime. And it burdens them with an additional affliction – the stigma of being labeled an addict, of being treated as a second-class citizen, guilty of moral turpitude and unworthy of respect. “Over the years, we've become more sensitive to language that disparages and stigmatizes people,” says neurologist and addiction medicine specialist Dr. Russell Surasky with Surasky Neurological Center for Addiction. “We don't refer to people with mental and physical impairments as crazies, cripples, and spastics. And we don't define sick people by their illness. Yet most people don't think twice before labeling someone struggling with a substance use disorder an 'addict,' dismissively defining an individual's entire identity and humanity with a single word that has overwhelmingly negative connotations.”

The language we use to describe people suffering from addiction is important. It influences how we frame issues and solutions – whether an individual should be punished or treated, whether we afford them the full measure of human dignity or condemn them to cower in guilt and shame. The stigma of addiction has serious repercussions for an individual's likelihood of recovery. Apprehension about social ostracism, anxiety about how they will be received by the medical community, and fear of legal consequences keep many from seeking help. Even those who recover from addiction continue to be viewed with suspicion – “once an addict, always an addict” – making it harder to build a healthy, addiction-free life.

Tips for Language that Supports rather than Stigmatizes
“Removing the stigma from addiction would help everyone,” says Dr. Surasky. “It would influence funding decisions, medical research and insurance coverage. It would help the general public understand that this is an illness not a moral failing, and most important, it would make it easier for people to seek treatment and regain their self-esteem. Simply choosing words that support and inform rather than discourage and embarrass can go a long way toward de-stigmatizing addiction.”

Dr. Surasky makes the following suggestions:

  • Words to avoid: Addict, junkie, crackhead... These words all pin labels on people that define them solely by their illness. People with cancer recover and are no longer cancer patients; consider the contrast of being known for a lifetime as an “ex-addict.”

Better: Person struggling with addiction, person with a substance use (not abuse!) disorder, patient (if in treatment). These phrases are more cumbersome than a single descriptive word but they accomplish something important – they put the person before his or her illness and de-stigmatize the condition.

  • Words to avoid: Substance abuse, drug abuse. Abuse is a strongly negative word, typically associated with child abuse, sexual abuse, domestic abuse, etc. It is a word that usually connotes harming another person and conveys the need for punishment rather than treatment.

Better: Substance misuse, substance use disorder, addiction. Addiction, unlike addict, refers to the condition rather than the person – a condition that can be treated – and is not a label that stigmatizes an individual.

“We must fight addiction,” says Dr. Surasky. “But to do so, we must separate the illness from the individual who suffers from it. We must erase the tinge of character flaws and immorality from addictive disorders and restore dignity and humanity to the people who struggle to overcome them. Being careful about the language we use is an important step toward that end.”

Dr. Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine, is one of the few physicians with this combination of credentials. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com

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