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Review: Rewriting the Language of Addiction

Felice J. Freyer (2016, Feb. 4). “A Struggle to Rewrite the Language of Addiction: Debasing words hinder treatment, advocates say.” The Boston Globe.


Cries of complaints have come from those struggling to overcome addictions. Struggling with issues of low self-image, partly a cause reinforced by addictive failures, they have been offended and discouraged by the language used to describe them.

Windia Rodriguez remembers voices from those supposed to be treating her: “Crackhead” and “Addict,” they called her scornfully. “They treated me as if I was beyond hope,” she remembers. Now she describes herself realistically, but with hope: “I’m an addict… in recovery.”

Rodgriquez has also become a regional coordinator of the Massachusetts Organization for Addiction Recovery, and adds “her voice to researchers and advocates who want to rewrite the lexicon of addiction.” Freyer explains:

These advocates seek to excise language that blames or disparages the patient and replace it with medical terms free of judgment. They assert that commonly used words—“junkie,” “abuser,” even “substance abuser” and “addict”—can discourage people from seeking help, induce health professional to treat patients harshly, and exacerbate the stigma that bedevils people suffering from drug addiction.

Dr. Barbara Herbert’s study and experience as practitioner and president of the American Society of Addiction Medicine led her to conclude:

The biggest thing we trade in is hope. Our biggest enemy is hopelessness. That’s why I think language matters a lot.

Michael Botticeli, director of the Office of National Drug Control Policy, agrees:

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….Words have to change so attitudes change.

His advice may seem soft to some, even ridiculous. Botticeli is not just talking about terms like “crack-heads” and “junkies.” He finds terms such as “habit” an understatement, likened to a nail biter, and “drug-abuser” too suggestive to comparisons with “child abuser.” And to describe someone as “clean” implies that when using, they were “dirty.” “Dirty urine” may imply the same.

John F. Kelly is director of the Recovery Research Institute at Mass General Hospital. His 2009 study presented 516 health care workers with a court-ordered treatment program. The instructions were identical except that half of the group’s court-order described the patient as a “substance abuser;” the other half read the patient as “having a substance use disorder.” Those thinking of the person as a “substance abuser” were more likely to blame the patient for his difficulties and recommend punishment.

Tom Coderre is chief of staff of the national Substance Abuse and Mental Health Services Administration, which collaborates with the National Academies of Science. Coderre concludes:

If we want more people to seek treatment, and we want public policy makers to make treatment available, changing the lexicon is going to be really important.

Questions for Reflection and Discussion

  1. What brings you to this article—is it for yourself, a friend or family member, or for society in general?
  2. Do you find this suggestive descriptive change an example of soft political correctness? Or a positive break-through in our response to the epidemic of addiction?
  3. Do you see chemical addictions more in terms of weak, if not immoral, decisions and escape mechanisms, or is your view that they stem from genetic dispositions, a disease? Or could it be a little of both?
  4. Could it be that both encouraging and hard approaches are sometimes helpful? In the complex issues of addictions, is it possible that some may need to see themselves and their own efforts as hopeless to begin an ascent, while others need encouragement to see themselves from a positive, hopeful perspective?
  5. Do you think there are physical and emotional, rational and spiritual, aspects to addiction—and the treatment of addictions?
  6. How have you been able to help yourself or someone else avoid, or overcome, addictive tendencies?


  1. Drug and alcohol addictions are a crisis in the United States, and in many parts of the world. Stamping out the supply side of the crisis has failed. Reducing the demand side is a critical challenge.
  2. As the road to addiction shifts from time to time and from individual to individual, so treatment of those suffering or struggling to recover must also be re-thought and methodologies be reviewed and refined. What worked decades ago may not be as effective today. And certainly what works for one or a few sufferers may not work for all.
  3. Continued research and theorizing must continue as we combat this costly crisis.

Dean Borgman

© 2018 CYS

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