“Words are singularly the most powerful force available to humanity. We
can choose to use this force constructively with words of encouragement,
or destructively using words of despair. Words have energy and power with
the ability to help, to heal, to hinder, to hurt, to harm, to humiliate and to
Power of Words
Consider the powerful force of the words used in the language of addiction and recovery. Should we look more closely at a vernacular based upon a disease entity that requires a life-long convalescence? What do the words addict, alcoholic, and recovery conjure up in our minds? A slave to some substance which has impaired, sickened and handicapped the user for life? A person perpetually on the verge of a relapse should a moment of moral weakness arise? These are some of the milder associations which come to mind. Again, what’s in a word? Often an entire world of meaning. A once empty container into which we have dumped the contents of our minds; including our biases. And although we have “medicalized” addiction, it remains nonetheless a set of classifications we might wrongly equate with some of the most severe, organic malignancies. In contrast there are medical conditions which are spared the implications of life-long impairment inherent in the diagnoses, treatment and after-care of addicted persons. Take for example the common analogy to addiction and diabetes. Diabetes is a progressive, potentially deadly disease if not treated. For those who are insulin dependent, monitoring glucose levels, changing eating habits, exercising and losing weight – in short, a life-style change – is crucial to survival. Denial, refusing treatment and ignoring self-care can be fatal. There are no Diabetes Anonymous meetings where the diabetic declares, “My name is Bill, and I am a Diabetic.” Remissions and relapses occur with the same regularity, yet they are managed by consultations with the immunologist.
There is no Red Letter ‘A’ for ADDICT which I must wear to advertise my shame. Yet, unconsciously, I do. If you think that this is mere hyperbole or a novel form of rational denial consider the history of change that has thus far happened in the field of addiction. In the 1970’s treatment communities worked with addicts who were labeled as having a character disorder. Approaches ranged from “character busting” to strengthening will power. Fortunately the treatment of addictions has greatly evolved over the last 45 years. Now the addict/alcoholic is considered a sick person working on becoming well; not a bad, morally depraved individual becoming a good one.
Words? In this new century we still recoil from labels like, “junky” and “Drunk” but they are words still used by the public at large. They say, that the clearest sign of a moral life is right speech, and the hallmark of a just society seeks to treat its citizens with compassion and respect. Individuals will do what they may. However it is the responsibility of the treatment industry to set the standard. In fact they must re-set the standards to conform to what the best treatment practices prescribe. And what is that? It is to bring addiction medicine into the 21stCentury. To do so by leveling the playing field, so that addictions are managed illnesses like others in its class.
The words and the word phrases must change. This isn’t about creating euphemisms – to make bad things sound good. The words represent a paradigm, a new context within which healing and sustained wellness can happen without the heavily laden stigmas, which stubbornly and inherently remain.
The New Nomenclature, and What It Means
Old: Alcoholic, Alcohol Dependency, Drug Addict, Opioid Dependency, Benzodiazepine Dependency, etc., etc.
New: Substance Use Disorder
The criteria that must be met for a diagnosis of dependency to any of these mood altering substances is the same.
New: Recurrence, Set Back
These Substance disorders are not cancers. They are set backs, often after which the affected person is strongly motivated to return to a stable condition. Work with an addictionologistas one with diabetes will routinely follow up with his immunologist.
Old: Program of Recovery, After-care Plan, Sober Support Group Affiliations
New: Continuation of care
Work with a Life Coachto establish a comprehensive set of life-style goals; through measureable objectives designed to meet the needs for training, education, jobs, etc.
The New Narrative
I believe we are capable of changing our narratives. It is the ability to effect a change in present thinking and functioning by re-editing the past. Transformative therapies facilitate this phenomenon. We are adults whose early life experiences may be reconstructed through the lens of more mature reasoning. Where once we could not solve problems through our incomprehension, we can solve them through new knowledge, understanding and action. If these experiences were associated with the damages caused by drug and alcohol use, trauma or the indiscretions of youth, they will yield to insight and self-responsible behavior. If the ‘words of addiction’ are gentle and kind, the immature in us will listen and respond. If the words we use are ones of encouragement intended to heal…not hinder, hurt, humiliate and humble, we will discover the motivation to change. Let us speak with mindfulness, in a way that solidifies our character, and does it through compassion for the “Drug Addicts and Alcoholics who populate our lives. And, “Addicts and Alcoholics,” discipline yourself to speak in a way that conveys respect for self, and do it with gentleness and humility.
Note: The ideas expressed by the author are not solely based on his opinion. They are proposals for changes set forth in discussions in the 2018 SAMHSHA literature. The new ‘language’ of Addiction will be a topic in the up-coming conference by the organization.
Roland Verfaillie, Ph.D., LMHC