How the way we talk about addiction can make it harder for people to recover

Many medical professionals agree that the language around addiction can affect a person's recovery, and there is a push to adopt terms that are less dismissive and more human.

People who need treatment often don't seek out help because they fear stigma

Amanda Dick says she would have sought help for substance use sooner but worried about being labelled an 'addict.' Many medical professionals agree that the stigmatized language around addiction creates a barrier for those who need treatment. (Craig Chivers/CBC)

Amanda Dick, who's being treated for drug use, says she might have sought help sooner if not for the stigma of being labelled an "addict."

"It makes you feel like a stereotype … stealing, crime, lying — all sorts of things," said Dick, 36, of Brampton, Ont.

Many medical professionals agree that the language around addiction can affect a person's recovery, and there is a push to adopt terms that are less dismissive and more human.

Dick was in her mid-20s, working full-time as a medical administrator and living with her mother, when she began experimenting with cocaine and heroin. She became ill and thought she had the flu, until a friend told her she was experiencing symptoms of withdrawal.

"At that point I was absolutely terrified that anyone would ever find out," she said.

"It's still very shameful, and I think a lot of people are very hesitant to seek help and treatments because there's this perception that you're a bad person."

Language changes perception

A recent U.S. study found that terms like "opioid addict" and "substance abuser" were strongly associated with "negative explicit bias," and concluded they should not be used by either the medical community or the general public.

Language is an important purveyor of social stigma, said Kenneth Tupper, of the B.C. Centre on Substance Use.

"The term 'addict' represents people who have lost control, who are morally blameworthy for the problems they are suffering from … and perhaps don't deserve the full compassion of our health-care system."

Kenneth Tupper, of the B.C. Centre on Substance Use, doesn't like the term 'addict' because it suggests people are 'morally blameworthy' for their problems. (CBC)

Tupper said terms such as "drug abuse" or "drug abuser" dehumanize people who are suffering.

"Child abuse, spousal abuse, animal abuse, elder abuse — in each case the thing in front of the word abuse is who or what is being harmed. But when it comes to drug abuse, who or what is being harmed? Certainly not the drugs. They are inanimate objects."

Tupper said shifting language can help alter people's perceptions of marginalized groups, citing as examples how our terminology has changed with respect to Indigenous people, people with disabilities and members of the LGBTQ2 community.

"It is entirely possible that in the future our children or grandchildren are going to look back and be aghast at how we have treated people who use drugs," he said.

Medical professionals are trying to lead the way with language that puts the emphasis on people.

A spokesperson for the Centre for Addiction and Mental Health in Toronto said most physicians and nurses no longer use words like "addict," "abuser" and "clean." Instead, they're treating "patients" with "a substance use disorder" and informing them of "positive or negative" toxicology test results. 

Health Canada, too, supports changing the language of substance use.

"When people who use drugs meet stigma in the health system, it reduces the quality of care they receive. It also makes the person less likely to follow through on a treatment program, out of fear they will face stigma again," the federal health agency says on its website.

"Stigma prevents people who use drugs from receiving the help they need. It can also prevent the people who use drugs and their loved ones from seeking the help they need."

But changing the larger conversation around addiction is much harder.

Sandee, who asked that CBC News not use her last name, said people judge one another — and themselves — when it comes to substance use disorders. She said she started using drugs at age 13 and attempted suicide at 20, which landed her in a psychiatric hospital.

"I had no self-worth. I had no self-respect and I had no self-love. So those were some of the tools that I learned how to acquire."

Treat addiction as an illness

Now in her 50s, Sandee says she hasn't touched alcohol or any illegal substance in more than 30 years.

She said addiction is a disease that chemically alters the brain, but someone who is diagnosed with addiction isn't treated the same way as someone diagnosed with cancer, especially if they relapse.

"People see it as: What did you do wrong? What have you not done right?" she said. "Whereas somebody with cancer, we put the pink T-shirts back on or we would do the walkathons…. I find that very demoralizing."

Sandee feels there can only be real change for people struggling with a substance use disorder if there is widespread acceptance that addiction and relapsing are part of the illness and not just a bad choice.

"I think that society needs to recognize that the people that they're stigmatizing could be their neighbour, could be their co-worker and could be their child. If we want people to find recovery, if we really buy into the belief that this is an illness, then we need to treat it as such."

Dick said it has taken her years, but she is nearing the end of her treatments for addiction.

Her advice to anyone who feels they may be suffering from addiction: "Focus on getting better and just ignore what any other person said, or what you imagined they could be saying, because your health and your life is the most important thing."

She said she hopes her speaking openly might inspire one person to reach out and get help sooner than she did.

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