Saturday, February 28, 2009

Would you want to be called a "drunk", a "crack head", a "doper"? Watch your language!

How important is language in the substance abuse field? Very important according to Dr. Norman Hoffman, Ph.D. His is part of what he writes in his editorial on BHC Journal.

Equally disturbing are the research reports on treatment outcomes for samples composed of a mixture of abuse and dependent cases. A variety of research studies have shown consistently that dependence is distinct from abuse.2,3 One would be horrified to find an oncologist reporting on the prognoses of patients with “lumps” without differentiating cysts or benign growths from malignancies. We should be equally horrified to find addiction researchers who fail to differentiate dependence from abuse. Failure to distinguish abuse and dependent cases is not just sloppy word usage; it is sloppy science.

Another way dependence is trivialized is by using abuse as the generic term to include both substance dependence and substance abuse. Abuse used as the generic term makes policy makers, elected officials and members of the general public think of all substance use disorders as willful behavior, minor conditions, or “habits” — not serious conditions requiring treatment services. Abuse implies that the person is in control and willfully abusing the substance. Perception becomes reality in the minds of the uninformed. The worst consequence would be to support the contention that public policies just need to make “those people” want to stop by criminalizing that behavior. As for prevention, all we have to do is promote “Just say no.” Remember how that slogan did nothing to cut drug use among the youth of our nation? “Just say no” did for the substance dependent youth what “Have a nice day” did for the clinically depressed.

If addictions and the treatment of substance use disorders are to be taken seriously, we need to call substance use disorders by their formal and technical names — all the time. Addiction to alcohol is alcohol dependence; not alcohol abuse; not problem drinking. Heroin dependence is heroin dependence; not a habit.

Discussions concerning substance use disorders require using the appropriate terms for the conditions in question. Those words need to be used when making the case for why adequate funding of treatment is important.

If professionals in the field do not take addictions seriously enough to use the correct and appropriate terms for substance use disorders, how can they expect the public to take addictions seriously enough to support funding for treatment and prevention?

At GCASA we strive to provide high quality, professional services. Using the professional terminology in appropriate ways is important in communicating with clients, colleagues, referral agents, families, and other community members.

I personally don't like to call people "alcoholics" any more than I would call someone a "diabetic", an "autistic", a "schizophrenic", and/or a "depressive". It is more correct to say that this is a person suffering from diabetes, or schizophrenia, or alcoholism. The disease is not the primary attribute of the person's identity. It is a disease that the person is suffering from. The problem is the problem, the person is not the problem. It is important for us to use appropriate language because it has implications for understandings and for functioning.

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