Revising the Language of Addiction

Experts say action against stigma starts with choosing the right words.

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Revising the Language of Addiction
Rose Lincoln/Harvard Staff Photographer Harvard Medical School addiction expert John Kelly wants to couch the language of addiction. “This goes beyond political correctness ... exposure to these specific terms induces [an] implicit cognitive bias."

Many of us are more familiar with the drug abuse, and its negative connotations as well. It’s so hard for people to give up the ‘abuse’ word.

While facing addiction power, one should essentially remember the power of language.

Wakeman said, “Both term abuse and abuser imply a willful misconduct and have been shown to increase stigma and reduce the quality of care. Both are equally harmful language often applied to the most effective form of treatment.”

She noted, “The stigma surrounding the use of pharmacotherapy, in particular, opioid agonist therapy, is arguably more potent and harmful than the general stigma about addiction. Drugs such as buprenorphine, which can curb cravings and withdrawal symptoms, are too often called a ‘replacement addiction’.”

“To counter that misconception, the use of buprenorphine, which is marketed under the brand name Suboxone, should simply be called ‘treatment’ rather than ‘medication-assisted treatment’.”

According to scientists, the difference between dependency and addiction needs to be made clear. Many individuals who utilize an opioid to treat chronic pain mostly become dependent on the drug. Means, if they stop taking it they will go through withdrawal.

In contrast, addiction is a medicinal issue in which you are impulsively utilizing increasingly of a medication that can make terrible things occur in your life.

Wakeman demonstrates her simple rule for language choices, “A doctor would never tell a patient suffering from diabetes that their blood was dirty with glucose. We should ask, ‘Is this a term that we would use for another medical condition?’ If the answer is ‘no,’ we shouldn’t use it.”

For many, who took a forward step toward recovery means admitting a problem. Most of the participants often used say their name followed by the statement and I’m an alcoholic. Wakeman also urges people to say whatever makes them feel comfortable.

Wakeman said, “The power of language is so strong, and the stigma is so deeply felt.”

Kelly, the Elizabeth R. Spallin Associate Professor crafted two depictions of somebody battling with addiction. During 1st description, he referred to the person as a “substance abuser,” which he believed might suggest the notion of willful misconduct and lead to more punitive approaches.

In 2nd description, he wrote “substance use disorder,” a term he thought might convey the idea of a medical malfunction and lead to less punitive, more treatment-oriented attitudes.

He even assigned the descriptions to 600 doctoral-level clinicians. He then asked them to answer a series of questions including whether the person should be punished or treated. Later Kelly repeated the test with the general population.

He found that individuals who were exposed to the ‘substance abuser’ term had much more punitive attitudes toward the subject than if he was described as having a substance use disorder.

Scientists then created a web tool called the Addiction-ary. The tool is a glossary of addiction-regarding terms including several words that come with a bold ‘stigma alert’ warning.

Revising the Language of Addiction
HMS Professor John Kelly helped to create the Addiction-ary, a glossary of addiction-related terms to help medical professionals and the general public modify their language about addiction. Graphic by Rebecca Coleman/Harvard Staff

Kelly said, “If we want addiction destigmatized, we need a language that’s unified and really accurately portrays the true nature of what we’ve learned about these conditions over the last 25 years.”

“This goes beyond political correctness. It’s not just a matter of being nice. What we now know is that actual exposure to these specific terms induces this implicit cognitive bias. If you really want to solve the problem, you want to remove any barriers and obstacles.”

REFERENCEHarvard Gazette
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