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COMMUNITY NEWSLETTER: Be aware of the language you use with substance abuse disorders

COMMUNITY NEWSLETTER: Be aware of the language you use with substance abuse disorders


Can we talk about how we talk, especially about others?

I recently watched “Hillbilly Elegy” on Netflix, and, though I haven’t read JD Vance’s memoir that the movie is based on, I do recall when the book came out and the outcry about the language of poverty.

The movie has a scene where an attorney asks the main character if he feels a disconnect, like, “How am I related to those rednecks?” or something similar. And the main character says, “Ummmm, we don’t use that word.” Interesting because this is the exact same phrasing I use when I need to correct a person’s language about substance use disorders: “We don’t use that word.”

We don’t use “addict,” “alcoholic,” “junkie,” “clean,” “dirty” (as applied to a negative or positive test), “clean” (as applied to a person no longer using substances), nor “recovered addict/alcoholic.” There are lots of other words not to use, but these seem to be the most troublesome in my world of substance use disorders, and I’m amazed at the people who use them.

Language matters. We know that how we talk about substance use in our everyday lives has an impact on how likely a person is to seek and successfully complete treatment. We can save lives just by changing our language. Seriously.

I know lots of people with substance use disorders. I love many of them. Some are in recovery from the substance use disorder, and others are people living with serious substance use disorders, but none are addicts or junkies…even if they call themselves that.

Here’s why “we don’t use those words”: because even if you think you’re simply being honest or forthright, what you’re really doing is giving your listeners a picture in their minds of what THEY see, not what you see. I’ve heard many people outside of support meetings say that they are “alcoholics” or “addicts” because that’s the language they use with others they know in recovery. But I’m not in recovery, and that means that speakers are risking my understanding of their language…and while I may, others may not.

Which brings me back to Hillbilly Elegy. At the end of the movie, which is in part about Vance’s mother who lives with a serious heroin use disorder, the written epilogue pops up and says that Beverly, the mom, has been sober for six years.

I work in the field of substance use disorders, and I literally have no idea what that is supposed to mean. She has an addiction to heroin, but she’s “sober.” Ask 100 people on the street what “sober” means, and 100 people would say “not drinking.”

So how, in 2020, does a movie about a person with a serious heroin use disorder make that sort of mistake … thinking we’re all on the same page? It’s because we aren’t consistently paying attention to the language we use.

And because of that, people are dying.

Guida Brown is executive director of Hope Council on Alcohol & Other Drug Abuse, Inc.


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