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

Amanda Dick, who’s being treated for drug use, says she might have got 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

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.”

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.