Reprinted from the "The Language We Use" issue of Visions Journal, 2018, 14 (1), p. 8
“I don’t think we can underestimate the power of language” – Carol Bruess
Language shapes our thoughts and actions. It has the power to include or leave out. The words we use to describe things, people and ideas also reflect our values and influence how we and others think and act. This powerful effect can be observed in all kinds of situations and conversations, including our discussions about addiction and psychoactive substances.
The language of addiction is tricky because words mean different things
Language is alive and constantly changing. A single word can take on quite different meanings over time and in different situations (think, for example, of words such as “server” and “tweet,” both of whose meanings have evolved in the past few decades). Yet, when someone uses a word wrong, we often understand them without difficulty. This is because meaning has as much to do with context as it has with the words themselves.
When it comes to the language around addiction, we tend to use words in confusing ways. For example, the word “drug” can mean a medicine or an illegal substance, or it can refer specifically to a substance (legal or illegal) that changes the way we think or feel (i.e., a psychoactive substance). The English word “addiction” was originally a legal term, having to do with the surrender of something to someone, by order of a judge. Over time, “addiction” became a metaphor to describe the notion of “surrendering oneself” to a particular pursuit or activity.1
In an environment of multiple and changing meanings, the language of addiction has taken on a negative tone. Consider, for example, the word “risk.” We take risks all the time, hoping for positive rewards but knowing that the opposite might happen. In the language of addiction, however, risk has become equated exclusively with danger. Another example of negative language is the phrase “getting clean,” with the attendant implication that addiction is somehow “dirty.” In both cases, we focus our attention on the negative and rarely consider the functional benefits that people may be seeking when they engage in certain behaviours.
The language of addiction is tricky because language can be a weapon
The language around addiction is also tricky because it is embedded within particular value systems and reflects particular interests. When people call someone an addict, for example, they are not simply suggesting that the individual is devoted to a particular pastime or activity. The term implies that, whatever the devotion (or addiction) is, it is a negative one. In the current climate, the term also carries the suggestion that the addict’s actions are blameworthy. This is even more the case with language such as “drug abuse” and “drug abuser.” With these words, we tap into a deep, collective reservoir of emotionally charged language, in which there are “victims” and “perpetrators.”
When we label someone a victim, we imply that they are somehow damaged and powerless. When we call someone an abuser, we imply they are monstrous, or somehow less than human. While we may not mean to suggest these extremes, the language we use creates stigma that excludes or disempowers people from the community or the conversation and ultimately impacts how we treat the people we label and how they think of themselves.
In our everyday lives, we tend to use stigmatizing language more often to refer to people we dislike or do not know. Thus, people from marginalized populations “abuse drugs,” while our friends might “party too much.” It is difficult to have a nuanced discussion about addiction without first addressing our biased and selective use of language.
The language of addiction is tricky because we blend different constructs together
The ambiguity of the language of addiction is systemic and has deep historical roots. Prior to the late 19th century, what we call addiction was most often seen as sin, the result of moral weakness. As the study and practice of medicine became increasingly influenced by science, a new construct formed. Drunkards and opium addicts could be regarded as sick, the result of factors about the drug and the person.
Our current use of addiction language tends to blend these two constructs of sin and sickness—a blending that has significant implications. If we focus on the individual choices people make, we tend to adopt moral language and emphasize responsibility and blame for the use of drugs. On the other hand, if we see people as subject to forces outside of themselves, we tend to regard them as sick and needing treatment.2
Without clearly articulating these constructs and their implications, we often blame people on the one hand and deny their agency on the other. People sometimes regard alcohol as the cause of a person’s violent behaviour, thus mitigating the responsibility of the individual. At the same time, we often hear people describe the use of illegal drugs as a personal choice reflective of the innate criminal nature of the user—essentially placing all of the responsibility on the individual. Often, the language used depends on the situation and the relative position of the speaker and the people described.
The language of addiction is tricky because our relationship with psychoactive substances is complex
The human relationship with psychoactive substances—a relationship that goes back thousands of years—is complex. People have used (and continue to use) drugs for a variety of functional reasons. We have used drugs to feel good, to seek pleasure and to enhance social interactions. We have also used drugs to enhance our intellectual and physical performance, to explore new ideas and to deal with pain or cope with anxiety and other health-related conditions.
No use of psychoactive substances is risk-free, and generally, using drugs to deal with a chronic condition is more likely to lead to problems than occasional drug use.3 But our motivations to use drugs are not the only factors that matter. Our choices, and the patterns we develop, are ultimately influenced by the options available to us. While we need to take responsibility for our choices and actions, none of us is completely free to do what we want. At the same time, few of us are completely dependent on circumstances; we all have some agency. In other words, accountability is a matter of degree.
Yet our current language of addiction is overly simplistic—black and white in its options—and does not adequately reflect the complexity of addiction in our contemporary environment. We continue to use this simple language without clarifying context or making the distinctions necessary for balanced and meaningful conversations.
A final word
It is impossible to define what the best language is when it comes to addiction. However, we should recognize that our words matter. Our words influence our thoughts and actions. They affect those we speak to and those we speak about. In using our words, are we building bridges or marking boundaries? If our goal is to connect and support, we must find the words to do that. We can’t build connections with language that divides.
About the authors
Gaëlle is a research assistant for the Canadian Institute for Substance Use Research at the University of Victoria (formerly CARBC)
Dan is Assistant Director (Knowledge Exchange) at the Canadian Institute for Substance Use Research at the University of Victoria. He has worked in substance use services in British Columbia for well over two decades
Footnotes:
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Alexander, B. (2008). The globalization of addiction: A study in poverty of the spirit. Oxford: Oxford University Press, 27-30.
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Franzwa, G. (1998). Degrees of culpability: Aristotle and the language of addiction. Humanitas, 11(1), 91-102 (p. 91).
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Kuntsche, E., Knibbe, R., Gmel, G. & Engels, R. (2005). Why do young people drink? A review of drinking motives. Clinical Psychology Review, 25(7), 841-861.
