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When words turn bad

The other day I was on a conference call and we were discussing which tags and keywords should be included in a collaborative online database.

The terms “substance use” and “harm reduction” were both on the list. I suggested we add “addiction.”

Some other people on the call said that we don’t use that term anymore, because it’s considered stigmatizing. Nowadays we prefer the term “substance use.”

I deferred to their expertise and dropped it, but I keep thinking about it. Not about addiction per se, but about how and why language changes. We decide a certain word has become corrupted by certain associations we collectively attribute to it, and then we retire the word and come up with another, less beleagured word.

In some cases I can see it, but getting rid of a useful word like addiction seems pointless to me.

Addiction is:

“compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly : persistent compulsive use of a substance known by the user to be harmful”

In my opinion it’s not interchangeable with “substance use,” because not all substance use involves addiction, and there are arguably some addictions that are unrelated to substances (eg behavioural addictions). There’s nothing about the word “addiction” that strikes me as value-laden or stigmatizing, other than that the thing it refers to IS stigmatized. Addiction is stigmatized, not the word but the condition. It doesn’t matter what we call it, the stigma will still be attached to the condition. And maybe we’re contributing to the stigma by saying the actual word for the condition is stigmatizing.

Do you know what I mean? Or am I missing something here?

Also, what happens to all the organizations that have the word addiction in their names? Will they all have to change their names now?

On a related note, I’m in the process of developing a survey, and one of the questions is about substance use (“How often do you use the following substances?” – tobacco, alcohol, injectable drugs for recreational purposes, non-injectable drugs for recreational purposes). I sent the survey out to a bunch of people for feedback before submitting it to the Ethics Review Board. Someone responded that the use of the word “substance” is objectionable because the only people who use the word are researchers and authority figures. People who actually use substances never refer to them as such, and might be put off by it. I racked my brain trying to think of an alternative word, but came up empty. Any suggestions?

8 comments to When words turn bad

  • Jen

    You could drop the word completely and the question would still make sense without implying any judgement: How often do you use the following – tobacco, alcohol, injectable drugs for recreational purposes, non-injectable drugs for recreational purposes

  • Catherine

    I agree with Jen, it sounds fine without the word substances.

  • Me too – I can’t believe I never thought of that! It’s perfect.

  • future landfill

    Ah jeez, now you’re in trouble! Friggin’ with the acceptability of terminology which changes by the minute. When did ‘Substance Abuse’ turn into ‘Substance Use’? Of course they mean different things but only to different people. I ‘use’ coffee, but after 4-5 cups does it become ‘abuse’? Wait till I stop squirming and having to go pee and I’ll discuss it. Addictive substances are pretty much always abused; marijuana, by contrast, may be excessively used, but only in rare individual cases is it ‘abused’.

    Language regularly gets strait-jacketed, even (especially?) by well-meaning individuals, and the tendency must be resisted, even at the cost of confusion.

    As a young lad I often remarked on an unusual circumstance with the phrase (in a scottish brogue) “Ay, that’s a queer carry-on.” Blank looks all around these days at best, if not a severe scowl in some quarters. I keep using it.

  • I think you were right about “addictions.” Words are powerful and we should be careful how we use them but in this case, you were suggesting a word that is accurate. You express this perfectly in your post.

  • We do the same thing in behavioral health. “recovery” (which we adopted from the addictions community and adapted it to our own use) is only the latest term. Developmental Disabilities has become Intellectual Disabilities-not the same thing in my book. Words have such power and we fling them around and give them new meanings without a lot of thought.

    You could phrase your question (using the language that many folks use), “When you were using, which of the following did you use….”

  • I worry about the increasing use of ‘neutral’ words to describe things that are not neutral. Our ability to communicate clearly is being choked off.
    It’s like trying to describe a rainbow when the only color name you’re allowed to use is ‘beige’.

  • Julia

    ‘Neutral’ words are never neutral after they become loaded with meaning. All words can get loaded with extra meaning – they have that potential. So context matters more than the word itself. All words can have the potential to become pejorative. The word ‘retard’ is still a normal French word that means delay or slow. It was used decades ago in a ‘neutral’ way to describe people who were somehow developmentally delayed. It only became pejorative when used by bullies, but now, no one can use it.

    Some words have triggers for some people more than others. If you don’t work in a field, you can get caught out because you are not up on the language. If people are offended by your use of a word, they should have the sense to see that you are using it in its normal, not pejorative sense. I am aware that language evolves but it seems a shame to throw away perfectly good words for the sake of a few peoples’ feelings.