Clean? Dirty? : The Changing Language of Addiction

Addiction is thought to be one individual’s fault, where one chooses to continually make the mistake of repeatedly taking a certain substance or substances. Rarely, when speaking about the topic of addiction, is it recognized as a serious medical issue. Like cancer, addiction is a disease that needs to be medically treated for the hope of recovery. Many diseases have medical language and rhetoric that accompany it, and strengthen the idea that it is a medical issue, rather than a personal. Sarah Wakeman, a Medical Director, and Substance Use Disorders Initiative Program Director at Massachusetts General Hospital, stated, “a doctor would never tell a patient suffering from diabetes that their blood was dirty with glucose,’ though when speaking to someone with a substance use disorder derogatory statements about the state of their use may be used in the medical community. The DSM-5, The Diagnostic and Statistical Manual of Mental Disorders, refers to someone dealing with an addiction, as having an “opioid use disorder,” or “alcohol use disorder,” rather than an, “abuser.” Calling someone an abuser fails to use any medical language, and is filled with negative connotations. Simply using words like, “having a substance abuse disorder,” instead of, “a substance user,” helps derail the stigma around substance use, and view it as a medical condition, in which more people will be willing to treat the addict more like a human being (Kelly).

When one is dealing with a disease that is not recognized as so, a strong sense of dehumanization overwhelms one, and the odds of seeking treatment greatly diminishes. When the medical language around addiction creates stigma, and dehumanization, the one who is addicted has a great chance of feeling their problem is not recognized, and is one that no one wants to deal with. Not only does failing to use medical language affect the one dealing with addiction, but also it creates a language of moralistic connotations and accusatory tones in society. When society does not recognize addiction as a disease, the language that follows is even more stigmatizing, based on a failure of understanding the medical truth behind addiction.

When people are faced with ideas of addiction, or someone who is addicted, there seems to be one use of language that always reigns prevalent, moralistic connotations. Moralistic connotations are, “characterized by or expressive of a narrow moral attitude,” (Merriam Webster Dictionary,) examples of these connotations can be seen when referring to someone who is addicted as a “junkie,” “clean,” or “dirty.” Moralistic connotations can also be characterized by metaphors when it comes to speaking about the one addicted, and phrases such as, “clean or dirty,” and “clean or sober,” fails to separate the one addicted from the addiction, and the idea that the fault is in the one addicted comes to life, (Dahl). When society continues to use moralistic connotations, a great stigma grows around addiction, and has the ability to shape the beliefs, and ideas, society has towards those addicted. According to John Kelly with Psychology Today, “stigmatizing language referring either to the individual or the condition can serve as a barrier to treatment seeking” (Kelly). By changing the language used around addiction, and ridding of moralistic connotations, society may begin to look at addiction in a different light, which also will allow those that are addicted to look at their disease in a different way, hopefully resulting in seeking recovery. If society can create away to speak about addiction in a way that separates the addict from the addiction, there is a higher chance that those addicted will be more willing to seek help.

The effect of using moralistic connotations towards one with a substance abuse disorder is heavily over looked, and plays a large role in one seeking treatment and going onto recovery. People dealing with substance abuse disorders lose a great sense of self throughout the addiction, which then is only strengthened by the terms associated with their illness. The rhetoric and language used, creates a stereotype in the minds of society of what a person with an addiction is. With this, one with a substance abuse disorder in a way takes on that stereotype, and constantly has to keep up the image of being, “clean and sober,” or at other times, visibly is using in which the “dirty” connotations seem heavily noticed. When the language around addiction is constantly pointing fingers at the one with the substance abuse disorder, and represents a personal choice and failing, shame and guilt resides in the mind of one with a substance abuse disorder. The moralistic connotations and metaphors shift all blame on to the one addicted, and makes it seem like a “fix it yourself” issue, which keeps many from seeking help from others. If one wants the language surrounding addiction to change than it seems that moralistic connotations should be avoided when speaking about addiction. By no longer using moralistic connotations, stigma has a higher chance of diminishing, and then those addicted are more likely to seek help, because embarrassment and shame will be lessened.

The use of moralistic connotations are not the only ways language can be damaging to the ideas of addiction, and those addicted. It seems another way language comes in to play with addiction, is the many accusatory tones that are used towards those addicted. When it comes to breaking through to those who are addicted, it is thought that a compassionate, humanly approach would be the best way to break the barrier, though time and time again many stray away from that approach. When dealing with one addicted, it is common for one to accuse the addicted of being the only one at fault, and simply once again shifting all the blame of the addiction on to the one with the substance abuse disorder. Many also try to use the plea that the one addicted should be able to get better for them, and then accuses the one addicted that they may not care enough for those around them to get better. This puts the one with the disorder in a sticky situation, because when dealing with addiction, relationships and connections that once would be deciding factors in decisions fly out the door, and the one addicted must surrender to their brains needs. The use of accusatory tones actually can cause, “overwhelming pressure [on the one addicted] we then place on them to get better for us actually debilitates the recovery process (Legg).” Timothy Legg with Healthline is suggesting that this pressure put on the one with the substance abuse disorder becomes so heavy through accusatory tones, that the one with the addiction’s ability to get better actually lessens. This is thought to be the case because in the end, one with a substance abuse disorder must decide their willingness to get better for themselves before anything else, and feel comfortable in reaching out. When people constantly accuse the one with the disorder, and shift the blame on to them, the one addicted may feel attacked and then has a greater chance of rejecting getting better because the pressure is so great one does not feel they can accomplish the task of recovery. Accusatory tones weigh heavy on those with addictions, and to improve the chances of one seeking treatment, and being successful, these tones must be strayed away from.