Erowid References Database
Botticelli MP, Koh HK.
“Changing the Language of Addiction”.
JAMA. 2016 Oct 4;316(13):1361-1362.
...history has also demonstrated how language can cloud understanding and perpetuate societal bias. For example, in the past, people with mental illness were derided as lunatics and segregated to insane asylums. In the early days of human immunodeficiency virus, patients were labeled as having gay-related immune deficiency, with public discourse dominated by moral judgments. Other examples apply to disability and some infectious diseases. In all of these cases, stigma and discrimination can arise when patients are labeled, linked to undesirable characteristics, or placed in categories to separate us from them.
Today, these complex themes have special relevance for addiction. Scientific evidence shows that addiction to alcohol or drugs is a chronic brain disorder with potential for recurrence. However, as with many other chronic conditions, people with substance use disorders (SUDs) can be effectively treated and can enter recovery. For example, medication-assisted treatment such as buprenorphine hydrochloride, methadone hydrochloride, and naltrexone hydrochloride--provided in conjunction with behavioral counseling--can be life extending for patients with an opioid use disorder. However, individuals with or in recovery from SUDs continue to be viewed with stigma, sometimes greater than that seen with physical or psychiatric disabilities.2 Commonly used terms can imply, or even explicitly convey, that the individuals with SUDs are morally at fault for their disease. Patients may be referred to as junkies, crackheads, or other pejorative terms that describe them solely through the lens of their addiction or their implied personal failings. These word choices matter. Language related to SUDs does influence perceptions and judgments, even among health care professionals with substantial experience and expertise. For example, in one study involving a case vignette, doctoral-level mental health and SUD clinicians were significantly more likely to assign blame and to concur with the need for punitive actions when an individual was described as a substance abuser rather than as a person with a substance use disorder.3
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