Sober Etiquette: Language of Addiction Recovery

How do we talk about addiction, substance use disorders, and recovery journeys respectfully? What is the appropriate sober etiquette for the words we choose? Why is it important?

For one, the way we talk about addiction affects more people than we know. Nearly 50% of households in the United States are directly affected by substance use disorder. (Buchholz, 2019) When we discuss the recovery journeys of celebrities like John Mulaney, Demi Lovato, Dax Shepard, and more, we must recognize that we are also talking about the recovery journeys of our friends, family members, and neighbors.

It is important to choose our terminology carefully when we are discussing the complexities of substance use disorders because our words matter. What we say about addiction can hurt or help our family, friends, and partners in recovery.

Stigma Harms the Recovery Community

Research has shown that societal stigma decreases a person’s likelihood of seeking treatment for their substance use disorder. Also, social stigma increases the criminalization of addiction, which in turn increases relapses and overdoses.

“Patients tend to internalize stigma and this leads to them developing a fear of being judged. They’ll avoid getting medical help for a problem until the problem is so big they have no choice but to seek help.” – Dr. David I. Deyhimy, Edge Medical Director

As Dr. Deyhimy points out, social stigma creates internalized stigma, or self-stigma. This prevents those suffering from seeking help. It is a harmful cycle, but we can change it.

So what can we do to support the recovery community? We can start by changing our language to embrace good “sober etiquette”. Here are a few important shifts:

Addict Vs. Person

The terms to describe a person with a SUD are numerous: addict, junkie, alcoholic, and drug abuser come to mind.

These terms are negative in that they contribute to the false idea that suffering from a substance use disorder is voluntary.

The terms also reduce a person to one aspect of their identity: the disease they suffer from. This is important because unlike terms like “diabetic”, “addict”,” junkie”, and “alcoholic” are pejorative and used to describe people outside of a medical context.

It can be confusing because in popular culture there are often scenes of support groups that open with “Hi, I’m _____ and I’m an alcoholic”. For the sake of clarity, assume that the way people describe themselves and their journeys is not universal. More to the point, the terms people use to describe themselves are not terms that should be imposed upon them.

A term that better supports a holistic understanding of substance use disorders: “a person with substance use disorder”.

Substance Abuse Vs. Substance Use

There are many negative associations with the term “abuse”, as you can imagine. Research shows that the term substance abuse perpetuates stereotypes about substance use disorders. These stereotypes lead to discrimination and inform negative attitudes towards those who suffer from SUD.

Terms like “abuse” also imply substance use disorders are behavioral and in need of punishment. This leads to criminalization, which research has shown increases relapses and overdose deaths, among other harms.

The preferred terms are substance use, disordered substance use, or substance misuse in the case of prescription medications.

Opioid Epidemic Vs. Overdose Epidemic

The term “opioid epidemic” does not fully capture the increase in drug-related harm, much of which can also be traced to polysubstance usage. It is a term coined in the “drug war” which has criminalized drug usage and disregarded many successful harm reduction strategies.

Swapping this term for “overdose epidemic” shifts from the negative perception and politicization of the issue. Also, the overdose epidemic much more accurately depicts the devastating human consequences of substance use disorder.

The goal, ultimately, is to prevent overdose, making “overdose epidemic” a more accurate phrase more accurate overall.

Why Change Our Language?

These changes may seem like such a minor shift, but they are important. Who do you think is more likely to receive the help they need, an addict or a person suffering from substance use disorder?

If you were to explain to friends and family that your child is receiving addiction treatment, would it be less hurtful to describe them as a "reformed junkie" or as a person working toward recovery? Which of those phrases is more likely to elicit the empathy a person suffering from chronic disease deserves?

If we want to address the growing issue of substance use disorders, prevent relapse, and prevent overdose, we must shift the way we frame the issue. That begins by acknowledging that those who suffer from addiction are people. The way we talk about them and their struggles can either be helpful or harmful.

In short, to practice good “sober etiquette” and address inaccuracy and confusion around addiction, we need to first talk the talk.

If you or a loved one need help to begin addiction recovery, contact us today:

References:

Buchholz, K. (2019, November 8). Substance Abuse Touches Around Half of All U.S. Families. Statista Infographics. https://www.statista.com/chart/19899/us-families-affected-by-substance-abuse/