Words Matter

Words Matter

Written by and for people with Lived Experience - Port Alberni Community Action Team - Families Helping Families

Today’s Learning Moment – 06 13 22 Issue: Words Matter.
Note: This is an opinion/commentary article reflecting the author’s views.

I used the term “people with substance dependency” in a recent article. A reader commented; you mean “addicts or addiction?” He posed a question that, on its surface, seemed genuine. Instantly, I went into education mode. I’m not one to miss an opportunity to explain why we need to shift our language when describing anything to do with substance and mental health topics.

I don’t consider myself naïve. On the contrary, past interactions on social media have taught me that many people have unshiftable biases or even critical thinking challenges. On top of these two significant problems, social media removes many people’s filters.

Critical thinking is fascinating. Someday I’ll write more about it because the application of critical thinking by ALL of us is that important. If you haven’t encountered the term, here are two links to get you started.

·         https://en.wikipedia.org/wiki/Critical_thinking

·         https://www.criticalthinking.org/

Let’s get back to why words matter. You would think that biased people, critical thinking issues and commenting before you engage your brain should cover most of the challenges around language. However, there is one more significant mindset you are likely to encounter. Some people hate anyone or anything associated with mental illness or using substances. Their thinking and views go well beyond bias and intolerance straight into bigotry. It’s one thing to have an unconscious bias because of decades of systemic opinions on mental health and substances. It’s a whole other thing to detest the very existence of a group of people because of their health circumstances.

In the past, we banished people with Leprosy. Fear and hatred fueled our treatment of Lepors. So it is with stigma toward people with mental health or uncontrolled substance use challenges. Hate and stigma minimize people. That allows some of us to see them as less than human and is the first step in absolving ourselves from caring about them. In other words, it’s our intellectual version of banishment. We think it’s not the same as physically exporting people to a remote island somewhere as we did with Lepors; it’s no big deal. Sadly the net result of stigma is precisely the same – You can be just as banished on a busy city street because you have concurrent disorders as you would have been if you were a Lepor.

Let’s get back to education opportunities. When I decided to respond to this commenter’s question, I knew any conversation thread would likely go off-kilter. However, the chance to educate often isn’t with the biased person trolling on social media or a heckler at presentations. Instead, it’s an opportunity to reach all the silent majority who may be sitting on the fence (those that haven’t completely made up their mind) and persuade them to consider a new language standard. One that reduces stigma and retains the humanity of people.

Yes, you guessed it, the conversation thread went utterly sideways. So, I had to apply my other social media conversation rules judiciously. Delete, delete, delete and refuse to engage further, no matter what they try.

However, the whole mess got me thinking about words and the importance of changing our vocabulary around substance and mental health topics. More importantly, the idea of providing some helpful knowledge for others with some fundamental tools when you face similar questions on words we use.

To start us off, here is a short list of some terms we’re shifting away from versus more human and respectful terms:

Old Term	Preferred New Term
Addict	A person who uses substances
Addiction	Dependency
Crazy	Mental health syndrome
Disorder	Condition
Disorder	Syndrome
Drug User	A person who uses substances
Nut Case	A person with mental illness
Junky	A person with substance dependency
Loonie Tune	A person experiencing severe mental illness

Language is fluid. Even as I write this, peers with lived experience are challenging some words on the preferred list. For example, some people consuming substances don’t see their use of drugs as a disorder, or to them, the term already has enough of a negative connotation to make it stigmatizing. In addition, their view is that there is a vast difference between a person whose substance use is uncontrolled and harms themselves, family, friends and community versus someone who has control of their substance use decisions. For one group, the word disorder might clearly define their condition; for the other, not so much.

That connects to another essential principle. The audience we use words with can be crucial. For example, the word disorder is widely used in medical audiences because it is a technical term for them. However, a better word would be syndrome, even in professional medical groups. The word disorder is already a dirty word within the substance use community. It is also finding less favour in some medical circles.

Nevertheless, it will probably be a very long time before medical professionals drop disorder from their general vocabulary. Instead, they use the term ubiquitously across many health conditions. Consequently, when talking to medical professionals, you’re likely to hear them refer to uncontrolled drug use as a substance disorder. Here is further reading on the word disorder.

To further explore the connection of language with your audience, the word addict is almost a badge of honour in some peer circles. I have heard peers describe themselves as addicts proudly. For them, it is a term earned by surviving the horrors of addiction, homelessness and their recovery journey. They won the right to refer to themselves using such words because they felt it gained them back a sense of power over their experiences. Some will even call out the rest of us by telling us to call it what it is. A spade is a spade to these courageous people. However, just like other marginalized groups in our world, they earned the right to refer to themselves in whatever manner resonates for them. The rest of us have not. Never be lulled into thinking it’s ok for you to use their language. They belong to an exclusive club the rest of us can never fully appreciate, and hopefully, a club in which we will never be a member.

Specific groups of people play a crucial part in the words you might use with them. For example, if my message targets blue-collar men, the words I use must resonate with them. At the very least, I might have to use old language alongside preferred terms. Using different words for different groups has one other consequence. You will end up having to keep track of your audience. For some of us, keeping up with what terms we use with who we communicate can be challenging. However, driving a clear, concise understanding of your message should be one of your highest priorities. Talking in language people don’t understand does nothing for anyone.

If you’re going to use less preferred words, quickly explain why you’re doing so. That way, you can introduce newer terms and people in your audience will begin to connect the dots. They’ll link old stigmatizing words to new words. That begins shifting and educating everyone.

Time to get down to brass tacks and discuss specifics around the words we use. Here’s the most important reason we’re shifting the language we use. It is all about stigma. How we perpetuate and sometimes even increase stigma in organizations and society. We call this social and systemic stigma. The personal burden we put on the very people most harmed by our words is even more crucial. Research evidence-based knowledge and observations tell us that using the wrong words harms people’s self-concept, spirit, and access to hope. The result is that WE create further trauma for them. Yes, that’s YOU, Me and our communities. It’s scary to think we have contributed to someone’s relapse or created barriers preventing them from reaching out for help.

We worsen the trauma committed to them; usually, at the very point in their journey, they’ve chosen to begin to heal (when they contact the system). The net result is people end up back in the nightmare they’re trying to leave. – craving or using substances again to dull their pain. However, it now comes with compounded feelings of lack of self-worth, inadequacies and guilt. We have the tremendous opportunity to break this cycle simply by using language that acknowledges them as humans and lifts them up in their path towards healing.

Then we run into the general public; we must understand that as much as sixty percent of society does not support enlightened mental health or substance use and treatment models. A portion of that group, let’s say ten percent is so polarized from newer concepts that they scream with a fevered passion seldom seen on other social issues. The good news is that in British Columbia, that leaves 2.8 million persuadable people. Do we create messages for our mental health and substance use community? Nope! If we are to make a real difference in stigma, our communication strategies must influence these persuadable people and be in terms they understand.

Let’s take apart a single word, so you have an insight into a process you can use to address answers to people who question the evolution of new terms. Be ready; many of those asking questions or commenting may not come from a sense of genuine curiosity.

Substance dependency versus addiction: Addiction is a word which is a more general term used to describe all kinds of behaviour or physical cravings that have become destructive or uncontrolled to the person, their family or community. Some well-known examples are gambling, shopping, cell phones, computer gaming, porn etc.

Because we specifical focus on chemical dependencies, we use the word (substances). It gets to the heart of our work. We use (dependencies) because, with newer evidence-based research, we know that it is a health concern when substance use becomes uncontrolled, not just a choice. Hence, the term (dependency) is a more accurate description of an individual’s health challenge.

Also, there is the stigma aspect of the word addiction. Over the years, the term has become highly derogatory. It's gained its offensive reputation from hundreds of thousands of eye rolls when someone used the word with disdain in their voice over dozens of decades. Many people struggling with substance use dependency have told researchers that even hearing the word causes them extreme distress AND often creates barriers for them when they finally are ready to seek help. (Nothing is more stigmatizing than laying on an ER bed and overhearing your nurse refer to you as an “addict” or “he/she has an addiction.”)

Language is important. Think of some of the words used in the mid-twentieth century to describe people of different races or ethnicities. We seriously frown on those words today for excellent reason. Terms like addict and addiction are leaving our lexicon for the exact same reasons. We hopefully are evolving. You can be a part of that evolution and help everyone get there faster. Use words wisely because words matter!

Note: We have deliberately arranged several paragraphs so that you, the reader, can easily copy/paste them when needed. (should you need to provide a ready answer for someone on your social media)

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Author: Ron Merk  – Ron is an advocate for families with loved ones who suffer from concurrent disorders. He also writes on various topics driving understanding to a more enlightened substance use policy in British Columbia and Canada.

Families Helping Families is an initiative of the Port Alberni Community Action Team. We regularly send out “Learning Moment” articles to help folks understand substance and mental health illnesses. Knowledge is vital in understanding the disorders of our family members. You may copy, distribute or share our articles as long as you retain the attribution. Add yourself to our distribution list by dropping us a note at - albernihelp@gmail.com