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Words can hurt the cause

April 03, 2017

As someone who caught the writing bug from the first exposure (an extra-wide red pencil and a sheet of paper with spaces a barge could navigate were the first tools of my trade), I have never doubted the power of words. The language we use can educate, even elevate. Too often in the substance use field, though, words inflict damage.

Our feature article posted today explores the language of the substance use treatment field and how commonly used terms can perpetuate stigma and discrimination. In issuing a January memorandum urging executive-branch departments to consider revising the language commonly used in their communications, former national drug policy director Michael Botticelli left his final mark among many noteworthy accomplishments.

I interviewed the Massachusetts resident and Boston sports fanatic for this article in February, on what for him was a euphoric morning after New England Patriots quarterback Tom Brady cemented his gridiron legacy. It might surprise some that a national drug policy leader who put a human face on recovery and had a major hand in the growing support for treatment sees changing the lexicon as his legacy issue. But Botticelli says a look toward the field's colleagues in mental health clearly illustrates how eliminating pejorative language can play a direct role in securing a community's place at the table.

If you're not sure if words really matter, consider this. When was the last time your GP looked at your test results and told you, “Your blood work came back dirty”?

As much as words matter, images also make a difference. Treatment and recovery advocates have long lamented the media's tendency to place images of drug- or alcohol-using individuals alongside coverage of field news. This arose again last month when The Hill included an image of someone shooting heroin when it published a column from the Coalition for Whole Health on the need to preserve mental health and substance use disorder coverage in any new healthcare legislation.

Trade publications aren't immune to the criticism, either. I experienced it early on, in the very first print issue of Addiction Professional in 2003. Our cover image, for an article on how programs should manage relapse (itself a controversial term), depicted two hands clenched around a drink. We heard about that decision.

It is important to emphasize that this discussion isn't intended to be about banning language. There are probably numerous reasons why no one soon will be launching a move to rename the National Institute on Drug Abuse, or many other agencies. NIDA's budget arguably carries considerably more importance than its title right about now.

Words such as “asylum” didn't just magically disappear overnight on the mental health service side. It is an evolutionary process. But as our article suggests, service providers are engaged in an important analysis of how the language they use affects patients, families, and those we enlist to protect their welfare.

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