Idioma

Rechazamos el lenguaje envenenado sobre la adicción que mantiene a millones de estadounidenses enfermos y en las sombras.

Este lenguaje dañino alimenta las barreras psicológicas, como el estigma, la vergüenza y el miedo, que impiden que el 90 por ciento de las personas que necesitan atención acudan en busca de ayuda.

De acuerdo con nuestro compromiso con la calidad y la ciencia, utilizamos un lenguaje coherente con el lenguaje de la ciencia, la medicina y otras enfermedades crónicas.

 

 

Words we don't like

Those that are prejudicial, those that are focused exclusively on consumption, those that are designed for reimbursement rather than wellness, those whose connotations have evolved in such a way as to render them no longer helpful and those that serve to distinguish this chronic disease from others:

  • Alcoholic – This word belongs in a museum of infamy; along with its short list of brethren that, by their very utterance, can inflame, incite, condemn, castigate and even cause death. We say, “Alcoholic, RIP.”
  • Addict – This word fails the tests largely because it is not person-centered. It probably also carries with it its own fair share of baggage.
  • Abuse(r) – This word fails the tests for many reasons, including: “(1) it negates the fact that (addiction) is a medical condition; (2) it blames the illness solely on the individual… ignoring environmental and genetic factors, as well as the (substance’s) abilities to change brain chemistry; (3) it absolves those selling and promoting addictive substances of any wrongdoing; and (4) it feeds into the stigma experienced not only by individuals with substance use disorders, but also by family members and the treatment/recovery field.” - Substance Use Disorders: A Guide to the Use of Language. William White – 2004.
  • Any slang references to people (e.g., junkie, doper, drunk) – These words fail for what we think are obvious reasons. And, the fact that many survivors choose to apply such labels to themselves or others (perhaps as badges of honor) doesn’t change their prejudicial nature.
  • Dependency – This word, when applied to those suffering from addiction, fails the tests because it focuses on only one of the numerous symptoms of this chronic disease.
  • Clean/dirty/sober – These words are of no medical or scientific utility and yet, they are clearly focused exclusively on consumption and they certainly reinforce society’s ignorance about the disease.
  • Relapse – While innocuous enough on its face, connotations of this word have become so closely associated with a return to consuming a substance as to render it of no further use. “The term has negative connotations for it often has projected a tone of moral judgment.” (White)
  • Rehab – Here’s another word for the museum. It’s as if this word were invented just to perpetuate stigma. Contributing to its disutility are:
    • An endless parade of celebrities cycling in and out of “rehab”
    • Reality TV’s glamorization and/or degradation of “rehab”
    • Society’s lack of confidence in the efficacy of “rehab”
  • Treatment – While a solid case can be made to salvage this word (since treatment is a term associated with patients receiving a certain level of care along a chronic continuum), the tiebreaker in favor of its rejection is the behavior and performance of the “treatment” industry. This word has become only marginally less prejudicial than “rehab.” One could even argue that derogatory connotations of treatment are well earned.
  • Drug or alcohol problems – While there are surely people with drug or alcohol problems, we concern ourselves only with those suffering from addiction. People suffering from addiction have a myriad of symptoms, only a fraction of which are directly related to drugs or alcohol. We will leave to others the resolution of “drug or alcohol problems.”
  • Habit – This word, typically the subject of a drug or alcohol adjective, when used to describe the behavior of a person suffering from addiction, is particularly offensive. It ignores science and minimizes the difficulties in cessation of consumption.
  • Problem drinker – By this point in this piece, the shortcomings of terms like this should be apparent. It is focused on a problem rather than a disease and is exclusive to consumption.
  • Substance use disorder – The shortcomings of this phrase almost deserve a separate web site. And yet, for many of the “experts” in these fields, this is the new generally accepted phrase. Before we get into why this phrase is so objectionable, consider for a moment what the “experts” adopting it says about the fields.
    • It focuses exclusively on consumption.
    • It ignores the fact that addiction is a chronic disease.
    • It is designed to accommodate reimbursement more than it is wellness.
    • It distinguishes this disease from other chronic diseases. We don’t call diabetes or hypertension, “nutrition and lifestyle disorder.” There are five many diseases to which consumption, lifestyle, behaviors, the environment, genetics and a host of other things contribute.

Words we like

Those that are factual and that don’t suffer from prejudice or at least the level of prejudice of the discarded poisoned language:

  • Addiction – Everything we are and everything we do are focused on addiction, as defined by the American Society of Addiction Medicine. In our view, ASAM is the most credible organization with the most comprehensive definition in a field where credibility and comprehensiveness are often lacking.
    • Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
    • Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. (American Society of Addiction Medicine)
  • Chronic disease – A chronic condition is a disease that has one or more of the following characteristics:
    • Is permanent;
    • Is progressive if unmanaged;
    • Is caused by nonreversible pathological alteration;
    • Requires special training of the patient for rehabilitation, self-monitoring and self-management; or
    • May require a long period of supervision, observation, or care.
    • Addiction is a chronic disease. End of discussion. To the best of our ability, we confine our references to the disease, its symptoms, its treatment, its management and survival to the language of chronic disease.
  • Survivor – We believe this word is the generally accepted, people-centered word applied to people with chronic diseases.
  • Remission – A state or period during which the symptoms of a disease are abated. (National Institute of Health)
  • Addiction management – People with chronic diseases manage them.
  • Disease management – A system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. (Population Health Alliance)
  • Patient – People who receive care from health care and/or specialty providers are patients.
  • Customer – People who access products and services from non-medical providers are customers.
  • Population health management - An approach that aims to improve the health status of the entire population through coordination of care across the continuum of health in order to improve behavioral/lifestyle, clinical and financial outcomes.
  • Symptom-free – A point when patients or customers no longer have symptoms.
  • Symptom recurrence – A return of a symptom
  • Wellness – Wellness is a conscious, self-directed and evolving process of achieving full potential. Wellness is multidimensional and holistic, encompassing lifestyle, mental and spiritual well-being.
  • Medical home – An approach to the delivery of primary care that is:
    • Patient-centered: A partnership among practitioners, patients, and their families ensures that decisions respect patients’ wants, needs, and preferences, and that patients have the education and support they need to make decisions and participate in their own care.
    • Comprehensive: A team of care providers is wholly accountable for a patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care.
    • Coordinated: Care is organized across all elements of the broader health care system, including specialty care, hospitals, home health care, community services and supports.
    • Accessible: Patients are able to access services with shorter waiting times, "after hours" care, 24/7 electronic or telephone access, and strong communication through health IT innovations.
    • Committed to quality and safety: Clinicians and staff enhance quality improvement to ensure that patients and families make informed decisions about their health. Source: Agency for Healthcare Research and Quality
  • People-centered words – We embrace people-centered descriptions of people and families who suffer, those who are being treated and those who achieve wellness and survival.