This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.
Addiction is an issue that impacts almost everyone in some way. I’ve been in recovery from alcoholism/addiction since January 2008. During that time, I’ve gone through ups and downs but have fortunately managed to stay sober. I’ll be answering a reader-submitted question about recovery every other week (information on how to submit below). I’m not an expert or mental health professional, just a sober person offering advice based on my experience and the research that’s available. This week, I’m talking about the updated Associated Press guidelines for writing about addiction and why I’m OK calling myself an addict.
I am a freelance journalist and recently saw the AP Guidelines changed for how to write about addiction. One of the changes they stress is not calling people addicts. Seeing as your column is called Ask an Addict (and the few sober people I know also refer to themselves as alcoholics or addicts), I’m wondering what your thoughts are on the AP changes.
I’m glad you are asking this question. The language around addiction, substance use and recovery is messy, ever changing and fraught with more controversy than one might expect.
Pre-Alcoholics Anonymous in the United States (and maybe elsewhere) an inability to control one’s drinking or drug use was seen as a moral failing—something some old fashioned willpower could overcome. If it couldn’t be overcome by sheer force of will, it was a moral, not medical, malady.
When Alcoholics Anonymous was established in 1939, the founders had the belief that addiction was a “mental, physical, and spiritual disease.” Although the “spiritual” component of AA now is the root of many critics’ rebuke of AA, at the time, the notion of addiction as a disease was fairly progressive. If you couldn’t stop drinking, you weren’t just a jackass; you were a person with a physical disease and a mental obsession who was also possibly a jackass. But at least your jackassery was part of the problem instead of the entirety of it.
Reducing the stigma of addiction was (and is) a slow process. The people who found themselves in AA in the early days were either people who were already stigmatized (i.e., known drunks) or so desperate they were willing to risk stigmatization if anyone found out (the anonymity component helped with this, but it was still a risk). Further, early members often “carried the message” to the alcoholics who were in hospitals or institutions—the people many in the recovery world call “low-bottom drunks.”
Many people find that their substance use isn’t accurately described by the word “addiction.” Someone who is drinking heavily for a certain period of time may indeed require treatment but doesn’t have the compulsion that’s characteristic of addiction. In short, the lines of addiction were never as black-and-white as people were led to believe. As we increasingly understand the nuances of humans’ relationships to substances, the language we use to describe those relationships must evolve as well.
The difference between dependence and addiction is highlighted in The Associated Press’ updated guidelines for writing about addiction. Their guidelines take important steps to make these distinctions clear and offer guidelines for getting rid of outdated language. The recommendations include avoiding using “words like alcoholic, addict, user and abuser unless they are in the name of organizations like Alcoholics Anonymous.” Instead, the language should reflect the way we talk about other medical conditions, putting the person first and separating them from the condition itself. The guidelines state, “choose phrasing like he was addicted, people with heroin addiction or he used drugs.”
As Zachary Siegel notes in Slate, this reflects how we talk about other medical conditions. He says, “we don’t call people diagnosed with Type 2 diabetes ‘sugar abusers.’” Medical conditions can and should be discussed without language that elicits shame or stigma. And according to a 2010 paper, research shows that the language we use to talk about substance use disorders and addiction really does impact how people think about folks with those conditions. A paper by President Obama’s former drug czar, Michael Botticelli, states, “Research shows that use of the terms ‘abuse’ and ‘abuser’ negatively affects perceptions and judgments about people with substance use disorders, including whether they should receive punishment rather than medical care for their disease. Terms such as ‘addict’ and ‘alcoholic’ can have similar effects.”
So, to finally get to your question, Journo, (and thank you for bearing with me), how can I think these guidelines are a good idea and also be comfortable calling myself (and this column) an “Addict?” There are a number of reasons, from the superficial to the important. Superficial? “Ask a Person Who Has an Addiction” is a mouthful. It’s an accurate mouthful, but still. More important, however, is that I am an addict. I’m a lot of other things, too, but an addict is one of them. And I’m OK with that “label.”
When I call myself an addict, it’s a way of reminding others and myself that I can’t use substances the way many other people can. Also, I don’t think being an addict is a bad thing. I know society at large doesn’t share this sentiment but addicts—those who use that descriptor about themselves or people who have addictions—are some of the best, smartest, most compassionate people I know. And if this column can do anything to change the association some people have with the word “addict,” I’m happy.
Here is what I try very hard not to do—I try not to call people addicts or alcoholics if they don’t choose to be identified by those terms. The author of the Slate article is a colleague and friend. He’s also a person who used to have a heroin addiction. In his piece about the AP guidelines, he says, “For me, being called an ‘addict’ defines my humanity with one small facet of my identity, essentially erasing the rest of me.” This is an equally valid and reasonable assertion. The AP guidelines are an important step forward for everyone who cares about more compassionate treatment for people struggling with substance use disorders and addiction. They’re excellent guidelines for how to describe people with those conditions if you’re a writer. As for me? I’m still an addict. And you can ask me anything.
Paste contributor Katie MacBride is a freelance writer and the associate editor of Anxy Magazine. Her work has appeared in Rolling Stone, New York Magazine and The Establishment. Every other week she will answer one recovery/addiction related question posed by our readers, based on her experience. Email questions to email@example.com with Ask Katie in the subject. By emailing, you are agreeing to let Paste publish your email. Emails may be edited for length.