Four Well-Meaning Things Not to Say to People Who Struggle With Drugs

Nov 14 2016

Four Well-Meaning Things Not to Say to People Who Struggle With Drugs

November 15th, 2016

We know what they say about good intentions and the road they pave. And while you won’t catch me attacking people for doing what they genuinely believe to be helpful, there’s a kernel of truth in the old cliché.

As a person with a long history of substance use, a criminal record that could fill the pages of a short novel and multiple mental health conditions, I have some experience of well-meaning people and their good intentions. Unfortunately, these often cause more harm than good—and even words that are kindly meant can be hurtful and damaging to vulnerable people.

The following isn’t intended as an exercise in political correctness, but language does matter. Readers of The Influence will understand the stigmatizing quality of terms like “junkie,” “alcoholic” and “addict”—words which carry not only immediate negative consequences, but also encourage us to assume disempowering, limiting identities (though I don’t question people’s right to attach those labels to themselves, if they so choose).

You’ll understand, too, how describing someone as “clean” when they pass a drug test implies that they—and other people who use drugs—are “dirty” when those tests produce positive results.

But there are more subtle examples of phrases—usually used by truly compassionate people—that reinforce the message that people who use drugs or struggle with them, or are living with mental health conditions (which often co-occur with substance use disorders) carry less social value, or even present some social burden to the rest of us. Here are some of them.


1. “Every Overdose Victim Is Somebody’s Son/Daughter/Brother/Sister/Parent/etc.”

As someone who co-founded an overdose prevention organization, I find myself having to bite my tongue more often than I’d care to admit. Often, but especially around International Overdose Awareness Day, the memes proliferate, proclaiming that every overdose victim or person struggling with addiction is someone’s “child”, “sibling,” “parent” or some other close relation.

This seems harmless enough. But let’s take a moment to unpack what’s being said here.

Why should my value as a person be defined primarily by my relationships to others? I am not simply someone’s son, brother, friend, father. (I am, in fact, all these things.) But I—like the millions of others who use or have used drugs—am so much more. We deserve dignity, respect and compassion on our own merits.

Subtly selecting people deemed more “worthy” of our tears than the marginalized people who overdosed is reductive, insulting and harmful. It’s reminiscent of the idea that we should feel sympathy for victims of rape because of how we’d feel if it happened to our mother, sister or wife.

If your argument for showing someone compassion is based only on the impact their death or suffering has on someone else deemed to have greater social value, it speaks volumes for your view of that individual’s own worth.

I know the people who produce these images and spread them around Facebook have good intentions. But if they truly want to help, they might begin by centering their arguments around the innate value of directly-impacted people’s lives.


2. “We Need to Keep Them Alive Until They’re Ready for Help”

This is one I myself used until recently—long after I was exposed to the principles of harm reduction and should have known to be more mindful.

Anyone who has studied the data in this field knows that some people who experience problematic relationships with drugs find that the best path for them is to stop using, while for others, abstinence is not the answer. This phrase makes the mistake of implicitly assuming that everyone fits neatly into the first category.

Worse, it suggests—often unintentionally—that keeping someone alive is something we need to do only because of the possibility that they will eventually seek help or quit. That’s a toxic line of thinking which, again, places greater value on the lives of those who behave in ways deemed socially acceptable.

A person struggling with harmful effects of drug use deserves life and the health services required to keep them alive—not because of certain possibilities of future behavior, but because their life has innate value here and now. And it will remain equally valuable whether they continue using drugs or not.

I regret using this phrase. I’m not going to beat myself up over it, though—and I wouldn’t want anyone else to, either. Instead, let’s all learn to be more mindful of the consequences our words can carry and move forward.


3. “I’m So OCD / ADD / Like, Totally Bipolar This Week”

We all display symptoms of different mental health disorders, even when we don’t actually have them. And casually talking as if we or people we know do have them—”he’s schizo,” “she went psycho”—has become part of everyday conversation.

But there are two huge problems with casually throwing around terms like these. First, living with depression, bipolar disorder, borderline personality disorder, obsessive-compulsive disorder and so on, can be incredibly debilitating. When a high-functioning person with no significant mental health issues throws these terms around without educating themselves about the actual conditions, it minimizes and trivializes the pain and struggles that impact our daily lives.

Second, throwing these terms around also makes identifying the real symptoms of these disorders, and the consequences faced by those of us living with them, that much more difficult.

It took me well over two decades to find help for my bipolar disorder—long after it had wreaked havoc across my life and the lives of the people I care about. It wasn’t so much the stigma I feared as the thought of facing a mental health professional who either didn’t take my symptoms seriously (like the many family practice doctors who tried to quell my complaints with the latest popular antidepressant) or who told me it was all in my head.

Looking back, I realize this was a classic symptom of the anxiety disorder with which I’ve also diagnosed—although I never would have known that before, given my poor understanding of anxiety rooted in popular misrepresentations of the condition.


4. “Directly-Impacted People”

This is a sensitive subject; so much so, I had a difficult time deciding how—or even whether—to approach it for this article. The pain suffered by people who have lost family members or other loved ones to overdose, drug mixing or alcohol poisoning—or are instead painfully watching loved ones struggle with substances—can’t be overstated. I grew up with constant reminders of that and face it myself every day. It is important and people who suffer from it deserve our love and support.

However, in our rush to console those folks, we often overlook the pain and struggles of the people who at the center of these issues: directly-impacted people.

You see, the person I lost to a drug overdose wasn’t my brother, parent, or child. He didn’t have any children and his family had cast him out years before. Me, my partner at the time and a handful of friends were all Nick had left pulling for him in this world. And I suspect we loved him more than his parents ever did.

Of course, when it came time to conduct a memorial service, Nick’s family held a private ceremony…to which none of us were invited. The people who actually loved him were denied the opportunity to say goodbye. To this day, it still feels like we were robbed of closure.

However, some good was born from losing Nick. My friends and I resolved that we would no longer make assumptions about relationships, or put the very real pain suffered by loved ones above the pain of the person struggling.

It’s part of recognizing the humanity of people who use drugs as, in every way, equal to everyone else’s. And not only that, but respecting their decisions to live their lives, through whatever problems they’re dealing with, as they see fit—and being there to provide compassion and support when they need it.

Jeremy Galloway is harm reduction coordinator at Families for Sensible Drug Policy, program director at Southeast Harm Reduction Project, co-founder of Georgia Overdose Prevention, and a state-certified peer recovery specialist. He lives in Atlanta. He writes and speaks regionally about drug policy reform, harm reduction, his experiences, and the importance of including the voices of directly impacted people in policy decisions. In his last piece for The Influence, he covered the nationwide prison strikes that began in September.

  • Marilee Odendahl

    Wonderful article Jeremy. Thanks for your careful reasoning & explanation of how the words and phrases we use define how we think about those we apply them to. I am particularly grateful for your pointing out the way people blithely & ignorantly throw around phrases having to do with mental illness. My son Ian, who died of a heroin overdose, struggled mightily with the stigma attached to the combination of his bi-polar diagnosis and his heroin dependency. I believe it was the combined stigma of the two that prevented him receiving the help he wanted & so desperately needed. You summed it up perfectly when you wrote, “When a high-functioning person with no significant mental health issues throws these terms around without educating themselves about the actual conditions, it minimizes and trivializes the pain and struggles that impact our daily lives.”

  • Sheila Wren Hand

    Great article Jeremy!

    I do feel it necessary to comment on directly- impacted people.

    I would never put the pain of anyone above the pain of the person actually suffering from a struggle with drugs. My daughter struggled with addiction and mental health issues for more than ten long yeas before she died. I KNOW that nobody suffered the way she did.

    I also agree that the people closest to the person who dies due to their drug use may be friends who have stuck around when things got tough. The parents may not seem involved or even in contact.

    But the parents have loved their child immensely despite not seeming to have been in their lives at the end.

    Many parents have cut off contact with their loved one.

    NOT because they didn’t ever love them that much. Because the so-called “experts” told them to.

    Loved ones are often lectured about “tough love”, “enabling”, and “letting the user hit their bottom”.

    Most people who practiced “tough love” in the grief groups I am a member of now regret it.

    It is unfortunate that our culture is so steeped in 12 Step programs and the abstinence model of treatment and Recovery. The concepts they promote can be dangerous and ineffective!!

    Harm reduction needs to be widely adopted, in my opinion.

  • Tesa Hayashi

    Good article, but as a person with mental issues, I have to correct you: It IS all in your head.

  • Gaynelle

    It’s a good article. However, as a person with more relatives than I can count who have SUD, I respectfully disagree with the notion that reminding people everyone who has SUD is someone’s loved one is dehumanizing. For one, we are social beings, it is in the fabric of our humanity. Also, I found that I gained my voice to speak out when I realized the scope of just how many of us are directly related to someone with SUD. I remember the moment clearly, because I was in crisis, having lost my mother to addiction when I was only 15 years old, and facing the prospect of losing my teenage son. I didn’t know why it never dawned on me before, but I thought, “One in 12 people over the age of 12 have a diagnosable substance use disorder, and they all have mothers (and fathers, and possibly brothers and sisters, and spouses, etc.)” I laughed and cried out loud, “Who do we think we’re fooling?” I think the admonition to remember everyone with addiction is someone’s loved one is a reminder, we are family. We need to remember that, withhold judgement, and care for one another.