Why I Can't Accept Johann Hari's Defense of the Word "Addict"

Apr 08 2016

Why I Can’t Accept Johann Hari’s Defense of the Word “Addict”

Johann, we have a problem.  

In your article on The Influence last week—“Should We Stop Using the Word ‘Addict?'”—you conclude, despite reservations, that no, we should not stop using it. You write:

“We have abandoned the terms ‘negro’ and ‘homosexual,’ because they do have older, uglier associations that nobody wants to revisit. I can understand why people think—over time—the word ‘addict’ may go that way. That’s why I’m open-minded—despite having some reservations—to the idea that a better term may come along. But my biggest worry is that the alternatives that have been proposed so far are actually, alas, worse.”

I appreciate your work to travel the world and tell the stories you artfully weave throughout your book, Chasing the Scream. You even quoted me in it. Thank you for that.

But we have a problem. A big one. Not you and me, but me and millions like me, and you and millions like you. It’s about who gets to decide if the word “addict” is okay to use to describe other people who are addicted to or struggling with drugs. And it’s about precisely how urgent this issue really is.

You write:

“When I argue for greater compassion towards addicts, I often get somebody replying who says something like: ‘Then you shouldn’t call them “addicts.” Stop using that word.’ It’s a serious argument, and one that is worth thinking through in public. I feel divided about it.”

You’re right that this is an issue worth thinking through in public. But I am not divided about it. While I do appreciate that you express some empathy for the millions of us trapped under that label we never asked for, you stop short of supporting our right to be free of it, immediately, citing your “reservations” and “worry.”

What is your right to have reservations and worries about how stigmatized people choose to fight their stigmatization? I am on the record as a person who struggled for many years with a serious alcohol and drug problem. You are not. So this is not your humanity at stake; it’s mine—and that of many others. And I’m fighting for it.

I am a woman with the lived experience of so many people, of internalizing the stigma of my drug use—of feeling not regarded as a whole, individual human being with thoughts, feelings and dreams. As I write this, if you type the phrase “drug addicts are” into Google, do you know what pops up? I’ll save you the effort: Apparently we are “selfish,” “losers,” “pathetic,” “criminals,” and “not victims.” And guess what kinds of things you see if you Google “drug addict meme”? This is the stigma we face, right now, today.

I was labeled and regarded as “an addict,” lumped into that big, mushy linguistic pit for the convenience of others. People found it easier to talk about me and my problems when they could reduce me to that one word. And when I first reached out for help, I was told that I was an “addict” (and an “alcoholic”) and that I would always be one, forever, because “once an addict, always an addict.” Even treatment centers call their clients “addicts.”

That was a bitter pill. It seemed to me the only people who felt okay about being called “addicts” were people who no longer used drugs. For everyone else, “addict” remained a shaming, hurtful slur. I didn’t know a single active drug user who enjoyed any kudos in identifying herself as an “addict.” The opposite was true. I didn’t want to own an identity riddled with stigma for the rest of my life because I sought help for a problem. I just wanted help for my problem. It was confusing and painful.

I kept all of this to myself for many years because like so many others, I internalized the shame of it. I’m still reluctant to tell my full story because I am aware that doing so risks exposing me to the scorn of colleagues, potential employers or average citizens. Research confirms I’m right to be worried about it. It absolutely happens. There’s even a technical name for how I manage my internalized stigma: secrecy coping. It’s how many people with drug problems deal with and hide the worthlessness, fear and shame that we experience from our stigmatization.

And for people like me who do not claim to be “working a recovery program,” disclosure is particularly risky. Even though I have not used drugs problematically in 20 years, in many people’s eyes, I may always be “at risk” of relapse and still an “addict”—a word, as I have written before, so singularly loaded with stigma and contempt that it’s appalling we continue to let it be used so indiscriminately.

Still don’t believe me? Then try to think of an example of a one-word identifying noun relating to a person’s mental or physical health issues that remains acceptable in public life. “A Down’s Syndrome,” as you noted in your article, is out, as is “a spastic.” What about “an epileptic”? “An autistic”? Still no luck?

It’s easy to think of examples, however, that were once used, but are no longer okay. Here’s one: “cripple.” Can we say “a cripple” any more, despite its pithiness as a way of denoting people with physical disabilities? Of course we can’t. We know it’s disparaging. So instead, we take the very slight trouble of saying “people with disabilities.”

So why might “addict” be seen as an exception to this rule? I’ll suggest two factors.

The first is that a significant number of people choose to self-identify as “addicts”—a choice I would argue is self-defeating, but one anyone has the right to make, nonetheless. If you want to call yourself an “addict,” peace be with you. It’s not my choice, but I get why you do it. Much of the internalization of the “addict” label originates in 12-step culture and many people have embraced it. Millions of us, however, did not and do not choose the 12 Steps as our path to wellness and have not internalized the “addict” identity. A person can call themselves whatever they want, and allow others to call them that, too. Many cultures and subcultures use in-group language to strengthen group identityBut you do not get to call me or anyone else an “addict” unless they identify themselves as such. It’s just that simple.

The second factor is that drug use and addiction are so unusually and profoundly stigmatized that people don’t find it necessary to extend the same respect to those affected as they would to people with other health conditions.

Like “cripple,” the term “addict” instantly others people, drawing a line between us and themWhile it’s important, as you note, to fight to deconstruct the stigmas and prejudices about addiction and drug use that drive the power of the word, we should still cut it from our vocabulary while fighting that good fight. We fight for the rights of people with physical disabilities without calling them “cripples.” Even if a person “caused” their own “crippling” by engaging in risky or foolish behavior (which is how many think of people using drugs), we would still respect their right to be regarded as people first.

Stigma has real-life consequences for people struggling with drugs. They are more socially isolated and less likely to seek treatment. These are facts. Words do indeed have the power to harm and “addict” is not the only phrase in this field that we should avoid.

All marginalized groups—women, people of color, gay people, people in poverty and others—must struggle for their rights and their dignity. It’s a shame we have to work this hard to be seen as people deserving of basic respect, but that’s where we are.

I’m relatively lucky. I’m a white, employed, middle-class woman. People will listen to what I say, even if they utterly disagree. But many people around the world who use drugs in ways that cause problems for themselves are denied the right to assert their own humanity in ways that you and I, Johann, would take for granted.

A black mother in poverty who compulsively uses meth has more to lose by going public, speaking up and demanding that we respect her as a person first, above any other labels we may wish to burden her with. So someone has to speak up for her, and all others like her. I’m honored to have that opportunity.

It’s been two years since I wrote “I’m Breaking Up with the Word Addict.” The response I received to that article was quite revealing, with some people trying to shame and silence me, telling me my lived experience is wrong—that I’m wrong—reinforcing my ever-present secrecy coping.

But with the culture of rights and dignity evolving so rapidly since then—the rise of Black Lives Matter, the Trans Rights movement—it now seems quaint at best and antiquated at worst to still be wondering if we should respect the request of people who use drugs problematically to not be labeled by us as “addicts.”

When even our drug czar, Michael Botticelli—a member of a 12-step program, and hardly the torch-holder for radical, cutting-edge social justice—calls on us to stop describing people as “addicts” because it makes them less likely to seek treatment, isn’t it time to let that word fade into obscurity?

And finally, Johann, isn’t it patently ridiculous to continue stigmatizing people as “addicts” simply on the basis that the word itself is quick and easy to use, and easy to understand?

I want to believe that typing “people with addiction” versus addicts” is not so onerous that you’re willing give up the fight of silenced people yearning to be treated fairly, for the sake of cranking out a pithier tweet. I know for sure that the phrase is no harder for anyone to understand.

And even if it is onerous to do this—may I be quite candid here?—I’m not troubled.

I’m not troubled if you are inconvenienced for a few seconds when wondering how to describe a woman struggling with chaotic meth use. I care about that actual woman struggling with chaotic meth use, whose humanity you are about to casually undermine.

For her sake, for mine—and really, for yours—please, let’s try to do better.

Woman in recovery; daughter struggling with heroin; son addicted to meth; friend battling a cocaine problem. There are many things we can say. Call it addiction, substance use disorder, addictive disorder, chemical dependence, a struggle, a battle, a journey. Call some “people who use drugs.” Call others “people addicted” to them.

But what’s vital, among everything else we must do, is to acknowledge our ownand other people’sinternalized negative feelings and beliefs about one specific word. Find a better way to talk about drugs and related human struggles. Just stop using the word “addict.”


Editor’s note: Johann Hari’s response to this piece can be found here.

Meghan Ralston is a drug policy consultant in Palm Springs, CA. She is the former harm reduction manager for the Drug Policy Alliance. Her previous articles for The Influence include “Rehabs’ Failure to Give Lifesaving Naloxone to Vulnerable Clients Is Unacceptable.” You can follow her on Twitter: @OverdoseGirl.

  • I’m a drug addict and alcoholic. Judge me at your peril.

    • Maurice Dutton

      Yes Mister or Miss Myth,
      people can lead normal lives & I believe that stigmatising with labels creates division within the broader community. Not long ago the top female executive for Toyota was busted entering Japan with a fairly good amount of Oxycontin without prescription. If she had not been busted no one would know that she was using these Opioids & also shows that people can perform at the highest levels of corporate America & keep their drug use under control, albeit not from a very serious customs agent though.

      • Lew Ricker

        Sorry to say, but unless you’re in the know at Toyota, and know for a fact all the background, there’s no way you can make a determination that this person was ‘performing at the highest levels’ of anything. Lots of people are carried along in life even when they aren’t performing. Happens all day, every day in America.

        • Maurice Dutton

          You have the wrong interpretation of Highest levels so I will spell it out for you. When a person is employed as an executive at a company they are at the highest level of employment except for CEO. So this woman who was employed as an executive would still be working at the highest promotion level as in highest female executive for Toyota and if she had not been busted and would still be there.

  • Marilee Odendahl

    My response to this article is precisely the same as my response to Ms. Ralston’s previous article “I’m Breaking Up with the Word Addict” – a hearty “AMEN!”. We can’t possibly believe that if we continue to use the same negative nomenclature imposed by the War on Drugs we can ever hope to dispel the pervasive attitude that accompanies same. The word “addict” is foundational – a flinty, puritanical keystone of the fortress built by the War on Drugs. The need to replace that catch-all/explain-nothing word with one, or several, that underscores our shared humanity and worth seems self-explanatory to me. I remember the verbal stutter of shifting to simple phrases like “African American” or “people of color” or “physically challenged”. It was a matter of acknowledgment of the importance of doing so for me to shift my speech to phrases meant to respect someone’s heritage or challenges – and our collective efforts in making those changes have helped in no small part to shift the content of the conversation on race and on disability. Words matter and we all know that they do.
    Thank you Ms. Ralston for a well-reasoned argument for doing the right thing.

  • April Smith

    Amen!!! You said exactly what I’ve been telling everyone who will listen. I refuse to be defined by difficulties I once had. I refuse to be labeled. You’re so right about this being particularly charged for those of us who don’t justify and apologize for ourselves by stating that we “work a program.” Excellent article. Sharing ! Bravo as usual to my favorite magazine ever !

  • Karl William Newton

    Hi Karl Newton here, author of ‘Get that Monkey off my Back’ about my own battle with addiction, results of studies I have done into the matter and an element of self help and also the book ‘Casting Stones’ which is a rally call from the front line of addiction and recovery for reform within the UK.

    I call be self a recoverist.

    My stance is one of us all being unique and wonderful and indeed complex human beings that can not be defined by one single term or word. How can you sum up a life time, in mine 32 years by one word or term?

    In meeting and training I always say
    My Name is Karl and I am………..ME!

  • Kenneth Anderson

    In HAMS we like to call ourselves “people who are changing our drinking habits for the better.” Or “have changed” if we have reached our goals.

    • Jesus Ken that’s a mouthful for introduction, I’d have to ask you to repeat. How about, ‘I’m Ken’ and let the other person make the judgement, ha!ha! In Solidarity brother.

  • Trond-Arne Ausdal

    Although I partially like what Hari is doing to battle “the war on drugs”, I have some problems accepting that just because he wrote a book about it, he now is the self-appointed go to guy when media and others need someone to weigh in on the problems caused by a failed drug policy.
    Why not ask us who ourselves have battled these things?
    He means only well, but it can be problematic when someone alone get the power to define the issues.

    Therefore your article was good and needed.

    Thank you 🙂

    (I am a Norwegian, also a former addict, receiving opioid maintenance treatment)

  • Jeff Zacharias

    How about we stop debating the use of the word “addict” and take that energy to getting on the front lines to actively help others? If you are or aren’t an addict or use a word to describe your story who cares how others perceive you? This is all word salad truthfully so stop defending your position and defend others who are dying every day from whatever word you want to use to describe their struggles.

    • Teilzeitwissenschaftler

      Did you read the article? At least it doesn’t appear to me that you understood it. Stigma impedes the initiation and the success of recovery. It blocks necessary political change. By defending her own position she is actually helping to identify the problems of the usage of the word “addict” and therefore in reducing its usage. This is important and effective.

      • Jeff Zacharias

        Um – yes I read the article and I fully understand her position. I’m quite versed in this area as I am a person in long term recovery, run a private practice working primary with this demographic and own a treatment center that is working with individuals/families/loved ones/spouses/partners that have these struggles. My point is for anyone to stop throwing out word salad defending words that may or not work for you. Take that energy and get on the front lines to help those who are in crisis and not sit behind a keyboard. I hope you’ll read this response and it doesn’t “appear to me that you understand it.”

        • Teilzeitwissenschaftler

          Nice to hear that you are actively contributing help. I totally agree that trying to come up with better sounding words just to replace “addict” won’t help anybody and is just a waste of time. But who do you refer to? Because your first comment seemed to me like you are talking to the author, but her position is clearly on the “stop using the word “addict”-side of the debate. And I hope, especially since you are directly involved twofold, you realize the importance of the public opinion towards substance use disorder.

    • Russell Newcombe

      Helping people and debating the implications of language are not exclusive activities. You can do both – they are both useful – and other things as well, eg. take drugs. Language evolves because humans change it. This is often a good thing.

  • Maurice Dutton

    Its the same for the adjective Junkie. This word originates from the homeless people around the twenties & thirties who would usually have a cart with their belongings in much as today & they would grab any loose metal they could cash out. So the police wanting to be derogatory started calling all people that very loosely fitted the description as Junkies. This is derogatory, stigmatising & paints people in a incorrect light to those who have very little idea of what substance use/ abuse is like. Many people either keep their problems to themselves because of this or just would not entertain coming out so to speak.

  • This us a long standing issue that has gone round the block a few times, I think this reply to Johann is, without doubt m, the most comprehensive response I’ve had the pleasure of reading for quite some time. My personal thoughts aren’t that uts the tag or title itself but the understanding, or lack of understanding, in the connotations. It has been whittled down to become a derogatory term by some, a. Overgeneralised term by others, and a stereotypical tag by yet others, even the definition is misleading in that it says, quite rightly, ‘A person who is addicted to a particular substance, typically an illegal drug’ I personally know quite a few blatant addicts who have never touched a drug in their lives, and who, funnily enough will openly admit their addiction, because there is no stigma attached to it. Another definition is ‘An enthusiastic devotee of a specified thing or activity’ for example a chocolate addict. No shame, no guilt and no denial in shamelessly chomping on a bar of bourneville, or cadburies dairy….Yet another definition states ‘A. Individual who is physiologically or psychologically dependant’ another misleading definition, there is quite a significant difference between addiction and dependence. What I have noticed with every single source that gives a definition, they all give an example related to drugs and, or drug use, this is where it is damaging. The old adage of shining a torch on one specific culture, group or individual automatically diverts public attention while others slip by in the shadows, at times doing much worse, hence shining a light elsewhere, springs to mind. I guess the point I’m trying to.make is that practically every human being on the planet is an addict, or enthusiastic devotee of something or other , I’m an addict through and through. If I do, eat, drink or feel something that my brain sends out messages of contentment and pleasure I’ll Addictively seek out more, because that is my default setting, in fact its a natural default setting for everyone. And unfortunately in current climate of attacks on the poor, vulnerable and different, more people will seek out the comfort and abuse anything that gets those messages of contentment and pleasure, so government are in fact endorsing and promoting addiction in their actions.Anyway, ranting and rambling, my feelings are mixed and I see the positives in both sides, but I’m of the opinion that its the societal concept that needs resetting not the badge. Me? well, I am an addict, and I have a problem called Kevin.

  • Dana Hall

    Thank you Meghan.

  • workingforchange

    Thanks Meghan, as always for so eloquently and reasonably expressing such an important issue.

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  • Russell Newcombe

    Great article, totally agree. Hari has written a book with many merits, and I support his general argument, but his language is problematic. We need clear and precise words and concepts to describe people who use drugs and their drug-taking behaviour, if we are to be serious about reducing discrimination and stigma. ‘Addict’ is a word loaded with implicit negative meanings, and saturated with unpleasant judgemental connotations. We replace it, as many people here and elsewhere have commented, with value-free language like ‘person who uses drugs’, or more specific forms – based on consumption features – like daily drug user, lighter drug user, injecting user, heroin user, poly-user, etc.. Many writers already use this more value-free language in scientific journals, research reports and online writings. But we will probably need an organized campaign – hopefully by a group such as INPUD or Transform – to encourage people to stop using discriminatory language like ‘addict’ and ‘clean’.

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