(Image from Pixabay)
Does what you call something affect how you perceive or treat it? Almost certainly. Politicians and activists have long known this. In George Orwell’s Nineteen Eighty-Four, the language Newspeak is designed to limit thought, and government ministries seem to be named the opposite of what they do (the Ministry of Love tortures dissidents).
In an Author’s Note to her book Unbroken Brain: A Revolutionary New Way of Understanding Addiction, Maia Szalavitz argues for using the terms “person with alcoholism” or “person with addiction” instead of “alcoholic” or “addict” because the latter is dehumanizing.
She also prefers “substance misuse” to “the now-obsolete psychiatric diagnosis of ‘substance use disorder,’ ” arguing that:
- “[Addiction] is not a sin or a choice,” and “abuse derives from a term meaning ‘willful misconduct,’ which basically labels addiction as a sinful choice.” This leads to harsher sentences by judges, tough love and an over-reliance on the 12 steps as a primary drug or alcohol rehab, when it is really just a support group. (It’s valuable, maybe necessary, but rarely a solution in itself.)
- The American Psychiatric Association’s fifth edition (2013) of its Diagnostic and Statistical Manual of Mental Disorders no longer uses the term, preferring “substance use disorder,” so it’s no longer an accurate or official psychiatric term.
- “ ‘Abuse’ is also associated with harms to children and sexual assault.” That “abuse” sometimes has an illegal sexual connotation is absurd. With a little argument, you exclude almost any word for use with any other word.
Szalavitz doesn’t embrace the definition of drug addiction as a chronic, progressive brain disease like Alzheimer’s, either. Instead she says addiction “is a developmental disorder – a problem involving timing and learning, more similar to autism, attention deficit hyperactivity disorder and dyslexia than it is to mumps of cancer.”
Marc Lewis in The Biology of Desire: Why Addiction Is Not a Disease makes a similar argument, that addiction is a problem of learning and development, a “very bad habit.” “Medical researchers are correct that the brain changes with addiction. But the way it changes has to do with learning and development – not disease.”
But the drug rehab treatment for addiction as a learning disorder is largely the same as for disease:
- Cognitive behavioral therapy.
- Medication-assisted treatments: buprenorphine (or Suboxone) and methadone.
Under medical supervision – once a day at a clinic, or an implant/injection that lasts a month or more, such as Probuphine or Vivitrol – these meds can be prescribed for the rest of the patient’s life, if need be, without risk of addiction.
Is it largely a semantic argument? Maybe, but that doesn’t mean it’s not an argument worth having.
