Substance Abuse Semantics

This is a guest post from my good friend, The Discovering Alcoholic, who writes a top rated recovery blog, www.discoveringalcoholic.com, covering alcoholism, substance abuse, treatment and recovery issues.

A well deserved hat tip to my favorite scientist blogger Abel Pharmboy over a Terra Sigillata for bringing to my attention this article posted by Science Blog’s DrugMonkey. Over there, the medical and science professionals are discussing a study that indicates the stigma of addiction is evident even in the manner that physicians comment on patients involved in judicial proceedings.

Compared to those in the “substance use disorder” condition, those in the “substance abuser” condition agreed more with the notion that the character was personally culpable and that punitive measures should be taken. ~ Research Paper by John F. Kelly and Cassandra M. Westerhoff

In layman’s terms, a person in court labeled as a substance abuser is more likely to be considered personably accountable and criminal whereas those described as having a substance abuse disorder are more often shown leniency and portrayed more as a victim of psyche and circumstances.

I find it a just as interesting matter of semantics that in my bailiwick of advocacy where I am dealing more with politicians, law enforcement, and suffering families that the use of “disorder” or any other disease concept terminology is likely to produce the opposite effect. These groups are more often than not willing to accept the actions of alcoholic and addicts without prejudice, but will react with scorn and disbelief when asked to consider them at least partly the consequence of a complex medical condition. Much of this is probably caused by the fact that addicts and alcoholics can be pathological liars and those that have been to deal with this on a daily basis consider the disease concept just another convenient excuse.

I do not cast blame upon those that have this bias and cynicism. As a recovering alcoholic and someone that had to work especially hard to stop habitually lying long after the drinking ended, I know that those that deal “in the trenches” with practicing alcoholics and addicts have been conditioned by our own actions into this mindset. Now on the other side of the fence it even happens to me (and for good reason), so that I am hesitant to use the disorder term when dealing with practicing alcoholics and addicts for fear that they will use it as an excuse and a rationalization for their behavior.

PS: No doubt I am a firm believer in the disease concept of alcoholism and addiction, but it can be an actual hindrance to those still struggling with sobriety or in early recovery… once again it is a matter of substance abuse semantics.


Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.
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