Words Matter: Alcoholic, Addict, Problem Drinker –


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From Psychology Today:

Labels Can Hurt More Than Help

Almost every time I see a movie or TV show that includes a depiction of heavy drinking or drug use, the terms “alcoholic” or “addict” are used. The latest example is the film, A Star is Born which won 2 Grammys and an Oscar this year. Predictably Bradley Cooper heads off to two months of (posh) inpatient rehab after a career of heavy drinking and wetting himself while blind drunk onstage at an awards show. Might he have entered treatment before this point if there was not the stigma attached to heavy drinking? We’ll never know (and the original movie came out in 1937) but we now know how labels can have unintended consequences.

While the medical community moved away from these labels years ago now (along with alcohol abuse or drug abuse), they are still in common use. And it’s time to re-think this.

Let me be clear though that I’m not referring to how people label themselves. If it’s helpful for a person to conclude that he or she is an “alcoholic” then that’s all that’s needed. It should be also be noted that whether one accepts a label of alcoholic or not does not have an impact on outcomes in treatment. Just as many people recover from alcohol problems who don’t admit to the label as do those who do. What’s important in this context is an acknowledgment by the person that their drinking is causing too many problems or putting them at a higher risk for alcohol-related problems, and they need to make a change.

Now back to how we think of others. How we describe a person and his or her alcohol or drug use affects our attitudes towards them. My colleague, Dr. John Kelly, at Massachusetts General Hospital and Harvard Medical School, has been studying how labels affect a person’s perception of the individual. He conducted an experiment that compared referring to a person as an individual with a substance abuse disorder or to a person as a substance abuser. In looking at the data, the substance abuser “was perceived as engaging in willful misconduct, a greater social threat, and more deserving of punishment” compared to the person described as having a substance use disorder.

Words and labels can be pejorative, harmful, and, ironically, increase or decrease the chances that heavy drinkers will seek help. Using terms like a person with a substance use disorder reduces the stigma that is a barrier to people entering treatment. Anything we can do to reduce barriers to help people resolve their alcohol and drug problems is a worthwhile endeavor. Something to consider the next time you talk with a person with drinking or drug misuse.

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