Words have Meaning

I went to the Fourth Annual Forum on Drug Policy on Friday, which was quite interesting. One panelist was Peter Moinichen who works with persons in need of both mental health and substance use services. He told an anecdote that I am familiar with: persons needing assistance with managing or stopping substance use prefer to be referred to as “patients”, whereas persons with a mental health diagnosis who need assistance managing it prefer to be called “clients”. I had not, however, ever heard anyone make another point he was very firm in making.

Moinichen was very firm that characterizing a person’s relationship with substance use or misuse as “substance abuse” impedes treatment. He called the term “violent” and “derogatory”, as well as nonsensical.

I had never really thought about it, honestly but it’s not an accurate term because no-one does harm to the substance. More to the point, it casts the person as an aggressor, as someone to be sanctioned or shunned, as a criminal. It’s not only detrimental in a clinical setting, but it’s counter-productive to criminal justice drug policy reform. It’s difficult to get support for treatment alternatives to incarceration, or for decriminalization, or even sentence parity when your terminology lumps drug users in with people who beat their spouses or molest children.

“Framing the debate” can be a dangerous distraction. People can get too bogged down in how to talk about things and never approach real action. Sure, it happens; I’ve been in those meetings; I’ve walked away from those activists.

Nonetheless, words matter if only because choice of words–or a question about our choice of words–can reveal another perspective and cause us to consider a hidden impact.


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