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<h1 class=""><a href="http://www.health.harvard.edu/blog/words-matter-language-addiction-life-saving-treatments-2016081510130" rel="bookmark">Words matter: The language of addiction and life-saving treatments</a></h1>
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<img src="http://hhpblog.s3.amazonaws.com/blog/wordpress/wp-content/uploads/2016/07/Sarah_Wakeman-150x150.jpg" alt="Sarah Wakeman, MD, FASAM, Medical Director, Massachusetts General Hospital Substance Use Disorder Initiative" class="" height="96" width="96">
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<time datetime="August 15, 2016" class="">
Posted August 15, 2016, 9:30 am
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<a class="" href="http://www.health.harvard.edu/blog/author/swakeman">Sarah Wakeman, MD, FASAM, Medical Director, Massachusetts General Hospital Substance Use Disorder Initiative</a>, <span>Contributor</span> </div>
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<p>News articles, radio, and television frequently report on the
current opioid crisis. As the death toll has mounted, the media has
importantly covered many aspects of the crisis. Unfortunately, this
coverage often focuses on the very visible individuals who continue to
struggle with active addiction. What is missing is a narrative of hope
for a chronic disease which is as treatable as diabetes or high blood
pressure.</p>
<p>In addition to the pessimistic portrait painted about addiction, the
language used by the media is often problematic. Articles frequently use
the term “abuse” or “abuser” or refer to individuals as “addicts.” Even
the term “clean” is laden when referencing sobriety, as it implies that
someone who is actively using is somehow “dirty.”</p>
<h3>Language matters–a lot</h3>
<p>The use of “abuse” and “abuser” has been shown to increase stigma
even among highly trained clinicians, who recommend more punitive
treatment when an individual is described that way. We do not call
patients with diabetes “sugar abusers,” nor do we say their blood is
“dirty” with sugar. Describing patients as having a <em>substance use disorder</em>
demonstrates that their illness does not define them, just as we should
no longer call a person with schizophrenia a “schizophrenic.”</p>
<p>The language we use related to addiction <em>treatment</em> also
impacts stigma. Methadone and buprenorphine are lifesaving, effective
medications for opioid use disorder. Their use reduces relapse and death
far more than any other available treatment. And yet they are
frequently referred to as “replacements,” worsening the mistaken notion
that these medications are simply a way to substitute a legal opioid for
an illicit opioid. They are not. Addiction is a behavioral syndrome
characterized by compulsive drug use despite negative consequences.
Patients successfully treated with methadone no longer meet the criteria
for active opioid use disorder. Taking a medication to manage an
illness is the hallmark of chronic disease treatment. Individuals taking
medication to successfully treat addiction are physically dependent,
just as someone taking insulin for diabetes requires a daily shot to be
able to function normally. Both will get sick if they stop their
medication. But someone on methadone is no more “addicted” than any
person who relies on a daily prescription to keep a chronic disease
under good control.</p>
<h3>Stigma can deter people from treatment</h3>
<p>In Boston, the term “methadone mile” has come to refer to a stretch
of Massachusetts Avenue where the devastation of active drug use is
highly visible. This reference is particularly unfortunate because it
lumps those on treatment for opioid use disorder with those actively
using. This insinuation that individuals on methadone maintenance are no
different than those actively using heroin is incredibly stigmatizing
and is one reason why many won’t consider this treatment.</p>
<p>Methadone was first discovered in 1965 through the groundbreaking
research of scientists at the Rockefeller Institute. Those early studies
demonstrated methadone’s remarkable ability to alleviate withdrawal and
craving while dramatically improving the ability to function
emotionally and socially. In the subsequent decades, the evidence
supporting methadone’s positive effects has grown. These include
significant reductions in drug use, new HIV infection, crime, and death
from overdose. The research is so strong that methadone, along with
buprenorphine (Suboxone), has been added to the World Health
Organization’s list of essential medications. And yet despite this, only
a minority of programs offer methadone treatment and the undeserved
shame associated with this lifesaving medication persists.</p>
<p>Many would be surprised to learn that most people with a substance
use disorder will get better, and the lifesaving medications methadone
and buprenorphine are the most effective pathway to recovery, not
detoxification. Those doing well on medication are often invisible
because they are scared to share their pathway to treatment in the face
of such misunderstanding.</p>
<p>Words matter and continued use of stigmatizing language perpetuates
false stereotypes, spreads misinformation, and keeps people out of care. <br></p><p><a href="http://www.health.harvard.edu/blog/words-matter-language-addiction-life-saving-treatments-2016081510130" target="_blank">http://www.health.harvard.edu/<wbr>blog/words-matter-language-<wbr>addiction-life-saving-<wbr>treatments-2016081510130</a></p><br clear="all"><br>-- <br><div class="gmail_signature" data-smartmail="gmail_signature">=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+<br><br> Harold F. Schiffman<br><br>Professor Emeritus of <br> Dravidian Linguistics and Culture <br>Dept. of South Asia Studies <br>University of Pennsylvania<br>Philadelphia, PA 19104-6305<br><br>Phone: (215) 898-7475<br>Fax: (215) 573-2138 <br><br>Email: <a href="mailto:haroldfs@gmail.com" target="_blank">haroldfs@gmail.com</a><br><a href="http://ccat.sas.upenn.edu/~haroldfs/" target="_blank">http://ccat.sas.upenn.edu/~haroldfs/</a> <br><br>-------------------------------------------------</div>
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