By Stephanie Thomas

Let’s play a little game called “What Would You Do?”

The scenario: You spot a friend out to eat. She’s waiting to be seated and standing directly in front of a fiddle leaf fig. You walk over to find her eyes nearly touching a stem.

“Look!” she says. Her gaze deepens, “This thing is all brown. It’s boring. It’s ugly!”

Your turn. Do you:

  1. Laugh
  2. Awkwardly walk away
  3. Encourage her to take a few steps back

After all, by stepping back she can get a sense of what she’s really looking at: a tree. A living thing where beauty abounds. A pot of dirt, sure. Some knobby branches, yeah. But also big green leaves, impressive height and a cheery shape.

Here’s my point, friends: When it comes to talking about folks with substance use disorders and mental health issues, we’re often a nation of people engaged in staring contests with the stem of a tree.

What We See Determines What We Say — and Here’s Why That Matters

Typewriter word graphicScience proves that drugs and alcohol actually change the brain of a user. The brain then tells the body that getting the drug should be the person’s top priority, above all else.1 The moral decisions we imagine taking place in the mind of the user are long gone by the time addiction sets in.

And yet it’s easy for us to assume otherwise. Our society often refers to people with substance use disorders as addicts, junkies or drunks — people who continuously choose a destructive lifestyle. We fail to see them — and therefore they often fail to see themselves — as human beings.

Studies show that accusatory language has a lasting effect on our cultural response to drug and alcohol use as well as on the individuals themselves. In fact, harsh words surrounding substance use disorders can even cause medical professionals to treat patients with greater judgment and less grace.2

Of course the most common problem with the way we talk about addiction is the increase in stigma, which people list as the main roadblock to getting help.3 And the number of people not getting help should shock you: 18 of the 20 million Americans with an alcohol or substance use disorder aren’t in treatment.2

Three Questions to Challenge Your Addiction Language

Imagine being labeled by your greatest failing or secret struggle. When a person battling addiction is called an addict, it strips away all the other things he may also be: a father, a friend, a sports enthusiast, an artist, a good cook, a funny and likeable guy.3

Do a gut check on the level of respect you hold for people with substance use disorders by asking yourself the following questions:

  1. Could my words be a barrier to someone who needs help?
  2. What do I gain by speaking ill of this person?
  3. What good do I see in this person, and how can I call attention to that?

Choose Your Words Wisely

While the old advice to avoid gossip rings true, sometimes you may need to talk specifics. So what should you say? Keep things simple with these quick tips:

  • Make statements that focus on the person, not the problem.4
  • Present information as supplemental instead of all-encompassing.3
  • Choose understanding over judgment.3

Run your words through this checklist before speaking. You might say, “My brother Matthew has a substance use disorder and is in recovery working to overcome his addiction to drugs.” Consider how this sounds compared with, “Matthew is an addict trying to get clean after years of drug abuse.”

The implications of the second statement are that Matthew’s addiction defines him, he’s inherently dirty and he wanted to be that way. A more careful wording shows the bigger picture: He’s your brother first, the battle he fights begins in his brain and there’s hope for his future.

Speak Out Against Stigma

Remember your friend in the game above? So caught up in the stem that she couldn’t see the tree? We talked about what you would do in that admittedly silly scenario. But now I’m wondering: What might you say to a friend who uses stigma-increasing language?

If you say something — if you attempt to help your friend see the bigger picture — you may get pushback. Your friend may balk at what she sees as political correctness or unhelpful niceties.1

Still, your efforts won’t be wasted. As you speak up, do so with kindness. Lead with a phrase like “I’m sure you didn’t mean anything by what you said . . .” and then share your own experience in learning to reframe the way you see and talk about people battling addiction.

Help a friend step back so she can see the whole tree, and she’ll realize a few incredible things: A tree needs water and sunlight. A tree puts out oxygen and takes in carbon dioxide. A tree is a thing of beauty and value.

And isn’t the same true for the millions of Americans hoping to beat their substance use disorders for good? With proper care, they’ll flourish. And as they grow, they’ll have the opportunity to realize their potential and see their true value in our world.


1 Castaneda, Ruben. “Is Calling Someone Addicted to Drugs or Alcohol a Substance ‘Abuser’ Harmful?” S. News & World Report, June 12, 2017.

2Talking About Addiction: Language Matters.” American Psychiatric Association, January 25, 2017.

3How Changing the Language of Addiction Affects Policy and Treatment.” WBUR, August 2, 2017.

4 Szalavitz, Maia. “Why We Should Say Someone is a ‘Person with Addiction,’ not an Addict.” National Public Radio, June 11, 2017.