Brief Remarks Regarding the Use of Pejorative Language Pertaining to Substance Use Disorders

There are many terms used to describe what we know today as substance use disorders, a term that is used in the Diagnostic and statistical manual of mental disorders (American Psychiatric Association, 2014, 5th edn). However, American culture has many colloquial or popular terms used to describe SUDs.Terms such as “addicts,” “alcoholics,” “junkies,” “drunks,” “dope fiends” have permeated our everyday, popular language over the course of decades and still persist to this day (Broyles, Binswanger et al., 2014; Heit & Gourlay, 2009; Warren, 2007). For example, the term “junkie” came about during the Great Depression of the 1920s when Americans who were using heroin would go around finding junk metal to exchange for cash in order to purchase heroin. Many of these aforementioned terms are pejorative or negative and sustain the stigma that, we as Americans attachto substance use disorders. This stigma also stems from the perception that many individuals hold, that substance use disorders are not a disease but rather the result of character flaws or moral failings.

Throughout this book we have attempted to use non-pejorative language. There are instances however, when we have used these terms, especially when from quoting older research studies using pejorative language (e.g. “alcoholic” or “addict”). It is important, that we, as professionals who treat SUDs are aware of the language we use when describing these disorders.

Summary: The Three Blind Men and the Elephant

There’s an ancient parable which is often referred to as “the three blind men and the elephant” (Blind Men and an Elephant, 2018). In this parable, three blind men learn that a strange animal called an elephant has been brought to the town where they live and having never experienced such a creature, the three men venture down to the town square to inspect the animal by touch. The first blind man hand lands on the elephant’s trunk and declares that “an elephant is like a thick snake.”The second blind man’s hand feels the elephant’s leg and determines that “an elephant is like a thick tree trunk.” While the third blind man feels the elephant’s ear and decides that “an elephant is like a large fan.”This parable is often used to describe how a partial truth can be true and yet at the same time may be limited or even false by limiting an account of other truths or perceptions. The parable is also prescriptive in that it advocates the need to take other perspectives into account as well as the need for communication between “experts,” as each blind man could claim expertise based upon the particular part of the elephant he happened to touch. Such is the case with addiction theory. As we describe each theory, you’ll see how each has its own merits and limitations.You may also think about people in your life who have struggled with addiction and how or why he or she may have developed a substance use disorder. We also know that timing is important, as some people may develop addictive behaviors early in life, only to “mature out” of those behaviors as they take on new responsibilities and endeavors (such as a family and/or career). Yet, we also know of many individuals who developed addictions later in life, in retirement for example, or after the death of a spouse.

In order to be good addiction counselors, we must always keep an open mind to various perspectives and we must keenly listen to the stories of each of our clients, as each will be unique. When people go to AA or Narcotics Anonymous (NA) they are often encouraged to “identify don’t compare.” In other words, look for similarities between your substance use and that of others in the room because if you just focus on differences you bound to come up with the conclusion “I’m different! I’m unique and therefore I can’t be an alcoholic or addict!” Also from the perspective of AA and NA, the etiology' or causes of addiction are generally not considered to be important. For example, in Father Martin’s well-known video “Chalk Talk on Alcoholism,” he cautions “if you have a toothache, do you want to know why it aches or do you want to have it pulled?”Yet, in counseling we, as addiction counselors are concerned with causes as it will help to guide

Introduction to Addiction Theory 13 effective treatment and also assists in identifying those issues that clients may need to address in counseling.

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