Words Matter: How Language Shapes Addiction Recovery

Can a simple change in language truly impact someone's path to recovery? In this episode, we explore this compelling question with Mary Brewster, from the Division of Harm Reduction. 
We introduce the newly released stigma glossary, a resource designed to guide us toward more compassionate, person-first terminology. https://oasas.ny.gov/stigma-glossary

Transcript

Isabel Byon: 0:00

The New York State Office of Addiction Services and Supports, or OASAS, provides this podcast as a public service. Thoughts and opinions expressed do not necessarily represent or reflect those of the agency or state. This is Addiction: The Next Step.

Jerry Gretzinger: 0:23

Hey, this is another episode of Addiction: The Next Step. I'm Jerry Gretzinger, your host, and today we are talking about something that is really, really important to have everyone be aware of, and that's language. You know, we've all heard the word stigma and I think sometimes people aren't quite sure what we mean by stigma. Maybe sometimes they just have, you know, got stigma fatigue, they're tired of hearing about it. But the reality is a lot of the effects of stigma come from the words we use, the things we say, and it is so important that we try not to have stigma be the result of the words we're using when we talk to people.

Jerry Gretzinger: 1:00

So, to get into that a little bit deeper, we're happy to welcome Mary Brewster. She's in the studio with us. Mary, nice to see you.

Mary Brewster: 1:07

Likewise good to see you.

Jerry Gretzinger: 1:09

And, you know, we're, actually this is good timing. We just were able to post online a stigma glossary about, you know, person first language, what not to say and what to say instead, before we get into some specifics of things like that. But let's talk about what I was just mentioning. You know why it's important to use the right words when talking to people, so that we don't kind of, you know, undo the good that we intend.

Mary Brewster: 1:34

Yeah, you know, I always I think back to the childhood phrase sticks and stones may break my bones, but words will never hurt me.

Mary Brewster: 1:41

And how that's so false.

Mary Brewster: 1:44

Think back in your life of the times that people have said something really disparaging about you or used language words that have hurt your feelings.

Mary Brewster: 1:52

So we've all experienced that. Now imagine that every single word that's used to describe you is a word that hurts you, that you're hearing it from your government, that you're hearing it from your doctor when you walk in the door, and that every single time someone says something about you, it's words that actually hurt and are negative words. So that's why I think it's so important is that we've all experienced that and it's something that we all can change. You know, working with people who use drugs, talking about addiction, can be really challenging and many of us are set in our old ways. But something that we can actually make a positive impact and make a positive change that can impact the people who use drugs and those that we serve, is just by the language that we use to show them that we aren't one of those people that's going to stigmatize them, that we welcome them and we want them and we want to focus on their strengths as a person and not their disease states.

Jerry Gretzinger: 2:47

And you know I sometimes go back to before I joined the agency, going back a couple of years now but coming in seeing some of the language that they explained. Hey, you know this is not the best thing to say when referencing a person or a condition, because this is the impact it has. You know, people don't necessarily say certain things because they have ill intent. It's just, like you said, the kind of the mindset people have been in for so long, not realizing how that's landing with other people and a great, you know comparison to the old phrase sticks and stones may break my bones, but words will never hurt me. I know I've spoken to my kids before. Hey, you know, you'll fall and hurt yourself in a game. Or somebody may throw a ball and it hits you in the arm and it hurts for a while. You forget about that. Somebody says something awful. You remember that forever.

Mary Brewster: 3:33

Forever. I mean, I can remember in third grade having a bully say something to me and still I'm 40 plus. I'm not revealing my age, I'm 40 plus years old and I can still remember that little Mary on the playground hearing that and it still hurts me to this day.

Jerry Gretzinger: 3:47

And 50 plus. I still remember the nickname some of my classmates had for me. So, yeah, those things never go away. So that's what we're trying to prevent, right? We want to make sure that people are feeling welcomed and accepted and certainly not feeling bad about what they're coming in looking to be helped with. So let's talk about some examples, right? I mean, what are things that people may say and not necessarily mean anything bad by it, but that's how it lands.

Mary Brewster: 4:14

Yeah, I think the one for me as a harm reductionist that someone has worked in this community for a long time is the word clean. It's like nails on a chalkboard for me. And so people use the word clean when they say a person's no longer using substances, and I think the thing that really bugs me about that is one it's not clinical right. So if we're clinicians, we're substance use treatment providers, we should be using accurate medical terminology and not slang. So the word clean is slang. Instead of using that, we should be using no longer using or is sober or is in recovery, and actually name what is going on with that person. And the reason we don't want to use clean is because it's very stigmatizing, because what's the opposite of?

Jerry Gretzinger: 4:55

Right.

Mary Brewster: 4:56

It's dirty. So that means that people who use substances, we're saying that they're dirty and that you only become clean when you actually stop using substances. So just that very basic word. We should not be using it. We shouldn't say that a toxicology screening is clean, right? No, it's not clean, that's not medical terminology, it's not positive for substances. So I think that's one that really grates me personally.

Mary Brewster: 5:22

Another one is the word addict. I understand why we've used that word. It's addiction and so it's a person who has addiction as an addict. But what we want to focus on is using person first language and strengths based language. So you're not an addict, you're a person who has addiction because you are a person first. You are a person before your disease state. You know, thinking back to the HIV AIDS community, which is where I came from and where harm reduction really is rooted, you're not an HIV positive person. You're a person living with HIV, right, because you are more than your disease. So I think that that's the other thing that we have to think about is putting the person first and not the disease state or the behavior first.

Jerry Gretzinger: 6:04

And interesting that you bring up that it's been a few years since New York State actually adopted the use of person-first language. I mean, that's even something that has gotten to the state level and it's legislation that supports that. You know, and you mentioned those couple of words. You know, you said addict, you said clean, and those strike me as two things where people may use them not understanding that impacts those hearing them.

Mary Brewster: 6:29

Yeah, I mean, imagine if you were told like, oh, you're clean now, Jerry, that's great. You're going to think, oh my gosh, before I stopped using, they always thought I was a dirty person, and we know, like being a dirty person is not a positive thing and you could have been the cleanest person. Actually, people that I know who use drugs are some of the cleanest people. They are very particular about the way that they use their drugs and they are not dirty people, but we use that language because it's so simple to fall on and I think also sometimes it makes us feel a little better and to put ourselves above another person at times. I don't think a lot of people do that, but it puts people who use drugs in their place, which is something that we often want to do, because so many times still, addiction is seen as a moral failure or a lack of willpower instead of as a disease state, which is what we actually know it is.

Jerry Gretzinger: 7:23

And you know a lot of this too. It kind of is rooted in years and years and years of just doing it that way and saying these things. And I think, with so many other things, we realize, oh, the way we've always done things maybe weren't really the best. We know more now, we're a little smarter, we understand, and this is a part of moving in that direction.

Mary Brewster: 7:42

Absolutely. I mean, OASAS changed its name in 2019, right, and we changed our name because our name was stigmatizing. Our name was the Office of Alcoholism and Substance Abuse Services, so we changed our name to be more, I think, less stigmatizing, more person-centered to the Office of Addiction Services and Supports, and that was very intentional. So we've been working on this for years. Just like you said, the state has adopted person-first language. We've put out the stigma guide that we should be using. Again, w e don't want to be a barrier for people to come in and receive treatment, and the language that we use can create that barrier, whether we know it or not.

Jerry Gretzinger: 8:22

Yeah, and that's the next thing I want to ask you too. So some people might be out there saying, okay, maybe I use this word or that word and it strikes somebody wrong, but does that really stop them from seeking services or doing well with treatment? And the answer is yes.

Mary Brewster: 8:37

Is yes. I mean we say in community stigma kills, and it does. It kills people because the stigma that they have experienced from the medical treatment, from the medical system, is so debilitating to them that they cannot walk through that door. It's so traumatizing to them. I had clients who were people who injected heroin and they would go into their primary care doctor because their foot hurt, because they wanted to talk to a podiatrist about their foot. They would talk to them about their substance use. I'm not there to talk about my substance use. I'm there to talk about my foot. Can we receive medical care for my foot? But it all comes back to oh, you're a person who uses drugs, so then that means everything about you is about that substance use. So we just want to really pay attention that we're not putting these barriers for people to get through the door, especially when we're in the overdose crisis that we're in. We can't be the reason that people aren't engaging in care.

Jerry Gretzinger: 9:30

Yeah, and you know just another area that we see some of these words and phrases that we're trying to get away from. As a former member of the press, I now see so many incidents of reports that are out there and whether it's online or print or televised or broadcast one way or another, where I cringe now and go oh gosh, why are they saying ?

Mary Brewster: 9:54

Welcome to the club.

Jerry Gretzinger: 9:55

Yeah, so it's you know. And again, we know that people aren't using this, at least for the most part. We hope that they're not using these terms in a negative, for a negative reason, to hurt people. But there really is a lot of education we still need to do, obviously, because it's out there. It's out there in the mainstream media. A lot of it's still being used and that's why we have that stigma glossary. We want everybody to be aware.

Mary Brewster: 10:19

Exactly and like the word drug user, right. What's a user? A user is not a positive affirmation to give to someone, it's not a positive word to use. A user is someone that uses you, who takes what they want and gets what they want. So, instead of using drug user, why don't we use a person who uses drugs? Right, because that's what they're using is drugs. They're not using you, and I get that. This seems like such nuanced, it seems silly to some people like why are we focusing on like these very small changes? But it is such a small change that we can make ourselves and it has such a huge impact on the community that we're serving. Because, again, when they know that you're using language that is person-first, it means that you've been intentional about how you're approaching this work and how you're going to care for that individual, and that's very meaningful to the person receiving services.

Jerry Gretzinger: 11:09

And as we said from our own personal experience when we were children, decades later, Stacey Trinichek. Oh boy, we're calling her out.

Mary Brewster: 11:17

Oh, she was so mean to me. Yeah, I still remember that third grade.

Jerry Gretzinger: 11:20

And that's the thing. Those things stay with you, and what we want to stay with people is the support that we're encouraging them to come out. They're going to be accepted, they're going to receive the services, the treatment that they're looking for, and only feel good about it.

Mary Brewster: 11:32

Exactly. Yeah, that's what we want.

Jerry Gretzinger: 11:34

Mary, thank you so much. I think this is one of those topics where it's always important to keep reminding people about it. If you do want to see that stigma glossary that we have recently created and put online, I'll tell you where to find it. It's at our website oasas. ny. gov, o-a-s-a-s, dot N-Y, dot. G-O-V. And also, if you have questions about services available, you've got our Hope Line 877-8-HOPE-N-Y. You can find those actual numbers and everything you need at that website. I gave you, Mary. Thanks again for sitting down with us today. All right, everybody, this has been another edition of Addiction: The Next Step. Thanks so much for sitting down and listening to us, or taking a walk and bringing us along to your podcast, or, hey, watching the video version. We've got that available now. We'll see you next time.