The words we use

By Bob Smith, LMSW, CAADC,
Clinical Manager, Cherry Health


The way we speak often impacts the way we feel and changes the lenses in which we see the world. One area in which this has impacted those suffering from substance use disorders are common terms I hear of being either clean or dirty to describe one’s using status.


These terms are used widely to describe people suffering from addictions and present themselves in use through media, news organizations, agencies, providers, trainers and even those individuals suffering from addiction themselves. They have become so broadly used and interconnected in the treatment of addictions that at times it seems we have lost sight of the impact these statements have on how individuals, providers, and our country views addictions.


Addiction is a disease defined by the American Medical Association and the American Society on Addiction Medicine including changes in the way our body and brain function. Over time and left untreated, addiction is a progressive relapsing disease, severe, disabling and ultimately life-threatening. We do not label those suffering from heart disease, diabetes or cancer as clean or dirty, and instead we treat them with compassion and empathy.


We all need to take responsibility for shifting these perspectives to disrupt the cycle of placing individuals suffering from a disease into a category of being labeled externally and internally dirty. When individuals use substances, or are screened for substances in their body, the correct terms we should be using is testing positive or negative for substances. I would challenge all of us to actively confront these statements when we hear them.


We all can be part to making changes starting with educating our patients on how they speak about themselves, educating our co-workers, writing letters to our local and national news broadcasters and Congressmen when they use these terms, as well as advocating for continuing expansion of treatment services in our community.


Whether we are suffering from heart disease, diabetes, cancer, alcohol or opioid addiction, or any other chronic health concerns, we all deserve to be treated with dignity and respect.


Reprinted with permission from Cherry Health.

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