Language Matters: The dirty truth about the word, “Clean”.

The word “clean” has been a part of language surrounding drug use and addiction for years. But we use it for other topics too, such as clean eating and clean living. It sounds positive and health focused and we need those components when talking about substance use disorder.

However, clean’s antonym is “dirty” and “being clean” when referencing sober time, implies that someone using drugs isn’t clean, they are instead dirty. That is a really unfair and false implication. Phrases like, “She’s been clean” or “he had a dirty drop” reinforce the ignorant and old school image of a “junkie”. Which is synonymous with unworthy, unloved, and the various other words we discussed in our previous post on language and the word “addict”. It instills the image of a homeless person, living under a viaduct, “shooting up” with old, used, dirty needles.

And here’s the thing about that image, today’s typical person with substance use disorder, isn’t homeless or dirty. As it relates to the opioid epidemic, the typical person with heroin use disorder is from the suburbs, and quite honestly, that doesn’t matter. Regardless of if the individual is from the city, suburbs, or a rural area, regardless of if they are homeless or not. Heck, regardless of if they are clean or not. They are people, and they deserve the same respect, treatment, and dignity as anyone else. We have to stop dehumanizing people and undermining their worth.

These words; “clean” and “dirty” have roots in the past and we can look just to the early 1980’s with the development of needle exchange programs following the CDC’s suggestion to avoid injecting drugs and sharing needles to prevent transmission of HIV during the AIDs epidemic to see it. (It’s not that needle exchange programs are bad; by no means do I mean to suggest they are. Needle exchange programs have demonstrated endless positive impacts in reducing harm; there is scientific evidence to back them, and I fully support them.) It is however, at that time when people with AIDS were viewed as “dirty”. Their condition was considered a result of their “lifestyle choices” and they were often shunned, making it difficult, if not impossible to access care. Is this sounding familiar?

It sounds a lot like we are repeating history instead of learning from our mistakes.

The words, “clean” and dirty” don’t belong in conversations regarding Substance Use Disorder, just like they don’t belong in conversation about AIDS. So what should we be saying instead?

Well instead of suggesting someone’s drug test was “clean” or “dirty”, we should just say the result were negative or positive. And instead of saying, “I’m clean” to reference the fact that a person is not currently using drugs, why not just say, “I’m not using”, “I’m in recovery”, “I’m in remission”, or “I’m sober” any of which not only highlight sobriety, but also don’t put down those who haven’t gotten there.

 

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Do we really need to keep arguing about choice?

In response to the following post…

 

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Typically when we think of a habit, we think of a regularly practiced tendency that is difficult to give up. But there are other definitions of a “habit” such as it is a person’s “bodily condition”. So you are right, addiction is a habit. But the definition this post is implying isn’t the one that was intended when society adopted the term, “habit” in relation to addiction. A person who has an addiction to drugs or alcohol depends on such substances, and therefore habitually uses. It’s a bodily condition because the way drugs work in our bodies, they have the ability to chemically alter the rest of our body, including the way we are wired to think and act. And regardless of which definition you, or anyone applies to it, it does not negate the fact that addiction is a health issue.

For so long society has taught us to view addiction as a moral failing and “a poor choice” but society has done a really terrible job at backing that claim up with science, or any evidence for that matter. Addiction, or substance use disorder as referenced in the DSM5 –think of it as a dictionary for doctors and used for making diagnoses—backed by science- classifies addiction quite different from society’s collective, generalized viewpoint. I personally, prefer the science over generalizations, society’s definition of social norms or socially acceptable behavior, and completely irrelevant unsubstantiated claims- but that’s just me.

So now that we’ve established addiction is a health issue. Let’s address some other points in this post. Twice, the phrase, “addiction is a choice” appears. I think this should be repeated ….silently….in one’s head…until the phrases implications really sinks in. “Addiction is a choice” implies people wake up and decide, “today I’m going to become addicted to drugs”. I find that hard to believe and think anyone with a smidgen of intelligence would agree that of the millions addicted to drugs, most if not all, didn’t wake up and make a choice to be addicted. So now that we’ve let that sink in, let’s just stop with the “addiction is a choice”. It was false the first time it was said. It is still false now. And it’s going to be false ten minutes from now.

Let’s focus on something in this post that is true. Before the drugs or pills you did not have an addiction. This makes me giggle because that’s just logic. But what does this statement do to negate addiction as a health issue? Before 8 years ago I didn’t have anxiety. Before 5 years ago I didn’t have PTSD. Before 6 months ago, I didn’t have polycystic ovarian syndrome. Before yesterday I didn’t have a migraine. But things change, including health, and now I do. And it’s weird because I totally didn’t decide to get ANY of them. Weird.

Interestingly, I’ve been given prescriptions for some of my health inflictions and some of them have highly addictive qualities. (I happen to be fortunate to know quite a bit more than the average person about a solid percentage of medications. And further, to have a doctor who will spend a full hour with me addressing questions and consulting with my pharmacist. But I wonder how many people get that type or treatment. Because I know one too many people who became addicted from prescription drugs following necessary treatment).

Regardless, of treatment procedures or “weak minds” or lack or self-control, as referenced in this post. What makes it ok to devalue a human life? And what kind of human does that devaluing? Debate that. Because “choosing to debate the science of addiction without the expertise”…..<—-well that, just read that til it sinks in.

A letter to David Vincent

A letter to Mr. David Vincent (and those sharing his post),

I’ve seen your Facebook post, as so many have. I think it’s worth a discussion.
davidvincent

I’ll start by admitting, I’m not sure I understand the placement of the quotation marks in your incredible inaccurate status. Unless it is there to imply sarcasm in regards to the word “free” given narcan is not free.

What makes you think it is free?

Narcan, or naloxone, is $5000 for the auto-inject, $150 for the nasal spray, and $45 for the vile and syringe at Walgreens, last I checked.  It isn’t always covered by insurance, unlike “chemo”. (Again, what’s up with the quotations?) It is made available for “free” by nonprofit organizations like the one I operate, which PAYS for it, and then gives it away because who am I or you or anyone else to judge the value of another person’s life?

Fun fact for you: The auto-inject naloxone was initially on the market for $400, but the price was raised to $5,000 as the demand for it increased. This may sound familiar if you are aware of Mylan’s appalling skyrocketing price of the epi-pen for anaphylaxis. One might argue pharmaceutical manufacturers see people’s lives as a matter of making profit. That said, if you want to have some kind of feelings or opinion about who gets treatment and who doesn’t…take it up with big pharma, start a nonprofit, or dish out the cash for someone else’s treatment. But deciding who gets to live and who gets to die based on YOUR interpretation of a disease – opposed to the definition in the DSM5 – is ignorant. And further, this uneducated “analogy” doesn’t actually help anyone. It does however, say a lot about the quality of individual who wrote it and arguably about those who share it. If the goal of posting it was to benefit cancer patients, it does absolutely nothing of the sort. What it does do, is hinder those who see it, who suffer with an addiction, from getting help. Perhaps helping people with addiction isn’t important to you or those who share it, but is it necessary to put those people down? That’s the only thing your status has accomplished. That and putting down the work of people who fought to change the laws to make narcan accessible.

You want to do something for cancer patients? Then actually do something! You can even call me up and I will gladly help you navigate setting up a 501c3, raise funds, donate my time and money, and hit up Washington as I’ve done for addiction. I’ll do it all without downplaying another health crisis and judging the value of another’s life.

Sincerely,
#wakethenation