By Amy Dresner 05/07/18
There’s a new push in the recovery advocacy movement to move away from certain words and terms: junkie, dirty, clean, druggie, hitting bottom, and others. Although I understand the concept of changing the vernacular to the more PC and science-flavored substance use disorder or even the banal people with addiction, I don’t think that just changing the language is going to be sufficient. Moreover I think tip-toeing around the issue adds to the stigma. We need more people coming out of the proverbial closet and showing the world that addiction is more prevalent than they think and recovery is completely possible, not rules for how to refer to ourselves.
I can understand why it makes sense to use more precise language in medical or legal settings, but do we really have to police ourselves? I was once called a “crazy crackhead bitch” by a stranger and I was not amused. I was actually so enraged I found myself doing a Bruce Lee fly kick at him. Badly of course. (Side note: I was on a lot of Effexor and it did not agree with me.) So I do understand that those terms can be offensive when used by others who have not experienced addiction. However, in the recovery community, I’ve had quite a bit of pushback on my book’s title, My Fair Junkie: A Memoir of Getting Dirty and Staying Clean. One recovery advocate group would only let me come on their show (where I was supposed to be proudly proclaiming my time in recovery) if I agreed not to say the title of my book. (I declined.) Another recovery podcast that interviewed me admitted they were fearful to post the book cover on their website or Facebook because of its provocative title. Huh?
This issue has become even more personal to me lately. On Instagram, thetatooedteetotalerposted a picture of my book and commented how excited she was to read it. There was a negative comment (by somebody who obviously hadn’t read my book) about how I was making addiction into a “moral issue” by using the words “dirty” and “clean” and further stigmatizing people who were still using. This person specified that there were no such descriptors, only “use” and “non-use.” However, to my relief and delight, thetattooedteetotaler commented: “I firmly believe that people living with addiction are experts on their own lives. And I live and work in a community where addicts have reclaimed words like junkie….I also think telling marginalized communities what language is or isn’t acceptable to describing their experience is problematic.” She doesn’t use that language to refer to herself, she clarified, but has no problem if others want to.
Another Instagrammer, Calebawesomepants, added: “Addiction is hell, and addicted people that recover can choose whatever language they want to describe what life felt like in active addiction and recovery. I will tell anyone that lying, stealing, doing anything to get drugs was a very dirty feeling. Not having drugs in my system feels clean. Clean/dirty is very descriptive of my experience living in both realities, and a lot of people who have recovered feel the same.” He finished up with a mic drop: “The recovery community often sucks –they can be punitive and exclusionary. This needs to change.”
As an ex-comic and a writer, I’m especially sensitive to anybody telling me what words I can and cannot use. And what matters more than the terms you use is how you treat people. I read from my recent book in San Francisco, the capital of PC-ism. The portion of the book I read involved the eight months I took care of a quadriplegic man in my 20’s. You could feel a hostile hush move over the audience as I said the words “for a so-called cripple” and “handicapped” which were used intentionally to show my prior fear and prejudice before working with this man. I wondered how many people in the audience had ever changed a quadriplegic’s catheter? Used a gloved finger to help him defecate? Hoisted his stiff body over their shoulder so they could get him into the bath? Done physical therapy or dressed a man who was paralyzed from the chest down? You know what this man wanted from me more than anything? To be treated like a normal person, not as someone so precious that I couldn’t kid with him like I would with my other friends.
I believe by using this weird overly-PC language we create a sort of preciousness around addiction. I’m of the camp of owning or reclaiming the language that has been used to deprecate us. Larry Kramer, author, public health advocate and LGBT rights advocate, did it when he titled his 1978 book, Faggots. William Burroughs took back a derogatory word for a drug user when he wrote Junky: Confessions of an Unredeemed Drug Addict.
I can only speak for myself, but by taking full ownership of my past in all its dirty (that’s right I said it) degenerate glory, I’m freed of any shame. I WAS a junkie. And to be honest, there were times when I was proud of it, loved the shock value, thought I was a badass, was drawn to the darkness of it all. I doubt I’m alone in this. In fact, I know I’m not. And sorry, but the term Substance Use Disorder doesn’t exactly encompass that.
I asked my old fave, Dr. Howard Wetsman, addictionologist, psychiatrist, author, as well as a person in recovery and maker of the coming documentary Ending Addiction, his thoughts.
“For me there’s no SUD. When I was drinking, I didn’t meet criteria for Alcohol Use Disorder even though it was driving me mad. When I quit and started overeating, I still didn’t meet criteria for any SUD but I was still in active addiction. I think the key thing here isn’t that SUD is a cleaned up version of vernacular speech; it is a different entity than addiction.”
He continued: “And here’s why the people in government, science, academics and insurance care: It’s hard to study addiction. It’s hard to operationalize the definition of the illness as it exists in nature, so like the blind guys looking at an elephant, we chop it up into understandable bites. The bites don’t lead us anywhere good, that is, they don’t give us an accurate model, but hell, at least we can study them. DSM has probably killed more people with addiction than drugs has, but that’s not stopping anyone in power from using it and demanding that others use it.”
As a professional, he acknowledges that calling someone a “junkie” is pejorative and has a very different connotation than when I use it. He also added: “I don’t call people addicts but I have no problem if they do. Hopefully, when I speak and write about people with addiction I use just those words, people with addiction. And when I mean people in long term recovery I use just those words. I do slip, of course, but I endeavor to. But SUD? It’s bullshit and won’t help in the end.”
My father, also a writer, who’s lived with my condition for over 20 years, has a different viewpoint: “Words matter. Once you were diagnosed with the medical description of ‘drug dependency,’ I felt the doctors and the rehabs had a handle on it. No such luck. That vague terminology simply justified any kind of unsubstantiated treatment for insurance purposes. Continuing to call you a ‘junkie’ or an addict would have been more honest.”
So although I appreciate recovery advocacy and am all for the eradication of stigma, I don’t appreciate fellow ex-addicts telling other ex-addicts how they can or cannot refer to themselves or what terminology they can or cannot use. If somebody needs to call themselves a die-hard dopefiend so they don’t forget where they came from, let them. I’ve heard heads of rehabs with double-digit sobriety refer to themselves as “ex-junkies” on national television. There are many roads to recovery and all fundamentalism (whether 12-step-, verbiage-, or advocacy-based) must be avoided.
And what will break the stigma? I think the addiction/recovery movement needs to model itself on the gay rights movement and be vocal, out there, shameless and visible: parades, glitter, boas. Bring it all on. When the public sees the population of people who suffer from addiction and the number of people who do recover, their perception will change. I’m all for the Recover Out Loud Movement and as most of you know, I’m not a fan of the AA 11th tradition which asks us to maintain anonymity at the level of press, radio, and films. I got shit for breaking that tradition in my book and saying I was in AA but guess what? Readers reached out to me and said I had made them think AA was less creepy, not just a Christian cult and maybe even cool. I recently met one girl at her first meeting.
But I’m just an ex-junkie so I asked Dr. Wetsman about stigma. He told me: “So, what will kill the stigma? Well, I’ve been working on that for a long time, and I’m not getting anywhere either. I think, just changing the name doesn’t work:
Well he’s not an alcoholic, you know. He’s a person with Alcohol Use Disorder, Severe.
I don’t give a fuck; he still owes me money.
I think the PC shit comes off just as it is, stupid PC shit that doesn’t really do anything but solidify the stigma by making people defensive….What I really think will kill the stigma is honesty. When we’re in active addiction we’re lying all over the place. Everyone in America is sensitized to people with addiction lying…I think we need to be honest. Not everyone can have addiction, only about 10-20% of us do. Not everyone who uses drugs has addiction…While people aren’t responsible for being ill, they are responsible for their recovery, but most modern, non-medical treatment sucks, and we can’t say they’ve failed treatment until we treat the disease not the drug. I think what will really kill stigma is hope, and hope is what I want to create with a new way to see addiction.”
Ahhh hope. And how do we give people hope? By coming out with our stories of recovery in every which way. I hope I never have to hear again the words uttered from a medical professional when I was 5150’ing a friend with bipolar disorder who’d relapsed after 12 years: “Once a drug user, always a drug user.” We can change that view by being out and proud in recovery, not by using same fancy name to polish up alcoholism/drug addiction which has been around, making a bad name for itself, for hundreds of years. Telling our stories will be the game changer, not trying to police language.
“We will not regret the past nor wish to shut the door on it!” That’s what it’s all about. Honesty!