I want to start by saying that this article is not meant to be prescriptive nor is it intended to police language used by others. When it comes to self-identification, I will always advocate for autonomy and agency. As long as it feels powerful, empowering and helpful for you, I’m here for it and I encourage you to use what works for you.
But what happens when it doesn’t? What happens when the dominant words, names and labels that exist – in this context, within the realm of addiction, sobriety and recovery – don’t feel powerful, empowering and helpful? Or worse, what happens if these words actually create problems? This blog post is for the folx who don’t identify with the terms and labels that are ubiquitous within addiction and recovery spaces and for those seeking out alternatives.
The label alcoholic is also riddled with stigma…
When we think about treatment for addiction, our first thought is often Alcoholics Anonymous (AA), which makes sense as it’s a longstanding, global recovery model. AA has been around for 85 years, boasts more than 2 million members and 118,000 meetings (in 180 countries) globally, and is the foundation for many 12-step programs and treatment centres (despite the fact that AA is not evidence-based or rooted in science). Given its history and ubiquitous nature, it’s no surprise that AA has become synonymous with addiction treatment. AA was created in 1935 by two white, cisgender, straight, able-bodied, middle/upper-class men who were struggling with their addictions, so it tracks that the program was designed with men like this and their needs in mind. AA has remained largely unchanged since its inception, though many AA meetings have taken it upon themselves to create and host women’s chapters, LGBTQ+ chapters, Black, Indigenous, and People of Color (BIPOC) chapters, etc. to account for the diversity of its global members. And perhaps the fact that the original model doesn’t account for this diversity.
While AA is not medical in it’s approach or methods, it vehemently takes up the brain disease model of addiction (BDMA) as its frame of reference. Some characteristics of the BDMA include:
- addiction is an illness and you either have it or you don’t;
- those struggling with alcoholism cannot control themselves;
- alcoholism is a lifelong, irreversible disease that requires constant maintenance and on-going abstinence; and
- relapse is an inevitable part of the disease.
AA’s belief in the BDMA is evident in the regular and encouraged use of the term “alcoholic”; in many rooms and meetings around the globe, it’s still commonplace for members to state: “Hi, my name is Sally and I’m an alcoholic.” Alcoholic is directly related to alcoholism (now referred to as alcohol use disorder), terms which firmly have their roots in the BDMA.
As someone who has struggled with alcohol addiction, labeling myself as an alcoholic never felt right for me. I didn’t feel diseased nor did I wish to take on the belief that I would be toiling with this affliction for the rest of my life and that I would have to diligently work, day in and day out, to stave off my urges, lest I fall prey to my cravings and submit to relapse. To me, this sounded like a prison, very much like what my experiences in active addiction were.
Problematizing words and the concepts, norms they represent
When important parts of us are stripped away, this effectively serves to dehumanize us…”
In my work as a sobriety coach and disruptor of normative alcohol culture, I have been problematizing language and words like alcoholic, addict and junkie for years. One of the things that I really dislike about the term alcoholic is that it’s become not only a label but an identity. Who you are (an alcoholic) rather than something you’ve experienced (addiction). Not only does alcoholic become an identity but it becomes an all-consuming one, swallowing up other important parts of our identities and lives, making our addictions prominent and dominant.
While my own experiences with alcohol addiction have certainly been impactful in my life, they aren’t representative of my whole life. But terms like alcoholic and addict erase all the other parts of us, leaving only our addictions to focus on. When other, equally important parts of us – that we’re a sister/ daughter/ niece/ partner/ friend, great at our jobs, contributors to our communities, avid readers, passionate about philanthropy – are stripped away, this effectively serves to dehumanize us, which not only creates disconnection but diminishes our compassion for those dealing with addiction. In addition to being an all-consuming identity, the label alcoholic is also riddled with stigma, shame, embarrassment and guilt. When it comes to creating change in your life and healing from your addictions, shame, embarrassment and guilt are often counterproductive to this process.
The term alcoholic also hoists all the responsibility of addiction onto the shoulders of the individual, which is deeply problematic for three reasons.
- First, instead of addressing and acknowledging alcohol as the wildly toxic and highly addictive substance that it is, it makes the individual the problem by not being able to “handle” their alcohol, which suggests that humans should be able to handle copious amounts of poison to begin with (we should also be asking ourselves why we want to aspire to “handling” large amounts of poison in the first place).
- Second, thrusting the blame onto the individual fails to acknowledge the myriad factors that increase our susceptibility to developing an addiction, including things like trauma; mental health issues; various points of oppression and marginalization (ie being a member of the LGBTQ+ community or being Indigenous, for example); connection, community and support; early exposure to alcohol; epigenetics and genetics; the environments we live in and norms we live under; and the predatory practices of the alcohol industry, all of which are largely outside of our control.
- Third, it fails to take into account the conditions in which we live our lives. The use of alcohol is often a (maladaptive) coping strategy to deal with life within the broken and oppressive societies we reside in. Oppression, discrimination and marginalization based on various identities is real and largely changes lived experiences. As such, we consume alcohol to escape, to numb and to pause the conditions in which we live because in many cases, these conditions are utterly unbearable.
The term alcoholic completely individualizes addiction, failing to take into account our complex histories, the poisonous and addictive nature of alcohol itself and the oppressive conditions in which many of us live.
As adults, we have autonomy and agency in whether or not we choose to consume alcohol and we are responsible for those choices; however, in most cases, we have little to no control over the things that happened to and around us as children that primed us to use alcohol as a coping mechanism. The label alcoholic reinforces the notion that addiction is the problem of the individual and fails to account for the many “whys” that lead to and reinforce addiction, which is neither helpful in the healing of people struggling with addiction nor in the dismantling of normative alcohol culture.
Language shapes imagination – and mindsets matter
So you might be asking yourself: why does this matter? What difference does it make if I call myself (or others) alcoholics? As I’ve outlined above, there are many issues with the BDMA and the words alcoholic and alcoholism, including failing to take into account the events in our histories that primed us for addiction, not acknowledging alcohol as poison and ignoring the lived realities of oppression. If that wasn’t enough, there was a study conducted in the mid-1990s establishing that there were two key factors that were optimally predictive of resumed alcohol use (aka relapse) and they were:
- a lack of coping skills and
- the belief in the disease model of alcoholism.
What this study tells us is that labeling oneself alcoholic and adopting the belief that alcoholism is a disease actually increases the likelihood of relapse. In many ways, the language of and belief in the BDMA functions as a self-fulfilling prophecy; as you continue to label yourself an alcoholic (despite not currently using alcohol), you reinforce your identity as someone who is diseased, out of control and that relapse is an inevitable outcome. When it comes to what we believe and indeed, how we speak about addiction, it actually matters quite a bit.
A 2019 study showed again that mindsets play an important role in recovery from addiction. In a significant contribution to critical dialogue about consequences of different communications regarding the nature of addiction the study illustrated that messages stressing the changeable vs. fixed nature of addiction influence beliefs and treatment intentions.
Overall, our findings support moving away from messaging about addiction solely as a disease,” said Sarah Desmarais, co-author of the research, as per NC State University News.
Instead, the finding suggests that it would be more helpful to talk about the many different reasons people become addicted.”Sarah Desmarais, Associate professor of psychology, North Carolina State University
Step number one in AA tells us that we’re powerless over alcohol and I wonder: does telling ourselves that we’re powerless lead to feeling empowered? Is powerlessness the ideal place to start a journey to sobriety? And if we are truly powerless, how do we envision being able to help ourselves? What would happen if we used different language and applied different narratives to addiction? What if while acknowledging that alcohol isn’t serving us, we also adopt the ideas that we are powerful and capable people who have what it takes to create change in our lives? What if instead of repeatedly telling ourselves that we’re powerless, defective and in need of external assistance, we reinforce our beliefs in ourselves as empowered, whole and equipped with the tools we need to support ourselves?
Language and words really matter. The words we use shape the way we talk to ourselves and others, influence our beliefs and actions and ultimately, create our lived experiences. When it comes to addiction, why not choose words that serve to empower us and propel us forward? That will always be my choice. If you’re looking for alternatives to the word alcoholic, click here.