Dr. Sarah Wakeman
speaker
484 appearances
2 recordings
2 series
first heard Jan 2025
last heard May 2025
Dr. Sarah Wakeman’s voice in public audio — every appearance, attributed to the second.
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And sometimes it sounds like I'm being politically correct or it's like an issue of semantics, but there's actually really good data on this. So if you think about words we use for addiction, one is substance abuse, right? So the term abuse, what does abuse refer to? So it actually comes from an old English word that means like a willful act of misconduct.
And it's a word that we use for child abuse, for sexual abuse, for domestic abuse. Like it's only for these like terribly violent acts of commission that are very stigmatized because they're like terrible things. And yet we use it for this thing that we're saying is a health condition, that you're like a substance abuser or you have substance abuse.
And so there have actually been these elegant studies that took like PhD level psychologists, really highly trained clinicians, and they described a person as either a substance abuser or as a person with a substance use disorder. And the clinician was actually more likely to recommend a punitive intervention for the person described as a substance abuser.
So in this case, they were given like an option. You read this paragraph about like a fictional patient, and they don't really know what the researchers are testing. And they're given a bunch of different options for intervention. And one is this like send them to drug court or send them to jail. One is like offer them, you know, outpatient effective treatment.
There's a bunch of different choices. When they hear someone described as a substance abuser, they're actually more likely to recommend the like jail-based intervention. So words actually like very, they influence how we think, even how we make clinical decisions. They've also done this to the public.
So if you describe someone as a drug addict, the public has a more negative view of them than if you describe them as a person with addiction. So there are these subtle ways there's been this shift in addiction to really using what we call person-first language, which has been true across medicine. So, like, we used to use terrible words.
Like, we'd refer to someone as, like, the schizophrenic, you know, or really labeling them as their health condition. And thankfully, there's been a change from that to realize that people are people first who have an illness or not defined by it. So I would never say, like – I'm going to go see the lung cancer in room 204. I'd say, I'm going to see, you know, Mr. Smith who has lung cancer.
And so with addiction too, like people are more than that. So to say, you know, person with addiction, person with an alcohol use disorder, rather than saying they're an addict or an alcoholic. And then even terms like clean and dirty, which are commonly used when we talk about addiction. So, you know, take the word clean. It sounds really positive. Like you're saying, oh, you're clean.
Like, what are you really saying? So you're saying, like, if you're clean now, when you were actively struggling, what were you? You were dirty. And so I always remember an example. A friend of mine who's in recovery was interviewing for jobs in the recovery space. And so people on the interview trail would say to him, like, how long have you been clean for?
And he would say, well, I've been bathing since I was a newborn. So I've been clean my whole life. And I've been in recovery for five years or whatever. So I think these little things actually matter that we should use terminology that we'd use for another health condition.
If we're labeling people with active addiction as dirty or people with addiction as the same as child abusers with that sort of language, we're really sort of subtly increasing stigma. So that's a small thing that we can all do is just try to use language that's a bit more humanizing. Yeah.
Yeah.
Yeah, it's hard to change. But, you know, like everything, you just want to be humble, curious, and keep trying. I mean, there's lots of language that we've changed. Like, think about so many terms we use for...
you know for you know people who are born with different abilities or for people of different races or other identities that we're really stigmatizing and we've like learned to use different language even if it feels a little awkward when you're first learning it I think understanding the science and the data behind the impact it has to use certain language I think is really useful yeah because that's helped me to understand just because now I understand the first principles of it I need to make sure I describe people as a person first yeah so a person with addiction addiction is much better than calling someone an addict yeah exactly
And one thing people ask me will say, well, what if someone refers to themselves that way? Because people may do that. And that's fine. People can use whatever language they want for themselves. But I think as a healthcare professional, for sure, or someone who's trying to help combat stigma, like we can choose to use different language.
And I've actually had patients sort of ask me like, well, why do you use that terminology when they use a different language? And it actually can be sort of empowering to be like, oh, yeah, I'm actually a person in recovery. I'm a person with addiction. I'm not going to label myself that way anymore. Yeah.
You're like defining yourself as incapable of doing something instead of being like, I'm working on organization right now.
Yeah, you're sort of labeling them as that is the only thing that they are and that they will be that forever. And, you know, a friend of mine is a journalist who is in recovery and writes a lot about addiction. Maya Solovitz wrote this great New York Times piece that addiction doesn't always last a lifetime.
Because I think there's this idea in our head that, like, you know, people with addiction will always have addiction. And it's this, like – incurable thing and that actually people have lots of different journeys. And for some people, you know, that becomes something they deal with and then they move on in their lives. For other people, it's something that they actively manage.
But this idea that you sort of boil things down to like the only thing I am in this world as a person with addiction, you really limit everything else about yourself.
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