• Sara Rimer

    Senior Contributing Editor

    Sara Rimer

    Sara Rimer spent 26 years as a reporter at the New York Times, where she wrote about education, the death penalty, immigration, and aging in America, and was the New England bureau chief. The Times nominated her for the Pulitzer Prize. Her coverage of the death penalty was cited by the Supreme Court in its 2002 ruling outlawing the execution of developmentally disabled individuals. Profile

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There are 31 comments on Don’t Call Jessica Lareau an Alcoholic. To Her, Words Matter

    1. You have 4 yrs sober, you’re not in long term recovery… all you have is a daily reprieve upon your daily spiritual conditioning … that school has you confused!!!!

  1. What if you have a person in your family or close friend who is actively over drinking or using drugs and not in recovery? is there non stigmatizing language someone can use when describing for them?

  2. AA members say “sober alcoholic” or “alcoholic in recovery” to emphasize awareness of the danger of relapse. Makes sense to me. Relapse is a lot more dangerous than whatever stigmatization still exists. But AA doesn’t have any rules for how you identify yourself. Whatever works for you is fine.

    1. Hi Bill, I completely agree that people should self-label in whatever way that “keeps them sober.” I responded to a similar comment below if you want to see a more clarified explanation of the target audience for these changes or some research behind the terms. Thanks!

      1. Jessica, I assume you know that AA and NA members identify themselves in diverse ways already. Off the top of my head “I don’t want to drink today”, “I’m a drunk” (remembering when he asked a bouncer throwing him out of a bar “Don’t you know who I am” and the reply was “I know. You’re a drunk”), “I’m addicted to more” and one you might like “Champion human being”. There are many more!

        In my opinion it makes sense to identify as an alcoholic or addict since complacency can set in with long term recovery and I think even little reminders can influence behavior.

  3. As a someone who is relatively obsessive about words, I think “Words do Matter”. However, in my opinion this approach sounds like a hedge so many in need of sobriety do not need. As a clinical social work and recovering alcoholic, I do not find the term alcoholic stigmatizing. One who is secure in their sobriety need not be concerned. Labeling oneself, if you will, an ‘alcoholic’ is simply a way to take full responsibility for recovery and ‘fess up to the devastation one may have caused in the lives of other people, and the need to fully embrace the challenging road to sobriety. Maybe I’m unique, but I don’t think I’ve ever considered alcoholism or ‘alcoholic’ a moral failing. Polite or clinical terms such as “person in recovery” or “person with a substance abuse disorder”, from my perspective, invite minimizing and rationalization of the terrible consequences of addiction. Alcoholic and addict are powerful words that remind me (and others) of where I’ve come from and a need for vigilance. Recovery is the polite and neutral moniker that glosses over the nature of the beast. Perhaps our colleagues are overthinking the issue.

    1. Hi Jim, thanks for your perspective, I completely understand what’re your saying. One of the stipulations is that everyone should self-identify however they wish, I’m a total proponent of “whatever keeps you sober.” This new language is simply another option for those in recovery and it can also be used to teach family, friends, and society about stigma & why someone might choose to identify this way. In reference to clinicians or universities, they should only be using these terms because they are the most clinically accurate, “substance use disorder” is the correct DSM diagnosis, and these newer terms are proven not to cause implicit bias. This movement is based on research proving that clinicians & people in society are unconsciously biased when they read/use the older terms. It has been proven that they view people with a more negative, punitive outlook & lean more towards punishment over treatment when they read, hear or use these terms. Basically saying that, although you do not see the term “alcoholic” as a stigmatizing term, research shows that people outside of AA unconsciously see it as negative or attribute it more to a choice or moral failing rather than to a disease. Lastly, if someone in society says “addict,” that carries a different meaning for that person than the one you were discussing. People in recovery can still identify in any way they like, these terms are meant for everyone else, in order to get rid of judgment, stereotypes & negative connotations that are inevitably attached to the “older terms.”

  4. Thank You Laura! I too am a graduate student at BU in the MSW off campus program working to obtain my LICSW. I have been sober from heroin 7 years this August. Words Do Matter! Education and Prevention Matters. We Matter! Great Work!

  5. This was an interesting read. I’d like to add another perspective here. It seems to me the new language is missing the point that often times the choices and especially untruths that “people with a substance abuse disorder” have made or perpetuated have resulted in hurt not only to themselves but also others. Unconscious bias has a basis in reality – the focus perhaps should be on addressing the source(s) of unconscious bias. Accepting and owning what the illness is (alcohol, drugs etc.) rather than trying to wrap it up with a vague generic clinical description seems to me to be more honest. Unless an individual has been on the receiving end of interactions with a person with a substance abuse disorder, people in recovery are not best suited to understand the “judgment, stereotypes and negative connotations” that come from the experience of others. People can self-identify any way they want, just don’t impose your language on others. If new terms are needed, let’s find some that are inclusive of everyone’s experience and rather than those that appear to be designed make one group of people feel better about themselves.

    1. Sarah, I’m so sorry, it sounds like your experiences, as a person close to someone with an addiction, have been difficult to deal with and painful to bear. They say that “addiction is a family disease” and I completely agree when you say that this disease hurts other people besides just the person with a Substance Use Disorder (SUD). Understandably, you sound very hurt and angered at the illogical actions of people with SUDs and I hope you know that people with SUDs also feel horrible about the devastation caused by this disease. I can tell you first-hand that the amounts of shame and guilt are overwhelming in people with SUDs, no matter how they self-identify. However, we have seen through history and research that shaming, punishment, and guilt do not motivate people to seek treatment, remain sober or stop using drugs & alcohol, as was evident in the “War on Drugs.” I agree that people should self-identify in whatever way they want, we do not “impose our language on others,” we simply provide another option and discuss why one might choose to identify this way. I understand why you don’t feel people with SUDs can understand the negative experiences of their family or others also affected by addiction. You are right, one won’t ever understand the hurt family members felt as a result of one’s SUD, however, many people with a SUD have also had relatives with addiction and have had to go through the same hurt, scientists have even found 11 genes that can prove addiction is hereditary. For example, I experienced the pain and destruction of a family member with a SUD long before I developed an addiction myself. Both positions are difficult to be in, but just because a person with a SUD wants to be seen as normal, like anyone else with an illness, does not mean that they don’t accept the gravity and the seriousness of the illness. So I ask you- have any stereotypes served any positive purpose throughout history? I rally against the belief that people with SUDs deserve to be viewed negatively for the rest of their lives. Since 1956, SUD has remained scientifically proven as a disease like any other and not a choice. Lastly, there are specific clinical terms like “Alcohol Use Disorder, Opioid Use Disorder,” etc. if one wants to be more accurate by naming the substance. These terms are not attempting to be vague, dishonest or delicate when it comes to the devastating nature of this disease, we are simply suggesting to follow the medical diagnoses already established by experts in the DSM-V and not require that a person’s disease become their identity and sole descriptor.

  6. I’d like to also add that stigma and discrimination against individuals with serious mental illness continues to be a problem and they too, need to be included in this conversation. I still see/hear people casually use the word “(that person is a) schizophrenic” to describe someone with schizophrenia and who is in recovery. The field of psychiatric rehabilitation (https://www.psychrehabassociation.org/about/core-principles-and-values) have considered this stigmatizing language and have advocated for change for years.

  7. Great article! There is a strong movement in the Peer Community teaching how to use human experience language, not only using the DSM V diagnosis for example a person with substance use disorder, but moving away from delusions/hallucinations with people who have fixed beliefs or a person who hears voices. Just using more everyday language to describe the situation.

  8. Jessica, I really appreciate what you are trying to do! Continue the great work! As a student of Social Work myself, I have to admit to using works such as ‘alcoholic’ and ‘addict.’I have never looked at it with the perspective that you have presented. Now that I have read your article, I hope to use those stigmatizing words less often and work together towards helping people get the help they need without feeling stigmatized.

  9. As a sober alcoholic, MSW student myself I detract. We can’t say “addict” anymore? That’s fragility gone too far. Yes, “people with SUDs” of course have a long history of stigma (to say the least) and language matters. But let’s get some perspective. Throw out things like “junkie”, but “addict”, really? There’s something about that language that helps keep people, like myself, ‘honest’ if you will. And as someone else pointed out, some consider those terms helpful, self-identifying language. In this instance, it’s not right to constrict how some speak because a select few are offended. At a certain point, you have to have enough ego strength to not let what society thinks affect you. Lastly, long-term recovery is traditionally considered 5 years.

    1. As stated in the article, these terms are simply a new option developed by researchers on stigma to further align with person-centered care practices and assure that a person’s diagnosis does not consume their identity. They are a person living with challenges, not just a label. These terms are also empirically-proven through research, debated by top addiction professionals and refined, no single person decided upon these terms. Additionally, these language changes are important because they are proven to cause implicit bias with clinicians, more punitive care practices and more negative treatment outcomes for patients. Lastly, people in recovery can refer to themselves in whatever way “keeps them sober.” No one is being forced to change their language, clinicians are being asked to use clinically-precise language within education and the medical field. Also, there are different connotations between a person self-identifying because it keeps them “honest” and society using the term as a stereotype or label with implications of negative connotations. I did not know there was a definitive time frame for someone being able to refer to themselves as being in “long-term” recovery, thank you for letting me know. From now on, I will refer to myself as a “person in recovery.” We all learn something new every day.

      Examples of research on this topic:
      https://www.tandfonline.com/doi/abs/10.1080/10410236.2018.1481709
      https://www.recoveryanswers.org/research-post/how-we-describe-individuals-substance-problems-affects-perceptions/

      1. I applaud you getting a conversation going and taking action in something you believe it and can see your perspective.

        But, I couldn’t disagree more.

        My fear is not saying addict ‘will not keep others honest’ either. I see the information you reference suggesting harm, however, I feel people not identifying thusly will do more harm than good. Simply see the points and responses here.

        Really, anytime I’ve seen addicts over identifying with a brain disease concept it’s when they are skirting responsibility. (But yes, of course biology comes into play. And no, I’m not in AA).

        On the topic of labels, I find ‘disordered language’ far more harmful in that it is often self-limiting (the way you feel about “alcoholic”; all encompassing, internalized stigma) and again, detracting from personal responsibility. You said it yourself, we don’t want a person’s diagnosis to consume their identity. “Alcoholic” isn’t a diagnosis but “substance use disorder” is.

        So, where does that leave us?

        How about “person who is an alcoholic”?

        1. Hi S, thanks for sharing your thoughts. Just to clarify, people can identify in whatever way they choose so it’s not for me to debate how people should identify, that is up to them and these terms are merely presented as an option. The intention is not for people to blame the illness as a reason to not pursue treatment or recovery, however, SUD is a disease. Clinicians are asked to use medical terminology as it is defined in the DSM-V, which is the point of this initiative. As clinicians, we should also be using “person-first” language. Therefore, to say “person with a substance use disorder” is accurate and person-first language, to say “person who is an alcoholic” would be labeling & defining who the person is other than what challenges they struggle with. If a person in recovery or clinician wants to be specific, they can choose to say “person with an alcohol use disorder” or another diagnosis that is substance-specific. I would love to meet with you and continue this conversation to learn more about your perspective and share some of the research that went into the development of this initiative. If you are interested, please e-mail me at jlareau1@bu.edu

          1. Well, I think every copy of the DSM should go up in flames so it will be a long discussion :)

            Let’s try to make something happen.

            I get your position and the research you are citing.

  10. Hi Jessica,
    I found your article very interesting and an eye opener. Having close relatives who are currently abusing alcohol/ drugs and also in recovery the term that is used “I’m a person in long- term recovery” really stuck out because individuals who are on the road to recovery often times describe themselves as an ex alcoholic or ex substance abusers. Which as you said is stigmatizing language and takes away all other things that makes them a person so in essence, all people see is an alcoholic or drug addict. Thank you Jessica for this article and your honesty.

  11. I’m repeating myself, but I feel strongly. There is a matter of priorities here. My absolute #1 priority is avoiding complacency and relapse. I’ve heard too many tragic stories. If I think identifying myself as alcoholic/addict provides some defense against forgetting the nightmare and going out for some more research, I’m going to do it, and not worry about anything else.

  12. I’ve read some comments of people that were sounding as if it all is just a matter of self-perception, and whether you are an alcoholic or a person with substance use disorder, you should own up to whatever disasters in life you’ve caused, so if you’re, as an “alcoholic”, ashamed with the way society looks at you, then it’s too bad. Deal with it or die. Well… As far as I’m concerned, personally, I am recovering addict, and I’m actually proud to be called one. However, I personally know some good, and strong in their recovery people, who prefer to keep the information about their addiction to themselves. Some of them told me that they, “Can’t afford it to go public”. I wonder, how some practicing MD or attorney, or politician, or just a son who doesn’t want to disappoint his parents, would feel about their issue to be exposed. Fifth Tradition of Alcoholics Anonymous says, “Each group has but one primary purpose–to carry its message to the alcoholic who still suffering”. In NA, for that Tradition we use the word “addict” just to include as well the individuals addicted to drugs other that alcohol… Also, in 12-step fellowship we always say, that a newcomer is the most important person in the room. We share our “experience, strength, and hope” in our groups, we allocate our personal time to go to hospitals and institutions to “carry the message”, and we pray for those who are “still suffering”. Today luckiest of us are privileged to be able, instead of running around looking for the “next one” or puking our brains out due to a hangover, to go online and theorize how we’d like to be called… Don’t get me wrong, I do like this option so much better, but let’s not forget that we are just a few of so many. If we, together, manage to make that change, which will allow for addicted individuals to start considering themselves as people with any other diseases do – in need of help, and actually start addressing their problem, then it is nothing short of a greatest revolution in modern history. Thank you, Jessica, and keep up your G”D’s work!

  13. Jessica I am very interested in this topic and would love to hear your story. Also I’d like to follow yoo and your work to see how this and other topics develop. The feedback forum for this article really made me think, especially a few of your thoughtful replies. How can I follow your work? Do you have a website or Facebook page? I’ll be sharing this in the recovery groups I run.

    Thank you,

    Nathan C
    Everett, WA.

    1. Hi Nathan, thanks for your support and interest around this important topic! Please e-mail me at jlareau1@bu.edu, we can speak further about the ongoing work around this initiative and changing SUD stigma in multiple settings. I am currently working on a research proposal to show evidence for the need of increased SUD education within social work curricula, as well as other fields. I would love to talk more about how others can become involved and help spread this initiative to additional forums. Thanks for facilitating discussion on SUD stigma with your recovery groups. I recently led a discussion at a family support group at McLean Hospital and families really appreciated the opportunity for education, asking questions and discussing their roles in how they can help change SUD stigma in society. I look forward to speaking with you and anyone else who would be interested!

  14. I think it helps when people in recovery self identify as alcoholics or addicts. So many people have such a negative twisted image of alcoholics and addicts . It helps when they see accomplished, intelligent and attractive people who are recovering addicts and alcoholics. It can happen to anyone. the disease does not discriminate.

  15. Call a spade a spade, it’s part of the acceptance we need to move forward into recovery and what keeps us alive. Alcoholic and addict are nasty words that fit a nasty disease. Who the heck cares if someone who doesn’t understand addiction winces when they hear me say I’m an alcoholic? (Millennials care, but that’s a whole other post).

    Proud Alcoholic/Addict

  16. I profoundly disagree with this approach to ‘people first’ language. Hiding serious problems behind what are essentially euphemisms helps no one. Even worse, it conceals those very problems from society, effectively sweeping them under the rug.

    Right now in San Francisco, where street crimes and addiction are escalating rapidly, the city council does the unthinkable: rather than address the problem directly, they decide to stop calling a crime a crime. Instead, convicted criminals are now “justice-involved individuals.” How does this help the victims whose cars are smashed, whose neighborhoods are needle-ridden, and whose women and children have to walk past hostile individuals?

    Is BU really this challenged to find legitimate problems in our society upon which to invest research dollars and countless hours? Creating these euphemisms, at best, hurts those it tries to help, and at worst, is a form of censorship.

    1. Perhaps in the context of your example, Andrew, you might have a point. But you clearly aren’t an addict, nor do you have a grasp of the disease of addiction. Addicts aren’t criminals for falling into a cycle of substance abuse. Any crime they might commit in pursuit of their problem is a separate matter, but their cycle of abuse is not a crime–it is a disease and should be treated as a health issue. So in this context, being sensitive of how we refer to people trying to help themselves, instead of putting stigmatizing labels on them, is harming nobody.

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