Vermont Public is independent, community-supported media, serving Vermont with trusted, relevant and essential information. We share stories that bring people together, from every corner of our region. New to Vermont Public? Start here.

© 2024 Vermont Public | 365 Troy Ave. Colchester, VT 05446

Public Files:

For assistance accessing our public files, please contact or call 802-655-9451.
Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations

The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

No More "Addicts?" How One N.H. City Wants To Overhaul Your Addiction Vocabulary

From a handout distributed by Nashua's Department of Public Health
Nashua Department of Public Health and Community Services
From a handout distributed by Nashua's Department of Public Health

Nashua’s Health Department wants you to stop using the word “addict.”

“We need to talk about substance use disorder like the disease that it is,” health educator Aly McKnight told a captive audience of thirty or so in the basement of Nashua Public Library last month.  She pointed to a list of “stigmatizing” words projected onto a screen. “Alcoholic,” “junkie,” even “addiction” should be avoided, it said. 

Residents had come to the Department of Public Health event to learn how to save someone from an overdose by administering the reversal drug Narcan. Each would receive a free package of the drug at the end of the night.  

But first, there would be a vocabulary lesson. Instead of “addiction,” or “substance abuse,” McKnight said, try “substance use disorder.” Instead of “addict,” or “alcoholic,” say “person with a substance use disorder.”

Aly McKnight at the Nashua Public Library
Credit Emily Corwin / NHPR
Aly McKnight at the Nashua Public Library

“I think that’s some heavy lifting there,” said audience member Eric Eastman after the event. Still, he said, “I think it’s constructive.”

The initial push to change the language around addiction was specifically geared toward federal agencies and medical practitioners.  Obama White House Drug Czar, Michael Botticelli sent a memo outlining recommendations to federal agencies, and co-authored an article containing similar recommendations in the Journal of the American Medical Association.

Botticelli’s recommendations referred to research, including a randomized study from the Center for Addiction Medicine at Massachusetts General Hospital. That study compared two sets of mental health providers. One received a survey referring to patients as "substance abusers." The other set got the same survey, except it referred to people “with substance use disorder.” The health providers, it turned out, were more likely to recommend punitive measures like jail time to the “abusers,” and more likely to recommend medical treatment to the people with a “disorder.”

Different labels lead to different outcomes.

But what about that old tenet of recovery - that you have to own your addiction with statements like “Hi I’m Sarah, I’m an addict in recovery”?

Dawn Torregrossa volunteers at Hope For New Hampshire Recovery in Concord, NH.
Credit Emily Corwin / NHPR
Dawn Torregrossa volunteers at Hope For New Hampshire Recovery in Concord, NH.

This is how Sarah Longval likes to introduce herself at recovery group meetings. I met with her and three other women at an addiction recovery center in Concord. Dawn Torregrossa was sitting next to her, and said coming to terms with the phrase “I am an addict” helped her seek help. “That denial can last for a really long time," said Torregrossa. "It’s when that light bulb goes on and you say ‘I am an addict, and I have a serious problem...A lot of people have to hit rock bottom before they come to those terms.”

Those advocating for a new addiction vocabulary make it clear that people in recovery should use whatever words they choose to describe themselves. 

Still, Torregrossa seemed to indicate that something useful might get lost in a vocabulary overhaul.

Michael Botticelli, from the Obama administration, has thought about this. “I’ve been a member of a twelve step organization for a long time,” he said over the phone. He, too, is in recovery.

Still, Botticelli said that iconic “I am an addict,” admission is only useful when the medical community has fallen down on their job. “We can do a better job at intervening with people before they have to hit rock bottom,” he said.

His point was, doctors don’t wait for someone with heart disease to have a heart attack before they prescribe statins. They also wouldn’t wait for a diabetes patient to confess “I am a diabetic,” before prescribing insulin. Why do that with people who have substance use disorder? It’s a question for medical professionals. And, perhaps, for the rest of us, too.

A handout provided by Nashua's Department of Public Health and Community Services

Copyright 2021 New Hampshire Public Radio. To see more, visit New Hampshire Public Radio.

Emily Corwin reported investigative stories for VPR until August 2020. In 2019, Emily was part of a two-newsroom team which revealed that patterns of inadequate care at Vermont's eldercare facilities had led to indignities, injuries, and deaths. The consequent series, "Worse for Care," won a national Edward R. Murrow award for investigative reporting, and placed second for a 2019 IRE Award. Her work editing VPR's podcast JOLTED, about an averted school shooting, and reporting NHPR's podcast Supervision, about one man's transition home from prison, made her a finalist for a Livingston Award in 2019 and 2020. Emily was also a regular reporter and producer on Brave Little State, helping the podcast earn a National Edward R. Murrow Award for its work in 2020. When she's not working, she enjoys cross country skiing and biking.
Emily Corwin
Emily Corwin covers New Hampshire news, and reports on the state's criminal justice system. She's also one of eight dedicated reporters with the New England News Collaborative, a consortium of public media newsrooms across New England.
Latest Stories