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Substance Misuse or Substance Abuser
Jun 12, 2018

Substance Misuse or Substance Abuser

Sometimes I use a butter knife as a screwdriver. I know that I am misusing this knife. I know that I should get a screwdriver, but either I’m lazy or just feel the knife will do the job just as well. That is the definition of misuse. With Butter Knife Misuse, nothing bad happens. No big deal and all the focus is on how the knife was not the best choice but the job still got done.

Now, let’s talk about Butter Knife Abuse. Maybe the butter knife is used more like a hammer, smashing a nail into a wooden surface. Maybe it gets bent, chipped or broken. It might even slip and cut the hand of the person abusing it. With Butter Knife Abuse the focus is on the person and the fact that he or she is abusing the knife and themselves. Now ask yourself, which example sounds more like the disease of addiction or alcoholism. Misuse or Abuse.

As you know I work in the field of Addiction/Recovery. For the longest time, I have used the terms addicts, alcoholics and substance abusers to name the people I am working with. This is due to what they tell me. They tell me that they can’t stop using. They say they are addicted. They tell me they’ve spent all their money. They say they’ve lost their jobs. They’ve overdosed, died and brought back to life.

The family tells of the devastation they have felt, listing anxiety, constant worry, and financial problems. They talk about the neglect of self and others, depression, loss of work, and accidents. They say they are sleeping too much, sleeping too little, overeating, under eating. They have intimacy problems. They isolate. These people are telling me about addiction and substance abuse.  A disease that is chronic, progressive and fatal for addicts and families.  But things seem to be changing. I don’t know if it’s political correctness.  I’ve begun to notice a new and disturbing trend. These new terms used by some in academia, researchers, educators and rehabs.

They are describing the people I work with as having a “substance misuse disorder or substance misusers.” What? Misuse? That seems like the person who may have had a little too much to drink. A person prescribed a medication that they may have taken at the wrong time of day or even taken more than prescribed. For the most part, this does not sound like the people I work with. That term seems to minimize what I know as a brain disease. Misuse is a watered-down version of what I see every day. Yes, I have people who tell me their drug use is not that bad. Some family members also explain that their loved one is not using “hard drugs.”  I get it. They may not be ready to admit or accept that this is a “real” problem.

When I got into recovery they used the terms addict, alcoholic and chemical dependency.  In my early recovery, I viewed alcoholics as losers and bums. I saw addicts as people who just didn’t know how to use their drugs right.  I didn’t like the term alcoholic or addict because I felt ashamed. In early recovery, I told people I was chemically dependent.  Now that had a ring to it. That term supported my grandiosity, made my drug use seem special. I was different and unique and this kept me at a distance from others.  I could conveniently compare rather than identify.

I took me several months to join the ranks of those in recovery. I had read a book on recovery that explained to me this “thing” I had that seemed to have taken over my life. I had wound up in full-blown addiction and unable to accept that I had it. Back then shame was running the show.  I just wasn’t able to come to terms with the mess I had made of my life. When I started using the term addict, the shame lessened. When I identify with others, I was able to see the similarities and recover.  I’m glad the professionals didn’t label me as a substance misuser. If they did I might have returned to Father Panik Village in Bridgeport with a not such great ending.  Today, I am an addict in recovery for 29 years. I had to accept my condition as it was and as it is. I had to accept that I was and I am an addict.

Substance misuse minimizes. Addiction and substance abuse seems more consistent with the problem and much bigger than misuse and needs to be understood and treated as what it is – a brain disease. I think calling it and treating it for what it is, fewer people die. No one would call the diabetic “a glucose misuser.”  They’d call them a diabetic.  Sure, the diabetic might feel labeled, but once the diabetic figures out who they are and the disease they have… they get better.

I recently was diagnosed with diabetes. My process of shame was the same as it was in my addiction. What has gotten me to health was identifying with and accepting my condition. We need to stop double stigmatize people with addiction. I understand that there are some who just don’t like the terms addict and alcoholic. Over time with education, support, action and accountability addicts and alcoholics do get better.  The comparison of the butter knife and the screwdriver may have been oversimplified and that was my point. Keep it simple!