'People first' approach important for addiction treatment

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The choice of words when discussing those afflicted with the disease of addiction creates a distinction that can make a difference, recovery experts agree.

Just as the language a society uses to refer to people with intellectual or physical disabilities shapes whether they are viewed accurately or are inappropriately defined by their maladies, the same holds true for those who suffer from addiction, said Neil A. Capretto, medical director of Gateway Rehabilitation Center.

For example, just as a person with a disability should not be referred to as a “disabled person,” a person who is addicted to heroin should not be referred to as a “heroin addict” or a “junkie,” he noted.

Additionally, a baby cannot be drug addicted, but one can have a physical dependence because of a mother’s drug use. A person should not be called an “alcoholic” but more accurately “a person dealing with alcoholism.”

There is increased national attention in the rehabilitation community promoting the use of language that emphasizes the person first and the addiction second. The same “people first” concept is used in language dealing with those who have intellectual, cognitive, developmental or physical disabilities.

“We want to humanize this because humans are being affected,” Dr. Capretto said. “Diseases of addiction tend to rob people of their dignity and respect. We want to show them dignity and respect.”

When society uses “people first” language in discussing addiction, the stigma that prevents many people from seeking treatment is removed, and getting more people into treatment is particularly important now that the region is dealing with an epidemic of opioid addiction and overdoses, Dr. Capretto said.

The situation has gotten so bad that Dr. Capretto and U.S. Attorney David Hickton are co-chairmen of an 18-member group that Mr. Hickton formed to deal with the problem. Those on the Working Group on Addiction: Prevention, Intervention, Treatment and Recovery include representatives of law enforcement, business, medical, governmental, religious and nonprofit communities.

Dr. Capretto said the public can help in the process of getting more people into treatment by using language that recognizes addiction for the chronic brain disease it is, just like other chronic diseases such as diabetes and asthma.

“We can either be part of the problem or part of the solution. When we perpetuate stigma through behavior and language, we become part of the problem. Part of the solution is treating people with dignity and respect,” he said.

“By using the correct terms, we identify a person with an illness, rather than a person whose identity is dictated by an illness.”

Nationally, it is estimated that only 20 percent to 25 percent of those who need treatment for addiction get the help they need.

“Stigma has become the barrier to reaching out and getting help. So many people come in here and [have been addicted for so long]. They say they didn’t seek help before because they were ashamed,” he said. “That’s the reason so many people suffer and die and don’t reach out for help.”

He noted that the “people first” approach “doesn’t mean those who are addicted are not responsible for getting help for their disease” just as any person with a disease is responsible for getting treatment and following through, “but there are so many who are so intimidated by the stigma that they won’t talk about it for fear of being ostracized. They’re so scared or ashamed they won’t talk about it with their family,” Dr. Capretto said.


Michael A. Fuoco: mfuoco@post-gazette.com or 412-263-1968.

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