Am I an Addict or a Person with Substance Use Disorder, or Both?

The language of addiction is changing, so should the way we identify ourselves in recovery also change?

I have a confession. One that's going to be really unpopular among the addiction and drug policy writers, scientists, and advocates I most admire: I like calling myself a junkie. Not all the time, not every day, and certainly not in a professional capacity or when I am using my personal narrative to illustrate a wider experience. But there is something about the word "junkie" that captures the breathless grit and desperate, poisoned romance of my experience with heroin addiction so entirely that as a creative writer, I can't deny the perfect utility of it. And, I'll admit, I like the outlaw feel of a "junkie" identity. But I also recognize the enormous burden of stigma this label carries, and that there is an element of toxic self-denigration to thinking of myself that way. It's a part of my identity that I have to keep in a box. If I carry it with me all the time, it begins to eat away at my self-esteem, and at the other parts of myself I have honed and value now that I am farther from an active addiction.

I like the outlaw feel of a “junkie” identity. But I also recognize the enormous burden of stigma this label carries, and that there is an element of toxic self-denigration to thinking of myself that way.

The reason I'm making this confession is that I understand, quite intimately, how important and empowering it is to choose how we label ourselves, even if the words we like for ourselves are considered socially unacceptable. The term "addict" is far more commonly accepted than "junkie." Its use transcends even the medical industry. Treatment professionals and hospital workers use the term, often in ways that are intended to be totally benign. It is also popular within the 12-step fellowships, in which members design identities around their recovery and the need to recognize their addiction as something that must be constantly combated.

Right now, a movement is gaining traction in the hopes of steering professionals and media writers away from words like addict, junkie, and substance abuse. There are good reasons for this. For example, a recent study found that the word addict carried negative associations, like the idea that the person would benefit from harmful legal intervention like incarceration instead of evidence-based medical treatment. But what about self-identifying as an addict?

Are we denigrating or empowering ourselves?

Words and phrases like "junkie," "addict," and "drug abuser" have decades of drug war stigma embedded into their meaning. There's no way around that. These words create an identity out of drug use and addiction, which continue to be tied to criminality. The movement for person-first language--saying a "person with an addiction," for example--is based on the fact that addiction is a medical condition. Recognizing a person's humanity before their condition (the way we do for other ailments) is a crucial step toward destigmatizing addiction and drug use. There's no question that anyone who is functioning in a professional capacity, or anyone who does not have personal experience with drug addiction, should use person-first language when it comes to drug use and addiction. It's insulting when an outsider uses these words.

Recognizing a person’s humanity before their condition (the way we do for other ailments) is a crucial step toward destigmatizing addiction and drug use.

But are people in recovery/remission (or active use) insulting ourselves if we choose to use words like "addict?" Amy Dresner, author of the addiction memoir "My Fair Junkie," writes in an article for The Fix that using what she calls "weird overly-PC language" creates "a sort of preciousness around addiction." She argues that owning her past mistakes, and the part of herself that has the ability to be consumed by addiction, helps her step away from the shame that too often goes hand-in-hand with substance use.

What do we owe others in active addiction and remission?

But how far is too far? And what duty do we have to those who are still grappling with feelings of shame and low-self worth because of their addiction? For most people who have no experience with drug use and addiction, words like "junkie" and "addict" conjure images of people at their lowest point. People who think of nothing but the next fix; people huddled in dark corners sticking needles into their arms and legs and necks. But that fixed image of addiction does not encompass the totality of the condition. Many people with substance use disorders never engage in that kind of behavior, and even those who do also do a lot of other things. Things like shopping for groceries, swimming at the beach, driving to work, helping a friend move, or going on a date to the movies... you know, normal stuff that everyone does. Addiction is one facet of a person's life. It does not permanently define a person. When we use fixed words like "addict" to define others, we rob them of their agency to define themselves differently. When we use fixed words to define ourselves, I think we also send ourselves the same message.

I like the way the word "junkie" encompasses part of my experience with heroin addiction, and I like the way it helps me feel a kinship with the people who are often shunned by regular society--but when I think of my relationship to addiction outside of the context of creative writing, I now think of myself as a person with a substance use disorder in remission. I think of myself as someone who used drugs, and who developed an addiction to some of them. I think of myself first in the context of my personhood, and I have noticed a change in the way I perceive my past. I am able to empathize with myself, and to think of my condition as something that can be healed, rather than an indignity that I should run from. I don't want to police your language or what you call yourself. I simply want to offer a suggestion that you try making a shift, even if just some of the time, in the way you relate to your substance use disorder. How does thinking yourself as a person before a condition change your perspective?


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Elizabeth Brico is a freelance writer with an MFA in Writing & Poetics from Naropa University. Her blog, Betty's Battleground, was recently ranked by Feedspot as one of the top 75 PTSD blogs. She is also a regular contributing writer for HealthyPlace's trauma blog. Her work has appeared on Vice, Vox, Stat News, The Fix, and others. When she isn't working, she can usually be found reading, writing, or watching speculative fiction.