Sometimes words don't wear well. They rise up out of the human experience, have their day and then sink again into depths of forgotten memories. Take the work "groak". It is what you do when you silently watch me eat. Or "gorganize" -- that effect Tom Cruise might have on the 20 year-old barista if he were to step into your local Starbucks to order a double mocha frappaccinno.
Words fall in and out of fashion. For us, words like "Addiction", "Alcoholic", "Rehab", "Drug Addict", and "Drug Abuse" have gone the way of "groak". We have learned too much about Substance Use Disorder (SUD) to hold on to outdated concepts that only serve to reinforce the myths and support the stigma that hurts so many people.
SUD is a placeholder for a constellation of symptoms that come together in one identifiable problematic behavior. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-V) uses eleven symptoms to diagnose SUD. They include:
Taking the substance in larger amounts or for longer than you intended
Being unable to cut down or stop using
Spending too much time getting, using, or recovering from use
Neglecting work, home, school, or other important things in your life
Continuing to use, even when it causes problems in your relationships
Giving up important social, occupational, or recreational activities to use
Using even when it puts you in danger
Continuing to use, knowing a physical or psychological problem is made worse by use
Needing more of the substance to get the same effect (tolerance)
Having withdrawal symptoms when you stop using
You probable recognize these from your own observations of people who live with SUD.
But these are just the symptoms. They are signs, not the cause of the problem. SUD has deeper causes that must be addressed for healing to begin. And the causes are not easy to identify. If it was easy, a solution would be simple. Indeed, not that long ago people had a simple solution. Or at least they thought they did.
There was a time when abstinence was believed to be the solution, and the only solution, for "alcoholism". Notice how the term itself assumes the cause. Alcohol causes the problem. Alcohol causes alcoholism. But does it really?
Granted, no one who has never ingested alcohol develops Alcohol Use Disorder. But here's the thing. Most people who have tried alcohol, and most people who even use alcohol on a regular basis, never develop a disorder. Alcohol is not the problem.
If only it was that simply. SUD includes a variety of influences -- biological, psychological, genetic, environmental, relational, and more. Each person comes to treatment with a unique set of experiences that contribute to the development of a SUD. It takes time, a certain understanding, a certain setting, and a group of people working together -- including the person seeking help -- to unravel the complexity of this condition that hurts so many lives.
It is time to put old, out-dated terms to bed. It is time to let them go the way of groak and gorganize. We are not a "rehab". The people we work with are not "drug addicts" and "alcoholics". We provide Substance Use Disorder treatment for anyone who is willing to do the work. And, even if they are not willing yet, that is okay too. We start the work whenever where ever we can. Everyone deserves to a live a life of purposeful meaning and joy.