Why I’m Careful with the Word “Alcoholic”

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I use the word “alcoholic” sparingly and deliberately, when I use it.    We each get to choose our own language when we talk about our self, our use of alcohol or drugs, and our choices.    There is no clinical evidence to support that people have to label themselves in order to complete treatment or to be well.   We can recognize the impact of our use and make meaningful changes in our lives, without choosing to label ourselves.   I use the word “alcoholic” on occasion with people I work with, if he or she finds it helpful to their understanding of themselves.   For example, I might say, “You’ve said that you’re an alcoholic.  What does that mean to you?”  By asking that question, I’m not labeling that person “an alcoholic” or assuming that I understand what he or she means by “alcoholic.”  I do not put the word into that person’s mouth or demand that he or she uses the word, if he or she finds it unhelpful.

For some people, the word “alcoholic” is helpful.  Yet that helpfulness depends on who says it, when they say it, and on where and how the word is used.  Words like “alcoholic” mean different things to different people in different places.  If I go to AA, I may choose to call myself an alcoholic.  At AA, I may experience being “an alcoholic” as having a community, so I’m not alone in a difficult experience.  When I am at a meeting, I can have a sense that everyone in the room has a similar understanding of what the word means.

On the other hand, the word “alcoholic” would carry different weight and meaning in another setting, like at my job.   My boss may not understand the word the way I do. If I told my boss “I’m an alcoholic,” he or she might make all kinds of assumptions about me.    Maybe my boss starts to think, she’s late all the time, maybe that’s because she’s “an alcoholic.”  Suddenly, my lateness is not viewed as a work performance issue, like it would for another employee.  Instead, my lateness might seem to a problem that won’t go away and that can’t be addressed normally.  Maybe I’ve been sober a long time; but, every time I have an issue with work performance, people are wondering if I have started drinking alcohol again.    The context of words like “alcoholic” really matters.  Calling myself an alcoholic at an AA meeting might be helpful to me.  Calling myself “an alcoholic” at work might create unfair judgment, problems and consequences.   Similarly, if someone calls me “an alcoholic,” I can have a very different experience with the word, then if I choose to call myself “an alcoholic.”

To many people, the term “alcoholic” has a negative meaning.   People make a lot of assumptions about someone who is labeled, “an alcoholic.”  I did a Google search for the phrase, “Alcoholics are…”  Google suggested some helpful things, like “deficient in what vitamins.”  The majority of the auto-fill responses were negative.  For example, Google auto-fill suggested:

  • Alcoholics are… losers.
  • Alcoholis are… liars.
  • Alcoholics are… pathetic.
  • Alcoholics are… self-centered.
  • Alcoholics are… selfish.

When I searched for “Addicts are…,” the negative messages Google auto-fill included:

  • Addicts are… selfish.
  • Addicts are… liars.
  • Addicts are… manipulative.
  • Addicts are… losers.

Keep in mind that terms like “addict” and “alcoholic” label the person, the whole person, as a thing.   The negative messages that Google returned to me are messages that we hear every day about people with drug or alcohol use disorder and people experiencing addiction.  I’d be horrified to think I’m “an alcoholic,” if my experience of the word told me that “alcoholics” were lying, pathetic, selfish losers.  I wouldn’t want to be seen that way, by myself or anyone else.  And, if see myself as “an alcoholic” with those ideas in my head, and, therefore, I see myself as a pathetic loser, it would be a lot harder to view myself as valuable and worthy enough to deserve meaningful change.

Think about people with drug and alcohol use disorder as human beings who are experiencing a medical condition.  One way to address the negative labeling of people who use alcohol and drugs is to change our language.  So, for example, instead of saying “addict” or “alcoholic,” I say “a person with alcohol use disorder” or “a person with drug addiction.”  This reminds me that the person is a person, a human being, first. And, I am framing that recognition with the person’s experience of a medical condition.

If you are frustrated about your personal experience with drugs or alcohol or someone you care about is experiencing an alcohol or drug use disorder, take a step back and get some context.   Alcohol and drug use disorders are a diagnosable medical condition known to affect the brain and those changes in the brain impact behavior, thought and emotion.[1]   Think about a behavior like lying.  Drug and alcohol use disorder can impact processes in the pre-frontal cortex tied with our ability to apply values and to recognize consequences.[2]    If I use drugs or alcohol regularly and my pre-frontal cortex is impacted, my brain is not working effectively for me.    Because of that effect, I may not recognize why lying or honestly matters, because my brain isn’t communicating strongly to me that those things do matter.    My brain also may not be signaling me accurately about the consequences of my behavior.   The part of my brain that should help me understand what will happen if I lie isn’t drawing my awareness to consequences.     This type of information can help explain why some people who use substances engage in hurtful behaviors like lying or seem to lie more often than other people.

As the research suggests, the thoughts, emotions and behaviors we observe in some people with alcohol or drug addiction can have biological reasons.  I am not saying someone who uses alcohol or drugs who engages in lying should not be held responsible for the impacts of dishonesty.  Rather, I am saying recognize that the brain may be influencing the behavior significantly.    People with alcohol or drug use disorders need to understand what is happening in their brains and develop skills and techniques to work through those impacts.

If we are loved one supporting a person with alcohol or drug addiction, we can benefit from the medical information and that information can help us better understanding the thoughts, behaviors and emotions we observe in our loved one.  Knowledge and understanding may help us be patient and more compassionate, as our loved one addressing their condition.  With that understanding, we may recognize that saying “all alcoholics are liars” is unhelpful both to us and the people we care about.  Rather we might say instead, “People with alcohol or drug use disorder sometimes lie.  The behavior can be related to medical impacts of use.”   Being thoughtful with our language choices is important, because our words can be hurtful, unhelpful and may lead us into making assumptions, rather than helping us to gain understanding.

[1] http://www.asam.org/for-the-public/definition-of-addiction

[2] http://www.nature.com/nrn/journal/v12/n11/fig_tab/nrn3119_T1.html


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