In fall 2008, the Hazelden Center for Public Advocacy conducted a national telephone survey of 1000 households throughout the United States. Much was learned from the study, but this short article focuses on one finding that may actually be helpful for all healthcare communicators – that consumers can be confused by our basic language.
People were asked what words they used to describe someone with a problem with drugs or alcohol – the most common words were addict (44%), alcoholic (22%) and illness/disease (12%). Consumer used other words including negative ones such drunk and druggie. However, many more respondents used using neutral terms, free of the stigma and moral judgments of earlier generations.
Figure 1: Addiction Terms (click to expand image)
The industry recognizes addiction as a lifetime illness, with the same problem with relapse as with cancer. Addict might be the most common term to use, but it has some baggage. Some only think of addicts as current drug users. Others expand the word to mean alcoholics who are sober. The industry view (for the most part) is that someone never stops being an addict, but attitudes change sharply with the substance abuse ends.
Next people were asked what they called those who had completed treatment and were no longer using. The most common term, at 35% was recovering, the official term of the industry. Nine percent mentioned rehabilitated. Most other words were very positive – successful, great, strong, sober, quitter, clean, reformed, normal and courageous. Consumers value sobriety, but most don’t use “recovering” or “in recovery.”
Figure 2: Recovery Terms (click to expand image)
Finally, people were asked to define “in recovery.” The top choices were “trying to get over it” (17%), “in treatment” (12%), “getting help” (9%) and “no longer using” (7%).
Recovery normally is used when someone has successfully completed treatment, not when they are in treatment. Although people in recovery “get help” from sponsors and AA, were consumers referring to those still in treatment? “Trying to get over it” is close, but not technically correct, because one never fully “gets over” or is cured of addiction. Only non-addict abusers who reduce or stop their use are cured. Not currently using is probably pretty accurate, although that leaves it difficult to understand the person who has a relapse, which if short term is sense as having a bump in the road to recovery.
Eventually consumers may start using common terminology, but that is less likely if those in the industry aren’t consistent themselves. Just think the illness that started out as swine flu that scientists are calling the H1N1 virus. On May 6, Google search found that 20.7 million listings for swine flu vs. 9.3 million for H1N1. By the end of the month, the ratio could be very different, but the level of consumer confusion probably will remain unchanged. In medicine, the standard advice is “first, do no harm.” In healthcare communications, it should be “first, do not confuse.” Addiction and recovery is one small piece of the healthcare puzzle that contributes to consumer confusion.
By Joel Stegner, Networking Chair
