The Stigma of Recovery Webinar

Official Transcript

Paul: Hello and welcome to our webinar. My name is Paul Toriello and I’m a proud member of the empowering youth and family program. This webinar is on recovery and the stigma of recovery. We’re very lucky to be joined by Donald McDonald who is a national expert in recovery and the stigma of recovery and how to battle it.

Donald, thanks for joining us on this webinar.

Donald: Thank you. 

P: Please tell us a little bit about your personal professional journey that led you to have this expertise that you want to share with us.

D: Yes, well my name is Donald McDonald. I’m a person thriving in sustained recovery from severe mental and substance use disorders now for 15 years. I’m a social worker. I’m an addiction specialist. I’m a recovery coach professional and a pie lover.

P: Ok, fantastic. Recovery. For you, what does that mean, what does recovery mean to you?

D: Right, well recovery means more than the absence of alcohol and other drugs from an unchanged and unfulfilling life. Recovery is my life. I am, I have purpose in my life today, I’m surrounded with loving people, meaningful relationships, and I have a desire to help other people find their pathway to recovery so that’s that’s what recovery means to me. It’s it’s a daily journey of self-improvement and helping other people to find freedom and wellness themselves. 

P: It’s a lifestyle.

D: It’s a lifestyle for me.

P: So you’ve extended beyond that though, you’ve become what you call recovery activist. I say that’s a new phrase or maybe a more recent phrase. What does recov- what does a recovery activist mean? What is it? What does that look like?

D: I’ve taken to calling myself a recovery activist and several of my peers nationally have been doing that as well and this came about when we began to shed the internalized stigma associated with with our pathology. We were thriving in recovery, we were doing so very well yet we were seeing systems of care continue to be inadequate, systems of punishment continue to respond to to public health issues so we realized that the recovery movement is a civil rights movement, that our issues with access to appropriate care, that our issues with acute care and incarceration versus recovery oriented care, these were all rooted in stigma these were discriminatory barriers to freedom and wellness for people, so I along with many of my peers are leveraging our recovery status, our knowledge, our status in the community, our privilege to try to demolish these barriers for other people who who aren’t as lucky or as privileged as we are. 

P: And one of the barriers probably one of the biggest barriers is stigmatizing language, the language that stigmatizes the addict or the person recovering. Talk about stigmatizing language or language in general and some in its importance from for perpetuating the negative as well as battling the negative.

D: Absolutely. I always draw in one of my mentors right now with with a quote from him. Don coyhis of the white bison wellbriety movement. It’s an indigenous American native wisdom pathway of recovery and he shared with us. If you want to care for something, you call it a flower. If you want to kill, something you call it a weed. And and these names are our social constructs for things that are strikingly similar in appearance but we’ve decided as a society: we kill weeds, we nurture flowers, and we’ve also discovered that the human brain has a similar reaction when we’re discussing human beings. If we use stigmatizing labels or pejorative language to describe folk, we are more inclined to care less about them and they are less inclined to seek help from us.

So that that’s what we’ve discovered is if we begin using more accurate less stigmatizing language, more people will seek help and generally speaking the help will be better, the policy environment will be better, the systems of care will be more robust, more recovery oriented and we’re slowly seeing that change since this movement started maybe around 10 years ago

P: Fantastic. More people seeking help and getting better help. 

D: That’s right.

P: That’s wonderful. So if those are the the broad goals of changing language more people seeking help and getting better help. What are some of the phrases we need to avoid? What are some of those the stigmatizing words or phrases that are that does have that give us that visceral gut reaction of “I need to hide”

D: Well the low hanging fruit is pejorative language. None of us should be engaging in pejorative language. That’s language designed to deride people, to harm people and pejorative language in this space are words like junkie and crackhead. Don’t use that language. That’s harmful language, no matter what your world view on addiction is you shouldn’t be using that kind of language around your children basically. 

So that’s easy don’t don’t use those words then it gets a little more nuanced there’s words like addict and alcoholic. See those those are labels that reduces a complex human being and all the contents of their character down into one singular attribute and as we know in this helping space, using person first language has become standard because it inclines us to see the people we’re helping as as people with breadth and depth beyond the diagnosis that we’re working with. It makes us better helpers

So don’t use the words addict and alcoholic. If there is a diagnosis in place a person living with substance use disorder or a person experiencing addiction. If there is no diagnosis in place a person with alcohol or other drug problems or a person experiencing problematic use of alcohol and drugs. These these are our friends and family members we’re talking about. 

We’ve discovered more recently a very pernicious label that is beginning to go away but it’s difficult for it to go away because it’s so engrained in the addiction space and that’s drug abuse, drug abuser, alcohol abuse, abuser. It once again puts a label on individuals. It propagates the self-inflicted myth of addiction. No one decides to become a person living with addiction so we’ve we’ve data supporting the fact that that phrase alone inhibits help-seeking and also inclines helpers to be less therapeutic in their responses to issues that may arise and more punitive in their responses because they’ve colored this individual as an abuser. That’s a powerful word so we’ve taken to using language, like if it’s prescription opioid specific and and individuals are going off prescription, that’s prescription opioid misuse. Now this may turn into too chaotic use, it may be diagnosable eventually. If it’s youth specific there’s no need to differentiate abusive use. We don’t want any youth using heroin or using alcohol or using tobacco so it’s it’s it’s substance use prevention, and if substances get used it it becomes substance use issues. So substance misuse, substance use issues, substance use disorder, problems with alcohol or other drugs. 

Other language for people in recovery we’ve taken to – I can’t tell you how many times I’ve been described in the newspaper as former addict Donald McDonald right? I’m a person in recovery. I’m not a former addict and I no longer refer to myself that way. I’m a person in recovery so so these are these are the suggestions that we’ve given to the community to use more accurate non-stigmatizing language with the hopes that more people will come forward. That’s a very clear answer. Thank you for that. Don’t use these words. They’re stigmatizing. They reduce people’s inclination to get help. It reduces the helpers effectiveness. 

P: That’s a very clear answer. You mentioned children several times in what you just said. For Empowering Youth and Families program, it’s a prevention program. What would you suggest to two parents who are raising kids, thinking prevention or the prevention educators? What’s the message you’d give to them about recovery and language to communicate to the children and their family to help them cross bridges that may present themselves down the road where somebody develops challenges around the use of substances or maybe they don’t. What’s the best way to to help a family move forward?

D: Well, first I would say trust prevention experts. Prevention is a science. Prevention is a well studied, well-funded science with deep infrastructure. Prevention works. We know how to prevent addiction. Unfortunately in this country we’ve been responding with less intelligent responses. 

We’ve done two things: we’ve tried to create fear around substance use – to prevent that from happening that hasn’t worked and we’ve tried moralizing as well and that’s where this language comes from, the pejorative language and and words like addict is is we’re moralizing alcohol and drug use in the hopes that our children will not use them. So many Americans use alcohol and drugs, a percentage of Americans will develop a problem because of their vulnerability. 90% of the time this begins in adolescence. So if your child has experimented with alcohol or drugs and they have developed some problems, are they going to come and seek help from someone who has traditionally either moralized this issue or tried to create fear around this issue. 

My suggestion to family members is trust that your youth are super smart. Kids today are are wicked smart so we know the science around brain development. We know the science around the development of substance use disorder. Share that science with them, share that science with them discourage them from using for as long as possible. We know that if you use alcohol or drugs before the age of 21, a 25% chance of developing an issue. If you wait till after 21, it’s a 4% chance so have them playing the odds. Wait, wait. It’s science it’s not moralizing, it’s not fear-mongering, it’s prevention science

P: Educate our children on the risks of the choices they may choose to take as opposed to making it a right and wrong issue and a fear-based issue.

D: And when will we acknowledge now for decades that that approach to prevention is not working?

P: So what would you suggest to families? How can families advocate for change in their communities for for addressing stigma addressing recovery and promoting recovery?

D: Well the recovery community is a really big tent. It’s people in recovery, it’s family members, and it’s allies and allies are basically everybody who knows someone who’s in recovery as someone who’s been impacted by addiction. So join this movement every September is national recovery month, so that’s a great place to start. Join a recovery walk, see if you have a recovery community organization in your state a recovery community center, these organizations are engaged in education and advocacy. They’re there teaching the same things that I’m teaching but they’re also organizing the community into one impactful voice. Speaking with legislators and policymakers and service providers, speaking to other family members to help them shed their internalized stigma so that family members will seek help and get the casserole that they deserve, not the not to be isolating behind the blinds thinking that they’re the only ones.

So join the movement is my message. It is it is a surging vanguard of human beings in America who have been shedding their internalized stigma and have begun demanding what they deserve. We have a very discriminatory system of care right now it this this is a pediatric – this is a pediatric public health emergency that impacts one in seven human beings but we have discovered that 90% of people experiencing addiction do not have access to services. What else is that other than discrimination?

P: Thank You. Donald for such a wonderful and hopeful message and thank you for watching this webinar. As always at the end of the webinar will be links for you to access more information on this topic. Thank you


Faces & Voices of Recovery

Organized Communities of Recovery & Storytelling. Links to local recovery movements and toolkits for advocacy and messaging.


Blogs, article, and videos on stigma, language, and advocacy.

Addiction Policy Forum

The Science of Addiction Prevention, Treatment, & Recovery. Free animated short videos, one-pagers, and infographics.

Recovery Research Institute

Research on the Impact of Language. Links to studies. Home of the Addictionary and language infographics.