August 29, 2017  | 

Harvard Gazette | Revising the language of addiction

Colleen Walsh, Harvard Staff Writer, August 28, 2017  

With Recovery Research Institute Founder & Director Dr. John F. Kelly


John F. Kelly, the Elizabeth R. Spallin Associate Professor of Psychiatry in Addiction Medicine, crafted two descriptions of someone struggling with addiction. In one paragraph he referred to the person as a “substance abuser,” which he believed might suggest the notion of willful misconduct and lead to more punitive approaches. In the other paragraph he wrote “substance use disorder,” a term he thought might convey the idea of a medical malfunction and lead to less punitive, more treatment-oriented attitudes.

Kelly then randomly assigned the descriptions to 600 doctoral-level clinicians and asked them to answer a series of questions including whether the person should be punished or treated, whether he should be blamed for his condition, and whether he was a threat. Later Kelly repeated the test with the general population.

In both groups the research found that “individuals who were exposed to the ‘substance abuser’ term had much more punitive attitudes toward the subject than if he was described as having a substance use disorder,” Kelly said.

After the Medical School published the findings in its Mental Health Letter, word spread. Kelly traveled to Washington, D.C., to meet with Michael Botticelli, then-director of the White House Office of National Drug Control Policy, and he presented the research at the first national drug policy reform summit in 2013. Soon the White House adopted his recommended terminology.

In 2015, Kelly spoke before the International Society of Addiction Journal Editors at a conference in Budapest. In response, the group formulated a consensus statement that recommends against using stigmatizing terminology, most notably “abuse” and “abuser,” in published addiction science.

Another move influenced by his research, Kelly said, was the decision by the Associated Press to include a new entry on addiction and to revise drug-related entries in the latest edition of its stylebook.

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