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Editorial: Addiction science needs new terms

We most often look at addiction through the eyes of therapists, physicians, police officers, family members and the addicts themselves.

Now, here are the professionals with whom society should consult next:

Linguists.

Yes, we're serious. Because the more we learn about addiction, the more we realize our language—our vocabulary—is inadequate to the task.

We use words that paint partial pictures of the phenomenon. Which means huge blank spots on the canvas remain; but we can't seem to see them, because we can't break free from the strictures imposed by our words.

We need new words, new words that better portray addiction in all its complexity. Because with new words, we might just reach a new and even richer level of understanding.

The word we're thinking about mostly here is "disease." "Addiction is a disease," specialists say. The concept of addiction-as-disease has permeated society from top to bottom. It gets talked about around the dinner table as often as it does in hospital conference rooms.

Why? Because it's useful. The word "disease" captures something vital about addiction—namely, the sense that an addict is a victim, not a criminal or evildoer, and in part at the mercies of forces beyond his or her control.

That insight has revolutionized addiction treatment and prevention programs, almost entirely for the better.

But ...

It's not enough. Because while addiction acts in part like a disease, it also acts in part like something else—namely, like a consequence of acts of will.

Other diseases such as cancer and heart disease have behavioral components. But addiction is unique in that the behavior is the disease. The addictive behavior—the drinking, the drug abuse—is the problem, and in many cases, abstinence from that behavior is the cure.

We need new terms that more fully capture this dynamic. Physics has often wrestled with such complexities. Even in high school, students learn about "wave-particle duality"—the notion that light, for example, has the characteristics of both a particle and a wave.

This duality "expresses the inability of the classical concepts 'particle' or 'wave' to fully describe the behavior of quantum-scale objects," as Wikipedia notes.

Or as Albert Einstein put it, "We are faced with a new kind of difficulty. We have two contradictory pictures of reality; separately neither of them fully explains the phenomena of light, but together they do."

That's what should be next in addiction science and treatment, in our view. Scientists—aided by linguists—should look for a fuller descriptor than "disease."

If this means inventing an entirely new term, so be it.

For only in this way will society understand addiction's duality—the sense that we have "two contradictory pictures" of the condition's reality, and that while "separately neither of them fully explains the phenomena," together they do.

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