Pubdate: Sun, 29 Jan 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Camille Bains
Page: A4


Calling someone a junkie was once the norm, but many people who use
illicit drugs and those who treat them say the word addict is just as

At the Crosstown Clinic, which provides pharmaceutical heroin
treatment for people hooked on the opioid, someone has crossed out
"addicts" on a notice posted by a group called the Addicts Union and
substituted "patients."

Dr. Scott MacDonald, lead physician at Crosstown, said the Diagnostic
Statistical Manual of Mental Disorders no longer lists the term addict.

"In the most recent version, I won't even say it, the A word is not
even in the professional language anymore," he said in the cramped
lobby of the clinic, which follows Switzerland's example in providing
pure heroin as a treatment option.

"For me, it's helpful," Dr. MacDonald said of the changing language
around substance use. "If I walked in and said, 'I'm an addiction
specialist and you're an addict,' that sets up a dynamic."

The BC Coroners Service said 914 people fatally overdosed in British
Columbia in 2016, with fentanyl being the culprit in many of the
deaths. The service said 90 per cent of the people died indoors, most
in private residences.

Just down the street from Crosstown at a flea market in Vancouver's
Downtown Eastside, Michael Totten, 44, said his life spiralled into
illicit-drug use after he was prescribed the painkiller Percocet
following a back injury.

Mr. Totten, who lost his home and now lives in a shelter after
enduring the "nightmare" of a filthy single-room occupancy hotel, said
many people driven to using drugs have suffered severe trauma and fear
they'll end up dead from unwittingly taking the opioid fentanyl, so
they shouldn't be defined by their behaviour.

"I think if people could hear some of the horror stories they'd be
ashamed of how they have stereotyped users," Mr. Totten said as
police, fire and ambulance sirens rang out in the area that was once
known as skid row.

Dr. MacDonald said people who chronically use illicit drugs are now
considered to have a substance-use disorder, not an addiction, which
is more stigmatizing.

"They're just people with a medical problem, a chronic disease that's
manageable with treatment," he said, adding clients at Crosstown have
tried an average of 11 other methods in their effort to quit using

An Amsterdam-based advocacy group calls itself the Junkie Union, but
only because people chose to apply the term to themselves, said Jordan
Westfall, president of the Canadian Association of People Who Use Drugs.

"It can be a powerful sort of reclamation of a term but as far as an
external, I think these terms, like junkie and addict, they reduce an
entire life, an entire human being, into a behaviour that society has
deemed problematic," he said.

"I refer to myself as a person who formerly used opioid drugs," Mr.
Westfall said, adding he was a university student who came close to
becoming homeless before quitting OxyContin, fentanyl and heroin to
pursue his goal of getting a master's degree in public policy so he
could advocate for reform to help others.

Loaded terms are often dropped to suit an evolving society, said Ruth
Derksen, a former English professor who specializes in the philosophy
of language at the University of British Columbia.

"Language shapes our perception and reality and the way we see the
world," she said. "It's like putting on another set of glasses and
suddenly we see the world differently because the language has shifted."
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