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AP Gives Important New Guidelines for Discussing Addiction

The Associated Press Updates Its Stylebook to Address Addiction as a Disease

Addiction will soon be discussed in a new way in newspapers, magazines and other publications, thanks to key updates the Associated Press made in June 2017 to the latest edition of its influential “AP Stylebook” — the reference guide used by news reporting outlets across the United States. According to the AP, the updates to its stylebook are intended to help guide journalists covering addiction to use person-first language that characterizes addiction as a disease or disorder, not as a weakness or moral failing. AP’s aim is to provide more appropriate words and phrases reporters can use to write about people who suffer from addiction — in the same way they write about people who suffer from other chronic diseases, such as diabetes and heart disease.

Changing the Public Discourse on Addiction, and Perhaps the Public View

What compelled the AP’s changes? Discussions with addiction experts who view and treat addiction from a disease-management perspective, and an observation that many of the news stories posted in recent months reveal how widely addiction is misunderstood among the media. The AP’s aim goes beyond political correctness in reporting — it hopes these changes help educate the media and the public regarding the nature of addiction and how the disease should be managed. Why make these changes now? The U.S is currently in the throes of a nationwide drug addiction epidemic that shows no signs of slowing down. Opioid painkillers, heroin, fentanyl and other opiates are causing the majority of problems, but powerful new cutting agents or mixers added to these and other drugs appear to be increasing the risks of addiction and overdose. A recent report from the surgeon general reveals that drug overdose deaths in America reached a historic high last year. In 2016, drugs caused more deaths in the under-50 population than car crashes or HIV/AIDS. The drug-related death toll is expected to climb as various states and counties across the country revisit and review their cause of death reports to uncover just how many cases have involved prescription opioids or other drugs.

Addiction in the News: Accuracy vs. Sensationalism

As the addiction crisis plays out, media outlets are racing to stay on top of the news, running stories with attention-grabbing headlines such as “Pregnant Woman and Unborn Child Die of Heroin Overdose,” “Woman Gets High on Heroin While in Labor,” “U.S. Doctors Cutting Back on Opioid Prescriptions” and “Opioid Epidemic Series: What Is Fentanyl? Drug Is So Powerful a Cop Overdosed From Touching It.” While some stories are fairly accurate in depicting the nature of addiction, others are off the mark, and run the risk of perpetuating misconceptions. The AP decided to facilitate reporting that is as accurate as possible by providing more specific language on the topic of addiction. Its updates are aimed at maximizing precision and reducing bias in addiction coverage. The style guide now directs writers to separate the person from the disease by replacing a phrase like “The addict …” with phrases like “He is addicted” or “He uses drugs.” It also advises writers to avoid words like “abuse” or “problem” in favor of the word “misuse,” or “use” with appropriate modifiers such as “risky, unhealthy, excessive, or heavy.”

Online Searches for Addiction Stories: Will Web Content Change, too?

The AP Stylebook changes may eventually lead to changes for web content managers, whose job it is to make sure that websites (even this one) are “search engine optimized” with the highest-ranking search terms used most often by consumers searching for news and information. Currently, “addiction,” “alcoholism” and “drug addict” are the most popular search terms for addiction topics in Google searches internationally, and particularly in the U.S. Thus, these are popular keywords used in web content to attract readers. It is interesting that many online news consumers are already favoring a term that describes the medical condition “addiction” over the less sympathetic noun “addict” — and this is encouraging. People also tend to search for “drug addiction” and “drug rehab,” which is another encouraging indication that consumers are focusing on the medical condition, and also seeking information about addiction treatment. Ripple effect. It will be interesting to track the changes in online searches stemming from the AP Stylebook updates to gauge how a transition to a more person-first, disease-oriented vocabulary in media stories might influence how news consumers search for addiction information online. Internet marketing managers and SEO experts may soon feel the ripple effect, and find that the web articles attracting the highest number of readers use person-first phrases like “people with substance use disorder.” An informal investigation of current Google search trends reveals that “substance use disorder,” the AP’s recommended person-first term, has not been a popular search term but is being used with increasing regularity in the U.S. Time will tell if this trend continues as more news outlets begin to implement the AP’s new guidelines.

More Than Words: How We Understand and Describe Addiction

In its updated stylebook, the AP has pointed out that physical “dependency” has erroneously been used as a synonym for “addiction,” though they are two different things. A person can become dependent on a prescription medication (such as for heart disease) without being addicted to it. However, withdrawal symptoms can occur if an opioid pain medication is stopped. For example, a person who is dependent on their pain pills and abruptly stops using them can experience a sharp spike in pain. This doesn’t necessarily mean that they are addicted. Likewise, withdrawal may not lead them to become addicted, misusing their medication by taking excessive doses or refilling more prescriptions than necessary — though the transition from dependency to active addiction often occurs. It is worth noting that while the words we use to discuss addiction more accurately and precisely are important, it is equally important to use appropriate context and consideration when describing addiction. For example, there are important distinctions to be drawn between habitual behaviors, even excessive or overly enthusiastic ones, and addiction. Doing something habitually or excessively — even drinking, sex and gambling — does not necessarily make it an addiction, even if it is potentially “addictive.” A person who drinks excessive amounts of caffeine and is a “workaholic” is not necessarily addicted to those things. Addiction is complex. To be classed as an addiction or a substance use disorder, a usage or behavior must comprise several key components, including an overriding preoccupation with the behavior or substance despite negative consequences like impairment or conflict with other activities and relationships, an increase in the substance use or behavior over time, and use of the substance or behavior to alter mood state. Using the right words and phrases to describe addiction as a cycling, relapsing and chronic disease is more than half the battle, and the AP’s progressive move to change word usage and reporting around addiction is to be applauded.

Sources

The AP Learns to Talk About Addiction. Will Other Media Follow? The AP’s Smart New Take on Addiction. Maia Szalavitz. Undark, June 2017. https://undark.org/article/associated-press-stylebook-addiction/ U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016. https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf Drug Deaths in America Are Rising Faster Than Ever. Josh Katz. The Upshot. The New York Times, June 5, 2017. https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=1 DSM-5 Changes: Addiction, Substance-Related Disorders & Alcoholism. John M. Grohol, PsyD. Psych Central, May 2013. https://pro.psychcentral.com/dsm-5-changes-addiction-substance-related-disorders-alcoholism/004370.html America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. Nora D. Volkow, MD, Senate Caucus on International Narcotics Control. National Institute on Drug Abuse, NIH. May 2014. https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse Inside a Killer Drug Epidemic: A Look at America’s Opioid Crisis. Staff Writers. The New York Times, January 2017. https://www.nytimes.com/2017/01/06/us/opioid-crisis-epidemic.html The Myth of the Addictive Personality. Mark D. Griffiths, PhD. Psychology Today, May 2016. https://www.psychologytoday.com/blog/in-excess/201605/the-myth-the-addictive-personality

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