Three Reasons the Term “Substance Use Disorder” is Harmful

I recently watched the show Painkillers, a series about how the Purdue pharmaceutical company (owned by the Sadler family) produced, promoted, and distributed OxyContin (oxycodone) — but mostly how addictive it is. When patients became addicted, instead of reducing the potency or taking the drug off the market, the Sadlers reframed the disaster. At first, when the dosage failed to alleviate the symptoms because of tolerance, they increased the dosage. Then, when someone became addicted Purdue claimed it was because they were a “substance abuser.”  Purdue said that the product was fine, despite many people struggling with dosage, withdrawal, personality changes, and even overdose.

Unfortunately, the current diagnostic manuals and treatment centers have adopted this same terminology by referring to addiction as “substance abuse (or use) disorder,” It’s supposed to be “less shaming” than the word addict or alcoholic. Quite the contrary. All these terms are shaming. Even worse, they are misleading by making the victim solely accountable for the abuse instead of the perpetrator.

#1 – Intentional Harm

Painkillers demonstrates the degree to which Purdue went to continue promoting their product despite the families, media, and a few concerned persons reporting the dangers. Their tactics ranged from seducing the FDA, to skillfully marketing through expensive social events, and an attractive sales force along with “evidence-based” charts and criteria for justifying the prescriptions. What was ultimately revealed through lawsuits was the deliberate intention to put profits above the well-being of people.

Eventually, the public harm by oxycontin created enough public outrage and lawsuits that forced the Sadlers to be accountable for their behavior — at least partially.

#2 – Divert from the Global Problem

Where’s the outrage for all the other deliberately addictive things?

In 2021, there were 107,000 opioid deaths[1] from oxycodone, morphine, hydrocodone, and methadone.[2]  But as we can see from the data, that’s a small number compared to the deaths from other substance use disorders including drinking and smoking.

Take the tobacco industry. They paid billions in claims to individuals and insurance companies for harm done to the public.[3] They pulled the same tactics as Purdue by claiming that the people who got sick failed to yield the warning on the cigarette packs. The public failed to heed the warning. There are 1.3 billion smokers and an estimated deaths of 1 billion smoking-related deaths this century.[4] Yet, even though nicotine is one of the most addictive drugs on the planet, the manufacturers continue to add other ingredients (ammonia, sugar, sorbitol, etc.) to increase the probability of addiction.[5] But hey, if your lungs are being destroyed by cigarettes, you can just switch to vaping. Just one problem — vaping is more addictive than regular cigarette smoking, [6] one vape cartridge is equivalent to a pack of cigarettes.[7]

The list goes on. The THC content in marijuana now has increased tenfold creating more addiction, especially in young adults.[8]

Who came up with the legal alcohol proof per bottle? Is the alcohol content at a level that generates a craving for more? There are 1/3 of 1 billion “alcohol abusers” globally and a million alcohol-related deaths annually.[9]

Sugar can also be classified as an addictive drug according to the Rutgers Center for Alcohol and Substance Use Studies[10] and as addictive as cocaine because it releases dopamine and opioids in our bodies.[11] Now sugar is so refined or used in the form of high fructose corn syrup, that it causes more cravings than ever. Sugar is one of the main causes of obesity and diabetes which results in 2 million deaths per year.[12]

Benzodiazepines (anti-anxiety drugs i.e., Xanax, Klonopin, Ativan, Valium, etc, are also addictive, prescribed to 30 million just in the U.S. aged 12 and over, and resulting in thousands of overdoses every year.[13]

Six million kids are on ADHD medication like Adderall and Ritalin,[14] prewiring the brain for further abuse. I’ve seen a surge of those who started with these drugs and escalated to cocaine and crystal meth by the time they were in their twenties.

These are just a few of the “substance use disorders.” Other clinically diagnosed disorders such as video addiction are called “gaming disorders,” and gambling is also a “disorder.” Porn or sex addiction are diagnosed as “impulse control disorders.”

The bottom line is most of these products are made with the deliberate intention to get you addicted and then you’re the abuser or the one with the disorder. Even though the producer spent money on research and development knowing full well how your brain works and how to best get you wanting more from your very first try — you are the one who’s labeled with a lack of self-control rather than the manufacturer being culpable.

#3 Gaslighting

When someone is physically or sexually abused, we don’t say they have a sexually abused disorder. Even though they’ve been groomed or even desensitized to succumbing to the abuser, they are still seen as the victims of abuse.

When something is intentionally intended to get a person addicted and then you label them as the “abuser,” the public has been gaslighted.

I know the drill well. My first drag on a cigarette resulted in twenty years of habitual smoking. Alcohol was the perfect sedative to calm my childhood demons and with a high tolerance, I drank alcoholically from the start. After breast cancer surgery I was prescribed oxycodone. It was an interesting high. Not too much, just enough that I didn’t care that my left breast was gone. I didn’t have any pain at all. I took all the medication and refilled the prescription (30 days’ worth) though I really didn’t need it after a few days. This was my first slip after sixteen years in recovery. I didn’t see it that way though, in fact since I didn’t have any withdrawal symptoms, my denial was easily fueled. I was only following medical advice. These were just a few of my “disorders.”

Many professionals (like Purdue) who are supposed to care for us and protect us have made us victims of their products. People who intentionally make addictive products and then blame the victim as the “abuser” followed by the psychological and psychiatric community diagnosing these conditions as “disorders” have achieved the pinnacle of gas-lighting. Shouldn’t the diagnosis be “victim of (alcohol, nicotine, prescription drug) abuse?” Fill in the blank.

As human beings, the time has come to reclaim our power. We must value ourselves enough to stop blindly following medical advice, or engaging in activities that could cause us harm. We must take responsibility for educating ourselves about things that could get us hooked. We must learn to love our brains, and our bodies in such a way that nourishes them as intended. There will never be substitutes for self-love.

If you’ve had one of these “disorders,” it’s time to take off your cloak of guilt and recognize what happened. Most of us innocently tried or were given something that took hold of our minds, and we couldn’t shake it loose. Once that receptor was opened, the search for the next big fix was never-ending.

Your mind and body are a beautiful gift to be honored and treasured. Don’t let anyone take that away from you. And if you’ve found yourself at the mercy of someone else’s profit, it’s never too late to reclaim your power and dignity. Once you know that you’re not the abuser, being a victim is then a choice.

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