Language Matters: The dirty truth about the word, “Clean”.

The word “clean” has been a part of language surrounding drug use and addiction for years. But we use it for other topics too, such as clean eating and clean living. It sounds positive and health focused and we need those components when talking about substance use disorder.

However, clean’s antonym is “dirty” and “being clean” when referencing sober time, implies that someone using drugs isn’t clean, they are instead dirty. That is a really unfair and false implication. Phrases like, “She’s been clean” or “he had a dirty drop” reinforce the ignorant and old school image of a “junkie”. Which is synonymous with unworthy, unloved, and the various other words we discussed in our previous post on language and the word “addict”. It instills the image of a homeless person, living under a viaduct, “shooting up” with old, used, dirty needles.

And here’s the thing about that image, today’s typical person with substance use disorder, isn’t homeless or dirty. As it relates to the opioid epidemic, the typical person with heroin use disorder is from the suburbs, and quite honestly, that doesn’t matter. Regardless of if the individual is from the city, suburbs, or a rural area, regardless of if they are homeless or not. Heck, regardless of if they are clean or not. They are people, and they deserve the same respect, treatment, and dignity as anyone else. We have to stop dehumanizing people and undermining their worth.

These words; “clean” and “dirty” have roots in the past and we can look just to the early 1980’s with the development of needle exchange programs following the CDC’s suggestion to avoid injecting drugs and sharing needles to prevent transmission of HIV during the AIDs epidemic to see it. (It’s not that needle exchange programs are bad; by no means do I mean to suggest they are. Needle exchange programs have demonstrated endless positive impacts in reducing harm; there is scientific evidence to back them, and I fully support them.) It is however, at that time when people with AIDS were viewed as “dirty”. Their condition was considered a result of their “lifestyle choices” and they were often shunned, making it difficult, if not impossible to access care. Is this sounding familiar?

It sounds a lot like we are repeating history instead of learning from our mistakes.

The words, “clean” and dirty” don’t belong in conversations regarding Substance Use Disorder, just like they don’t belong in conversation about AIDS. So what should we be saying instead?

Well instead of suggesting someone’s drug test was “clean” or “dirty”, we should just say the result were negative or positive. And instead of saying, “I’m clean” to reference the fact that a person is not currently using drugs, why not just say, “I’m not using”, “I’m in recovery”, “I’m in remission”, or “I’m sober” any of which not only highlight sobriety, but also don’t put down those who haven’t gotten there.