Category Archives: News

The AP Learns to Talk About Addiction. Will Other Media Follow?

266524_9d4d244cd88045faa08c8e214afb8b18-mv2_d_4000_2656_s_4_2FOR YEARS, people with addiction have wondered when the media would recognize our condition as a medical problem, not a moral one — when they would stop reducing us to mere “addicts” and speak of us in the more respectful and accurate “person first” language that has become common for people with other diseases and disorders.

Last week, The Associated Press took an important step in that direction. The new edition of its widely used AP Stylebook declares that “addict” should no longer be used as a noun. “Instead,” it says, “choose phrasing like he was addictedpeople with heroin addiction or he used drugs.” In short, separate the person from the disease.

The style guide clarifies other important language to maximize precision and reduce bias in addiction coverage. There are new entries on “alcoholic,” and an array of substances, from bath salts and cocaine to PCP and synthetic cannabis.

Unlike many matters of style, these changes aren’t mere semantics or political correctness. Widespread media misunderstanding of the fundamental nature of addiction has led to some deadly misconceptions about how it should be managed. The AP provides news to around 15,000 media organizations and businesses, and its stylebook is highly influential in setting standards for usage. If its more accurate terms are adopted and understood by institutions like The New York Times and CBS News, it could genuinely help improve drug treatment and policy amid an overdose crisis that shows no signs of slowing.

“Around the beginning of the year, in January, we noticed that there was a hole in our guidance on addiction,” says Jeff McMillan, an AP enterprise editor who was the lead author of the new section. He adds, “As we began talking to experts, we learned that the language that was traditionally used is changing, and we thought it would be good to give people a vocabulary.”

The new language is being widely welcomed. “It’s very good — really well done,” says John Kelly, an associate professor of psychiatry at Harvard and founder and director of the Recovery Research Institute at the Massachusetts General Hospital. Kelly was the lead author of a study published in 2010 that showed that even doctoral-level professionals take a more punitive stance when patients are described as “substance abusers” rather than “people with substance use disorder.”

The stylebook directs its users to “avoid words like abuse or problem in favor of the word use with an appropriate modifier such as risky, unhealthy, excessive, or heavy. Misuse is also acceptable.” Notably, it adds that not all risky use involves addiction — a distinction that has been clear to epidemiologists for decades, but has not often been noted by the press.

And perhaps most important, the new style specifies that journalists should not use “dependence” as a synonym for addiction. In fact, “substance dependence” was dropped as the official diagnosis for addiction by psychiatry’s diagnostic manual, the DSM, in 2013, in part because it erroneously implied that the two are the same.

While the AP doesn’t spell this out, journalists and readers should understand why it matters. In essence, “dependence” means relying on a substance to function normally. People who take certain medications for blood pressure, depression, and addiction will suffer withdrawal if these medications are stopped abruptly, but that does not mean they’re addicted. This is true even for those taking opioids like methadone or buprenorphine to treat addiction. When people are stabilized on an appropriate individualized dose of either addiction treatment medication, they are not impaired at all because of the precise way this specific class of drugs affects the brain and causes tolerance.

By contrast, addiction is a medical disorder marked by compulsive drug use despite bad consequences like impairment. So while addiction is always a problem, dependence may not be. Understanding this is critical for good pain care. Patients taking opioids over a long period of time are often physically dependent, but unless they experience negative consequences and compulsive use, they are not addicted.

Similarly, babies exposed to opioids in the womb may suffer withdrawal symptoms from dependence after they are born, but they aren’t addicted either. Addiction requires persistent compulsive drug use, and such babies don’t even know that what they need is opioids, let alone have the ability to obtain and use drugs to support an addiction.

Yet the media has often failed to recognize these differences. Headlines about “addicted babies” abound and this stigma can itself do great harm. During the crack years, exposed children were subject to abuse and neglect by caregivers and others who misinterpreted normal behavior as malicious.

Recently, The Washington Post surveyed chronic pain patients on opioid therapy, asking them whether they were “addicted or dependent” but without defining those terms. Not surprisingly, one-third of the patients answered yes. While that made for a scary headline, it didn’t tell readers how many actually had substance-use disorders. And that is what you really want to know: Stopping effective pain treatment when you mistake it for addiction can be deadly.

At The New York Times, there are no plans to update the paper’s style manual along The AP’s lines. “I definitely understand the arguments and the sensitivity,” Philip B. Corbett, the paper’s associate managing editor for standards, wrote in an email, adding that “language evolves, and we will continue to think about these terms and consider changes as they seem warranted.” But about dependence and addiction, he said he thought  “very few readers would immediately understand or pick up on the distinction.”

Yet an unhappy result of conflating addiction and dependence is to undermine the only treatment we know that cuts mortality from opioid addiction by 50 percent or more: long-term treatment with methadone or buprenorphine. Too often, these treatments are mischaracterized as merely replacing one addiction with another. If the AP’s guidance can help members and their readers stop making this error, it could end up saving many lives.


OF COURSE, how the news media talk about addiction is only one aspect of a deep-seated cultural problem. In 12-step groups, which are used in at least 80 percent of American addiction care, people are encouraged to identify themselves as “addicts” or “alcoholics.” They often use what the AP’s McMillan calls this “almost self-punitive language” when speaking to the press, even if they don’t publicly identify themselves as group members.

This could be seen as a way of trying reclaim stigmatized terms by an oppressed group, just as other marginalized people have sometimes done with slurs against them. The AP suggests similar guidelines for using “addict” as a noun. It’s all right when used in a quote or in the name of an organization, but not otherwise.

Language is complicated and often slow to change — and for a group that has been criminalized, fighting stigma and misinformation is a constant struggle. But when the media start treating people with addiction with the same respect that they use for other patients, perhaps the rest of America will start to accept that addiction is a medical problem and that moralizing and punishment have failed.

By Maia Szalavitz: author of the best-selling “Unbroken Brain: A Revolutionary New Way of Understanding Addiction,” which was just released in paperback.

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LETTER: Mothers of people with FASD need recognition and more services


Comment to original story: Re: School Board Hears Karri’s Story” Jan. 13

I would like to give my sincere gratitude to Karri for having had the courage to come forward and share her difficult journey with Fetal Alcohol Spectrum Disorder (FASD).

Without stories like hers, we would not realise the struggles these individuals face on a daily basis, particularly when they enter the school system, where the stigma becomes a very stark reality for many of these individuals and their families.

It is often far too easy to lay blame on the birth mother for being the only cause of this devastating and totally preventable disorder.

I mean, who else should we blame? Unfortunately, this kind of attitude has the unintended consequence of doing more harm than good.

The fear of being perceived as villains because of circumstances that led them to drink throughout their pregnancies, only perpetuates the shame and stigma these birth mothers may be experiencing, and pushes them further into isolation and secrecy.

This could have a detrimental impact on not only the quality of their prenatal health, but also of the health, well-being, and future outlook of their unborn child. And it does very little to address the help and counsel they may need for the problems that caused them to drink in the first place, leaving them vulnerable to future alcohol-exposed pregnancies.

Many of these women are living with alcoholism, substance-use issues, and chronic adverse life conditions, and they have no-one to turn to and nowhere to go for help as a result of this stigmatic attitude.

And even if they do have the courage to come forward and reach out, the treatment services are sadly either unavailable to them, or deficient in quality. Many treatment facilities do not allow access for pregnant women, nor provide childcare for the children who are already in their care.

Birth moms are human beings too, and all human beings have a right to human dignity.

What society does not recognise, however, is the critical role birth moms play in improving the lives of those affected by FASD, and in preventing more alcohol-exposed pregnancies. But what is equally important is the role that our families, our communities, our governments, and our societies play in understanding and supporting the root causes of women’s use of alcohol during pregnancy.

Bernadette Fuhrmann

Birth-mom and founder of

Wheel of Life Support Services

South Slocan, BC.

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New program aims to reduce birth-mortality rate for Alberta aboriginal mothers

Pregnant Stomach

A new program aimed at the maternal health needs of indigenous communities will seek to reduce the risk of death during childbirth.

“The death rate of aboriginal women here in Alberta is twice that of the general population and we find that unacceptable,” said Dr. Naveen Rao, lead for the program Merck for Mothers. “The unique challenges they face (include) the social determinants of health, such as housing, food and security, cultural insensitivity, lack of education … on the medical side there is obesity, hypertension, addiction.”

On Friday, Rao announced a $1-million grant that, along with $300,000 from Alberta Innovates, will go towards initiatives in Maskwacis, Little Red River Cree Nation and inner-city Edmonton. In collaboration with Alberta Health Services, the funding will be used for education, peer support in the weeks before and after birth, as well as improved care co-ordination and evaluation.

“There is room for both traditional teaching and western medicine to play a role in healthy pregnancies and childcare,” said Randy Littlechild, executive director of Maskwacis Health Services. “Every year we have approximately 200 to 300 births in our communities. … There are challenges Maskwacis women and children face — transportation is an issue, there’s a very high demand for this service.”

Dennis Laboucan, community services director for Little Red River Cree Nation, said staff is stretched too thin to reach all expectant mothers in the nation’s three communities.

“We are a remote community, our traditional ways are still intact, but they have been impacted by history,” he said, adding that there were 129 births in 2015. “We look forward to more staff funded by this program.”

Alberta has the third largest aboriginal population in Canada, with more than 220,000 First Nations, Métis and Inuit people. Regardless of place of residence, the perinatal mortality rate for aboriginal women in Alberta is around seven in every 1,000 births, compared to around four in every 1,000 births in the non-aboriginal population.

Along with addressing needs in remote communities, the $1.3 million in funding will also go towards helping vulnerable expectant mothers living in inner-city Edmonton through an initiative dubbed Pregnancy Pathways. The program, launching next spring, will establish a 12-unit apartment building where homeless expectant mothers can live and access support services on site.

“Imagine being hungry for two, being homeless for two. Unfortunately, this is a reality for many in our community,” said Cecilia Blasetti, executive director of the Boyle McCauley Health Centre. She added that of the more than 100 women in Edmonton who find themselves in this situation every year, between 60 and 80 per cent are indigenous.

Alberta Health Services CEO Dr. Verna Yiu said Friday’s funding announcement offers a “glimmer of hope.”

“We’ve heard loud and clear from the AHS wisdom council of the struggles that (indigenous communities) face,” she said. “(It) goes to ensuring that pregnancy and childbirth for vulnerable women is a safe and healthy and joyful experience. … One we assume that everyone has, but in fact many do not.”

Written by: CLARE CLANCY

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How one woman overcame fetal alcohol syndrome and found art

How one woman overcame fetal alcohol syndrome and found art

By: Sharon Oosthoek


“How are you going to change your part of the world in a positive way for the next seven generations?”

That was the challenge that Jennifer Tourangeau put to her fellow graduates at Grande Prairie Regional College’s two-year visual arts and design program in Alberta this spring. She urged them to take an Indigenous approach to stewardship—that is, to live and work for the benefit of seven generations into the future. As valedictorian, it was her job to send them out into the world with a message of hope. The 36-year-old Dene woman’s very presence at the lectern was likely hope enough for many in the crowd.

“My own change began when I chose Grande Prairie Regional College as my first stop in the journey to my dreams,” she told them. “During this time, I have  had my own struggles, joy, excitement, and at some points wanting to give up. As you can see, I didn’t.”

Tourangeau, who describes her art as a mix of painting, sketches and ink drawings, often inspired by her Indigenous heritage, says she loved the way her instructors built on her strengths as an oral and visual learner. But it’s been a long road to this point.

She was born with fetal alcohol syndrome in the Northwest Territories community of Lutsel K’e, on the shores of Great Slave Lake. When she was 14 months old, her mother gave her up for adoption and she grew up with her adoptive family in Fort Smith, N.W.T. While Tourangeau’s adoptive father, who is Indigenous, and her adoptive mother, who is not, were supportive of her, she struggled with feelings of abandonment and long periods of depression.

When she met her biological mother again at the age of 13, it was an emotional experience that shook her up. “I mean, how do you explain to a 13-year-old who has a disability why you gave them up? It took me a long time to realize the biggest sacrifice a mother can give is to give up her child so she can have a better life.”

At the age of 16, Tourangeau landed a job as a disability and community worker in Fort Smith. She enjoyed it, but was never able to do it full-time, even after graduating from high school. “The heavy lifting”—often part of the job, working with the disabled—“was hard on me,” she says. “I’m only four foot ten.”

After a short-lived attempt at a career as a computer technician, she found another job as a group-home worker. But she pushed herself hard and worked long hours, leading to burnout and a medical leave for stress and anxiety.

It was during this time—as Tourangeau was trying to figure out what to do with her life—that she enrolled in the visual arts and design program at Grande Prairie. “I had no idea what I wanted to do with the diploma. I just needed something to enjoy,” she says. “The art allowed me to release a lot of pain and find out who I was.”

But Tourangeau’s pain was not over. As she began her first semester, she received news that her biological mother had been strangled and her body left in an alleyway in downtown Yellowknife. As Tourangeau began the final year of her program last fall, her mother’s murderer was sentenced to life in prison.

“It may not be enough, but at least I got closure. A lot of Indigenous people don’t get this,” she says. “My mother is the product of the residential school system and so am I. I choose to break the cycle.”

She praises her instructors for supporting her request to complete the two-year diploma over four years and allowing her to ease into the program with studio-based work.

One of those instructors, Native studies teacher Kirsten Mikkelsen, describes her as a “highly focused and determined human being who strived for excellence in spite of the barriers.”

Mikkelsen recognized her student’s potential. This fall, she helped recruit Tourangeau as a peer mentor for Indigenous learners in the college’s department of arts and education.

While Tourangeau loves her new job, she sees it as a stepping stone to a degree in art therapy and a career helping others work through their anguish with art.

Her art history instructor, Edward Bader, says she’ll no doubt get there: “She works very hard. She’s very passionate about her art and follows up on every opportunity.”

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Women seek help for their drinking as rates of risky alcohol consumption climb

By Cosima Marriner

Nicole Cliff knew she had a drinking problem because she could never manage three alcohol-free days in a row. But it was only on the eve of turning 30, when she once again couldn’t remember what had happened the night before, that she decided to get help.

“My friends’ lives were going in one direction and I was still going out and partying,” Ms Cliff recalled. “I took a good hard look at myself and thought ‘this is not living, this is not a life’. Alcohol had a hold over me and I hated it.”

Young women are now as likely to drink as their male counterparts, a new study has found.

She joined the Hello Sunday Morning healthy drinking movement and initially stopped drinking for three months. Then she took the plunge and stayed sober for a year. “It really opened my eyes up to who I am,” Ms Cliff, now 33, said. “Now my life is going the way I want it to.” This includes running her own yoga business in addition to her career as a scientist.

Ms Cliff is part of a growing breed of women seeking help for their drinking. Support services which once catered mainly to male alcoholics report a steady increase in female clientele.

Alcoholics Anonymous now runs women-only meetings, while women outnumber men at Hello Sunday Morning. Sixty-three per cent of HSM’s 100,000-plus members are women, and the average age is 39.

“We’re living in a very anxious time with women gaining equality and the stress that comes along with that,” Hello Sunday Morning founder Chris Raine said. “Alcohol is a drug we use to manage anxiety, so it’s not surprising more women are drinking.”

Mr Raine suggested that women juggling work and children found it easier to seek help online than turn up at a face-to-face support service.

Recent research from the UNSW Drug and Alcohol Research Centre showed women are now drinking as much as men, and younger women may even be out-drinking their male peers. Ms Cliff said: “I think a lot of women who do drink may be addicted without realising. It creeps up on them; their weekend drinks or after-work drinks morph into four days’ straight drinking.”

Alcohol researcher Janice Withnall said that as the first generations to enter the male-dominated work culture, female babyboomers and Generation Xers are most likely to be consuming alcohol in quantities that are harmful to their health. One in six women aged 35-59 is now classed as a high risk drinker, double that of 20 years ago, according to research Dr Withnall conducted for Western Sydney University.

“We have a group of women who have been drinking for a very long time, which is why we have increasing alcohol dependence in this midlife group,” Dr Withnall said.

She said the increase in female alcohol consumption is linked to the improved social standing of women, their increased disposable income and changes in social attitudes towards female drinking. As women are marrying and having children later in life, they also spend more years drinking before settling down, and the alcohol industry has deliberately targeted this group.

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Binge drinking rising at a dangerous rate: U of C Study


Researchers at the University of Calgary have released some troubling statistics in a study on binge drinking.

Dr. Andrew Bulloch, deputy director of the Mathison Centre for Mental Health, found that 20 per cent of Canadians engage in binge drinking, which is defined as having at least five drinks at least once a month in the past year.

“It’s dangerous,” said Bulloch. “We think that alcohol is becoming more heavily advertised. It’s becoming more available, and it’s becoming cheaper.”

Bulloch added that people who show a pattern of binge drinking also show a loss of control over the use of alcohol. That means the behavior can progress into a dependency over time.

“It’s a warning sign,” said Bulloch, who proposed that successful attempts to regulate accessibility in other countries would point towards a need for local policy makers to make a change.

Dr. Scott Patten, who co-authored the study, said that binge drinking can have dangerous consequences.

“There is quite a link between depression and drinking,” said Patten.

But it doesn’t stop there. Patten said that violence, social problems, suicide, and a number of chronic diseases can also result from the excessive consumption of alcohol. He said it’s imperative that both health officials and policy makers take heed.

“Trends suggest tightening alcohol laws rather than loosening them. Or changes to the taxation, or regulations surrounding the marketing,” said Patten.

Some data that wasn’t released in the paper showed that almost 40 per cent of individuals between the ages of 18 and 24 are binge drinkers, something Bulloch attributes to a Canadian culture.

“I think it just becomes a cultural norm, but it doesn’t mean it’s morally or ethically acceptable,” said Bulloch.

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A different approach: The struggle to deal with FASD in the justice system

A different approach: The struggle to deal with FASD in the justice system


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