TOXIC “POISONING” OR “OVERDOSE?”

The Language Of Addiction

The intent of our words makes all the difference of understanding our own stigma’s.

The stigma of addiction and the lack of organized advocacy for affected people have been the biggest barriers to creating change for so very many here in Canada and around the world.

But what about the language used by those professionals supposedly in the know? The accidental “overdose” of fentanyl  laced drugs requires us revisit the language surrounding this exploding epidemic and health crisis.

Aren’t we using the wrong language here to describe the toxic lacing of illicit drugs, to a level of potency that makes the use of them so dangerous, so poisonous, that unbeknownst to them, what was a typical dose for an addict, now becomes deadly?

“When a patient has over-consumed alcohol, we call it alcohol poisoning, we don’t write about it as an alcohol overdose,” – Dr. Edward Xie

While people tend to imagine that overdoses primarily occur when drug users are alone, in fact, at least half of them happen in the presence of others. In England, for example, 80% of users who overdosed did so while with others and 54% had also witnessed others who had OD’d. A study in New York similarly found that 57% of over 1,000 crack and heroin users had personally witnessed at least one overdose. A Rhode Island study revealed that 35% of opioid users had overdosed at least once themselves and two-thirds had seen someone else do so.

In an article written by: Jeremy Allingham

When someone drinks too much, we call it alcohol poisoning. 

When someone takes too much of a drug, we call it an overdose. 

The difference in language may seem slight, but it says a lot about how our society differentiates between alcohol users and drug users.

If we speak about the fentanyl crisis in a more clinical, straightforward fashion, we can see it for what it is: a public health issue that can be addressed through the medical system.

Poisoning is a technically accurate diagnostic term for what’s happening inside the body. Meanwhile, the word overdose, meaning “to administer medicine in too large a dose,” implies that a drug user knows what the dose is, and chooses to take too much.

 

dr-christy-sutherland
Dr. Christy Sutherland, with the BC Centre on Substance Use and medical director for the Portland Hotel Society, says the word ‘overdose’ implies blame for victims of the ongoing crisis. (BC Centre on Substance Use)

Dr. Christy Sutherland, an addiction medicine physician with the BC Centre on Substance Use and the medical director for the Portland Hotel Society, says overdose is the wrong word.

“When the drug supply in B.C. is so toxic, and patients are at such high risk — I’ve had patients who’ve had more than 30 overdoses this past year,” she said.

“Really we could say that they’re being poisoned by this toxic drug supply.”

With 780 dead in B.C. between January and July of this year, Sutherland worries that the victims of the crisis will be blamed for their own deaths.

Poisoning more accurate than overdose

“As a society, we have to value each other and care about each other … our neighbours, and our brothers and sisters, and parents…. They deserve safety,” she said.

Overdose is an accepted term in the world of medicine. It’s used in hospitals and clinics, by the provincial government, health authorities, law enforcement, and the BC Coroners Service. The word is commonly found in medical journals too.

But while it may be widely accepted, it’s not actually technically accurate in describing what’s happening in the body.

“What’s happening in the body of the patient is a poisoning. We shouldn’t need to refer to how the patient got there, which is an overdose. They’re two separate issues.”

In that document, the term “overdose” is used only to describe the action that led to the recommended diagnostic term, which is poisoning.

dr-edward-xie
Dr. Edward Xie, an emergency room doctor with the University Health Network in Toronto and a lecturer at the University of Toronto, says ‘overdose’ is not a technically accurate medical diagnostic term. (Edward Xie)

Dr. Edward Xie, an emergency room doctor with the University Health Network in Toronto and a lecturer at the University of Toronto, thinks medical professionals’ language should be focused on what’s happening to the patient’s body.

“If a cyclist falls and breaks a bone, we call it a fracture and not a bicycle fall,” Xie said.

“What’s happening in the body of the patient is a poisoning. We shouldn’t need to refer to how the patient got there, which is an overdose. They’re two separate issues.”

Xie points to the way we talk about alcohol, a legal and socially acceptable substance, as proof that the word “overdose” stigmatizes drug users.

“When a patient has over-consumed alcohol, we call it alcohol poisoning, we don’t write about it as an alcohol overdose,” he said.

Changing the lexicon

The province of B.C. commonly uses the term “overdose.”  And while the deputy provincial health officer, Dr. Bonnie Henry, recognizes that it’s not a technically accurate medical term, she says that it still has value.

“It is a word that resonates with people…. It was a general enough term that it could be a whole variety of things … but also, it’s something that people understand,” Henry said.

With the term “overdose” so entrenched, it will take time to change the way people speak.

Sutherland recently spoke at the Canadian Medical Association annual meeting, where she advocated for more progressive and accurate language to limit the level of stigma surrounding drug users.

Meanwhile, Xie and a number of his colleagues are writing a letter to the Canadian Medical Association Journal urging doctors to move away from the term “overdose.”

Some might dismiss the debate over the language we use in this crisis as semantics. But with four people dying in this province on a daily basis, this has become less a crisis, and more a new reality that we must approach in new and innovative ways.

If discarding a stigmatizing, technically inaccurate word can contribute to saving even one life, shouldn’t we do it?

 

Resources: Time Health, Rik Jespersen, Jeremy Allingham for CBC News

Author: Jeffrey Dibble

Jeffrey Dibble is currently the owner of Daily Dibbles.com, a site in which he blogs about Movies, Entertainment, Toronto Life, as well as many other related and unrelated topics to enhance ones general lifestyle. Jeff is currently living in Toronto Canada and earns his living from the writing he does on his website, his YouTube Channels, as well his affiliation with Set Tv Now, a subscription IPTV service and his affiliation with Tangerine Bank, a subsidiary of The Bank Of Nova Scotia.

2 thoughts on “TOXIC “POISONING” OR “OVERDOSE?””

  1. A well written argument concerning the language we use in relation to drug addiction. As we know the root for all addictions is the basically the same (an escape mechanism to avoid pain). The societal views arise because there is a hierarchy of acceptable addictions (e.g.. work) and ones that create more societal shame and judgement such as sex and drug addiction. I agree that overdose is used specifically with drug addiction and should be renamed. After all isn’t any addiction an “overdose” (work, food, sex, drugs, shopping etc) that eventually poisons the addict mentally, physically and emotionally?
    Personally I will now be more careful of my terminology. Thank you for your offering of this viewpoint, Jeff.

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    1. Thank You Hanna. As a “Recovered Addict,” I know all to much of the stigma surrounding addiction, mental health, homelessness and the driving forces behind these issues. Cleaning up from whatever the behaviour of addiction is, encompasses a full range of change for an individual, (i.e., Bio, Psycho and Social modification). The language we use surrounding these issues can make all the difference in our interpretation and understanding. Again thank you so very much. – Jeff Dibble

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