[Guest blog by Karen Bernetti, SMART Facilitator and Family Recovery Coach]
During a recent SMART Family & Friends meeting, an amazingly rich conversation errupted just as we were going over our standard meeting guidelines. We got to the part about how we try to avoid using labels like "addict", "alcoholic", "codependent", etc.and how we work on using "person-first" language instead. One of our participants asked, what in the world could possibly be wrong with calling someone what they are?! This person noted that it's common practice to identify as an alcoholic or addict in 12-Step rooms. Excellent question! This is precisely what makes recovery work so complicated, so personal, and so misunderstood.
When it comes to recovery, what works for one, can actually be harmful for another.
For some, calling oneself an addict or an alcoholic can be life saving. For others, using that very same language is stigmatizing and could feel shameful. It often comes down to what image comes to mind when you hear the word "addict." It's different for everyone. For a lot of people the word "alcoholic" conjures the image of the drunk guy stumbling down the street, drinking out of a paperbag, or passed out on the sidewalk. That's an image MOST people do not want to be associated with. And if the label is rejected, so is any possibility of seeking recovery.
Could that be why fewer than 20% of the people who struggle with addiction reach out for help?
What unfolded in our meeting was such a rich discussion! And what became crystal clear is this: the language we use around addiction isn't just semantics. It shapes identity, and either opens doors to recovery or slams them shut.
Why Labels Work in 12-Step Programs
Let's start by acknowledging why "I'm an alcoholic" or "I'm an addict" works beautifully for millions of people in 12-step recovery programs like Alcoholics Anonymous (AA):
It creates immediate belonging. Walking into a room and saying "I'm an alcoholic" is met with "You're in the right place." There's instant connection, instant understanding, instant community. No one judges you for the label because everyone in the room shares it.
It cuts through denial. For people who have spent years minimizing, justifying, or explaining away their substance use, claiming the label can be profoundly liberating. It's an acceptance of reality that stops the exhausting mental gymnastics.
It provides a framework. The 12-step model offers a clear path forward once the label has been accepted. There are meetings, sponsors, steps to work through, and a proven structure many people find life-saving.
It reinforces commitment. Identifying as "an alcoholic" even after years of sobriety reminds people of what's at stake. It keeps recovery front and center as a core part of identity.
For people who find power in these labels, that's legitimate and should be respected.
So Why Does SMART Recovery Avoid Labels?
SMART Recovery deliberately discourages the use of labelslike "addict" or "alcoholic." Not because those labels are inherently wrong, but because research shows they can prevent many peoplefrom seeking help.
Here's what we know from research:
Labels can increase judgment and stigma - even self-stigma. Studies show that people described as "substance abusers" or "addicts" are viewed more negatively than people described as "having a substance use disorder".
Studies have shown that medical professionals and addiction treatment providers treat patients differently based on the language used to describe the patient/client. And when people internalize these stigmatizing labels, they might be less likely to believe recovery is possible for them.
Labels can become self-fulfilling. When someone is defined by their worst behavior ("I'm an addict"), it can actually make it harder to envision a different future. Identity shapes behavior. If you believe you ARE your addiction, change can feel like losing yourself.
Labels deter help-seeking. Many people - especially young people, professionals, parents, and those early in problematic use - will avoid treatment entirely rather than accept a label that feels permanent, shameful, or incompatible with how they see themselves. The label becomes a barrier rather than a bridge.
Labels don't account for complexity. Addiction exists on a spectrum. Some people have mild substance use disorders, others severe. Some people have co-occurring mental health conditions. Some use substances to cope with trauma. Reducing all of this complexity to "addict" or "alcoholic" erases nuance that matters for effective treatment.
Person-First Language: An Alternative Approach
This is why SMART Recovery (and increasingly, the medical community) use person-first language. Instead of "addict" or"alcoholic," we say:
The difference might seem insignificant, but it's actually profound: saying "I'm an addict" means the substance use disorder defines one's entire identity. "I'm a person with a substance use disorder" means you're a whole person who happens to have a treatable health condition. See the difference?
Think about how we talk about other health conditions. We don't say "I am cancer" or "I am heart disease". We say"I am battling cancer" or "I have a heart condition. Why?Because people are more than their diagnoses. Your loved one (or patient/client) is not just their substance use. They are a person - with hopes, talents, dreams,relationships, a history, a future - who also happens to struggle with substances and/or other problematic behaviors.
The Danger of Using Labels as Weapons
Sometimes frustrated family members use these labels not as neutral descriptors but as accusations. You might say, "you're acting a like an addict", "you're just a selfish loser who only cares about yourself and your next fix" or "you're just like every other junkie." No judgment here - loving someone struggling with addictionis REALLY hard. It's scary. Losing your temper just makes you human, and, it comes with consequences. When labels become insults we hurl in moments of anger, we're not helping anyone move toward recovery. We're only deepening shame, increasing defensiveness, and reinforcing the very identity we hope they'll move away from.
Even when we're not being intentionally hurtful, referring to our loved ones as "my addict son/daughter" or "my alcoholic spouse" reduces them to their worst struggle. It communicates that this is the only and/or the most important thing about them worth mentioning.... the thing that defines them in our eyes. And people live up (or down) to the identities we assign them.
The Breakthrough
Here's what was so beautiful about our discussion: we got to the heart of something most people never articulate. It's not about which language is universally "right" or "wrong." It's about understanding that different people need different things. Some people need the clarity and community of a label. Others need the spaciousness and hope of person-first language. Some people will shift between these approaches at different points in their recovery journey.
Our job as family members [and care providers] isn't to police language or insist everyone adopt our preferred terminology. Our jobis to simply be thoughtful about the words we choose and curious about howthose words land.
Here are some great questions to explore:
What This Means for You
If you're reading this and feeling confused about what language to use:
Follow your loved one's lead. If they identify as "an alcoholic" and find power in that, respect it. If they bristle at that label and prefer "person in recovery" or "person struggling with substance use," honor that too.
Default to person-first language yourself. Especially when talking ABOUT your loved one, use language that acknowledges they're a whole person. It's a subtle change that reduces stigma and keeps you focused on their humanity rather than their diagnosis.
Never use labels as weapons. Even in anger, even when you're right, even when they're deep in their addiction, even when their behavior is atrocious and you know it's true - resist the urge to define them by their worst behavior. You can still protect yourself, set boundaries, express hurt, and hold them accountable without reducing them to a label.
Be curious about language that creates shame. Notice if certain words cause your loved one to shut down, argue, or distance themselves. That's feedback. Try different language and see if it opens communication rather than closing it down.
Remember: one size doesn't fit all. Recovery is deeply personal. What works in AA rooms might not work in SMART Recovery rooms. What helps one person connect might make another person feel judged. That's okay. That's why we need multiple pathways to recovery.
And here's one more thing... they they might call themselves an addict or alcoholic, but might not like it when you do. Honor that too. It's how they feel and it doesn't have to make sense.
Why SMART Recovery's Approach Matters
In SMART Family & Friends meetings, we specifically avoid labels - we're not judging people who use them - we just want to create space for families supporting loved ones who might be alienated by traditional recovery language.
We use person-first language because:
It aligns with how the medical community is increasingly starting to talk about substance use disorder as a health condition - not as a moral failure
It keeps the focus on behavior that can change rather than an identity that feels fixed
It reduces the shame that keeps people from seeking help
It makes room for people at all stages of change, not just those ready to accept a particular identity
This approach doesn't make SMART Recovery "better"than 12-step programs. It makes it different - and that difference matters for people who haven't found connection, hope, or a path forward in other spaces.
The Bottom Line
That Tuesday night conversation reminded me why this workmatters so much. Language isn't just about political correctness or following trends. Language shapes reality. The words we use influence whether our loved ones believe change is possible. Whether they feel defined by their worst moments or seen for their full humanity. Whether they're willing to walk through the door of a meeting, treatment center, or therapist's office.
For some people, claiming the label "alcoholic" or"addict" is powerful, healing, and identity-affirming. For others, those same labels are barriers to seeking help, sources of shame, and reasonsto stay stuck. Both experiences are valid. And understanding this complexity makes us better supporters, better advocates, and better facilitators of change.
So the next time you're about to use a label - whether about your loved one or someone else's - pause. Ask yourself: is this language opening a door or closing one? Is it helping this person move toward change, or reinforcing an identity they're trying to shift? The answer might surprise you. And it might change how you show up for the people you love (and the people you serve.)
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