Clean or Dirty?

I'd like for you to consider omitting a word from your vocabulary when it comes to Substance Use Disorder. This term is deeply ingrained in our culture, so I know I'm asking for a big favor. But my hunch is that most people haven't really thought through the term and have just repeated it because they heard it from another person.

The term is "Clean," and it refers to someone who is not using using drugs.

An example might be, “I have been clean for two weeks.”

Or, “When I've been clean for a few more weeks I might apply for that job.”

The first problem with the term is that it is incorrect. In order for a person to be clean they must have zero emissions. Zero waste. Last time I checked, that does not include humans. Solar energy, yes. Hydro energy, yes. But clean people? That's a myth. So when the term is used it doesn't meet the classic definition. I wonder what else the term could mean?

Side note: The first time I wondered about the use of the word I was in a support meeting years ago and a gentleman was talking about being clean for ten years. He was chain smoking, lacking in basic hygiene, drinking coffee thick enough to patch a roof, and probably needed to lose about 50 pounds. I am good with all of those things (live and let live, right?), but not as a description of clean.

The second problem is more nuanced. If you are clean when you don't use drugs, then when you are using drugs you are dirty. The antonym of clean is dirty. Other antonyms include polluted, tarnished, sloppy, soiled, and filthy.

The description is not accurate for those who are using chemicals. People use chemicals to diminish pain or to enhance pleasure. Those are the only two reasons. Pretty good reasons, at that. To use terms like “filthy” and “dirty” to describe the behavior is only an attempt to use shame to get someone to change their behavior. Guess what? Shame, as a change agent, is totally impotent. Plus, shame produces deep emotional pain. Any idea what might be a quick solution to alleviate emotional pain? The same chemical that causes the shame alleviates to sting of it. I am clinically and personally acquainted with shame, and that bitch is ruthless.

Not only do the terms elicit shame, they put distance between the object and the proclaimer. The shamer and the shamed are now not on the same team. Different jerseys. Clean and Unclean. Different goals. There is no collective energy there. So no mutual progress. Just labels.

I found three bottles of vodka in our waiting room the other day. Three airplane bottles in the trash can. Our waiting room is for clients who are waiting for mental health services by their clinician. I'd be interested in hearing your reaction to that story. I imagine two reactions. First, someone might be offended or angry and try to figure out who the client was and then set some limits with them about the waiting room of a counseling practice being an inappropriate place to get your drink on. Second reaction: You might be cognizant of how much pain a person must be in to drink in the waiting room of the place they were in to solicit help and relief. They could have consumed the alcohol in the car. Or even in the bathroom.

I want to find out who the client was so I can make sure they are getting the help they need. Their clinician needs to know so they can be diligent in their search for solutions to the deep pain their client is in.

The person who drank in our waiting room isn't dirty. Or filthy. Not polluted or sloppy. They are just in pain. And they will not seek a solution from someone who calls them dirty.