“And God said, ‘Let there be…'”

This is how creation happens in the Abrahamic faiths: not as a meticulously planned engineering project or even a work of magic, but entirely spoken into being. The Word not only communicates God’s intentions, it accomplishes them. A Word created the world.

I shared this reflection yesterday at the Faith in Harm Reduction pre-conference leading up to the national Harm Reduction Coalition conference in New Orleans. I was helping facilitate a conversation about language—the words we use, what we mean by them, and how to speak to one another. We were specifically focused on language that hinders or helps communication between drug users and communities of faith, but the conversation had much broader implications for how we speak, listen, and strive to understand.

By sharing about how creation was spoken in to being, I tried to set the stage for our discussion by posing two related questions:

What worlds are we creating with our words?

Are those worlds safe and hospitable for everyone?

As I’ve learned more about harm reduction and compassionate responses to drug users in the last few years, I’ve become more sensitive to the ways words can stigmatize. Some discriminatory terms are obvious—”junkie,” “crackhead,” etc.—and some might not be obviously stigmatizing to someone a different lived experience—”addict,”* “substance abuse,”** etc. The one that I most recently had my eyes opened to was “clean”—as in, so-and-so has been clean for 6 months. If a person is clean, that meant he or she was previously dirty. Is that really what we want to say?

With our words, we can create worlds that are or are not hospitable to people who are different from us. At the same time, we cannot get it all 100% right all of the time—and sometimes the words that are meaningful and powerful for one group can feel oppressive and restrictive for another.

For example, when we did an exercise in the pre-conference to brainstorm words that can be stigmatizing, some of the terms that came up were things like “disease” and “relapse”—parts of common parlance in abstinence-based recovery communities. We shared, too, about religious terminology that can be a barrier to effective communication between marginalized persons and people of faith—like “sin,” “redemption,” “salvation,” and more.

For some, calling their relationship with substances a “disease” feels derogatory or misrepresents their experience; for others, it is a necessary step toward freedom from a cycle that looks and feels very much like a chronic illness, a step toward breaking away from the shame and self-blame that perpetuate that cycle. For some, “sin” implies judgment, blame, and condemnation; for others, it speaks to shared human brokenness and systemic oppression that must be named and responded to, and from which there is the promise of release.

What do we do when the worlds we create with our words are one person’s everything and another’s shame or sense of exclusion?

What I have appreciated most about the conversations on language that I’ve been a part of in relation to harm reduction is that they have never been about policing language or political correctness. Our group acknowledged that language is a two-way street, that we should not only be willing to speak different words but also to hear beyond unintentionally harmful words to try and understand what the person actually means. There are some words we can agree not to use, and there are some words that mean different things to different people and so demand that we listen for context and intention.

In the room yesterday were people of faith and people who do not identify with any faith; there were current drug users and former drugs users and people who have never used illicit drugs. We all agreed that not all substance use is good, that some forms of use are chaotic and destructive, and we reminded one another that one of the principles of Harm Reduction is not to minimize the real harms and dangers associated with substance use.

This is the kind of world I want to create with words: a world where we can share openly and without fear, not only about our hopes, dreams, and successes, but also about our failures, fears, and shortcomings. We create this world not only with the words we use but also in the ways we listen, in how we translate for and with one another, in how we strive to hear beyond the things that might put up walls between us and instead build bridges together.

“And God said, ‘Let there be…'” Let there be love. Let there be welcome. Let there be life.


* Often we presume that if someone is using illicit drugs, he or she is an addict; however, substance use does not automatically equate to addiction, and “addict” can be a derogatory term when used to belittle or control a person. On the other hand, members of 12-step programs refer to themselves as “alcoholic” or “addict” as part of their program, and some active drug users have even taken back “addict” as a term of empowerment. 

** As I’ve gotten to know the harm reduction community, I’ve stopped using “substance abuse” and instead refer to “substance use“—which can be modified with adjectives like “problematic” or “chaotic” as needed, but which also removes the value judgment inherent in the term “abuse.” 

Published by Sarah Howell-Miller

"I believe in kindness, also in mischief. Also in singing, especially when it is not necessarily prescribed." {Mary Oliver}

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