We hear so much about stigma and how it is at least part of the reason that less than 7% of those who need treatment actually access it (NIDA legislative).
Our language has changed, though I contend that we may have taken things a bit too far when I can’t actually figure out what words to use to say that someone drinks too much. While progress has been made, there’s still more work to be done.
The language has changed so fast that I am not able to keep up. In June 2021, NIDA asked us to stop using MAT (see below for explanation) completely, saying “The term MAT implies that medication should have a supplemental or temporary role in treatment. Using ‘MOUD’ [medication for opioid use disorder] aligns with the way other psychiatric medications are understood (e.g., antidepressants, antipsychotics), as critical tools that are central to a patient’s treatment plan” (NIDA research).
In November 2021, the American Society of Addiction Medicine, ASAM, also asked that “MAT” be retired, but they want us to use the phrase “addiction medications” instead. And, in the meantime, ASAM asked us to consider that the acronym MAT really means “medication for addiction treatment” rather than “medication-assisted treatment,” indicating, “When the acronym MAT is used or referenced in laws, regulations, academic literature, the media, and the vernacular, we recommend reading MAT as medication for addiction treatment. This term takes into account all manifestations of addiction and indicates that there are medications specifically tailored for treatment. ASAM recommends the term MAT be retired from use and instead use the term addiction medications to refer to pharmacotherapy for substance use disorders” (ASAM; emphasis theirs).
So both entities are telling us to stop using MAT, but now we need to use different phrases for what we mean.
Per NIDA, we use
- Medication treatment for OUD
- Medications for OUD
- Opioid agonist therapy
- Pharmacotherapy
- Medication for a substance use disorder
Per ASAM, we use
- Addiction medications
You know what we currently use, still, in May 2025? “MAT,” meaning “medication-assisted treatment.” Give it a google. I’ll wait. Very few of us have caught on, and I contend that it’s at least in part because the language has changed too quickly. We can’t keep up!
And what does any of it mean?
We have shied away from using “addiction,” adopting instead the nonsensical phrase “substance use disorder.” Because, you know, when you have skin cancer, you have a skin disorder. When you have asthma you have a respiratory disorder. Diabetes? A pancreas disorder, of course!
Addiction is a real, diagnosable disease, and using other phrases to soft-shoe the diagnosis does no one any favors. I get it, though! In a sense, addiction is a disease of exclusion since there isn’t a specific test to diagnose it. Except there is. Marty Mann figured it out as early as 1981. If you’re new here, read on:
“The Test: Select any time at all for instituting it. Now is the best time. For the next six months at least decide that you will stick to a certain number of drinks [or number of hits, lines, etc., however your drug of choice is measured] a day, that number to be not less than one and not more than three. If you are not a daily drinker [user], then the test should be the stated number of drinks [or number of hits, lines, etc., however your drug of choice is measured] from one to three, on those days when you do drink [or use]. Some heavy drinkers [users] confine their drinking [using] to weekends, but still worry about the amount they consume then. Whatever number you choose must not be exceeded under any circumstances whatever, and this includes weddings, births, funerals, occasions of sudden death and disaster, unexpected or long-awaited inheritance, promotion, or other happy events, reunions or meetings with old friends or good customers, or just sheer boredom. There must also be no special occasions on which you feel justified in adding to your quota of the stated number of drinks [or number of hits, lines, etc., however your drug of choice is measured], such as a severe emotional upset, or the appointment to close the biggest deal of your career, or the audition you’ve been waiting for all your life, or the meeting with someone who is crucial to your future and of whom you are terrified. Absolutely no exceptions, or the test has been failed.”
So there IS a test AND a diagnosis: addiction. Let’s all call it what it is, and use the proper language to help others.
Rule #1: Put the person first. Use “person with addiction,” not the shortcut words of alcoholic or addict.
Also, rule #1: Addiction is a disease. No one chooses to have it.
References
https://www.asam.org/quality-care/definition-of-addiction/glossary-of-addiction
A really great article about the founder of what became the NCADD, Marty Mann! https://ncaddnational.org/what-the-alcoholic-owes-to-marty-mann/
Guided by Guida 
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