In continuing our journey toward compassionate person-first language, it’s crucial that we examine Substance Use Disorder (SUD) for what it truly is: a complex, chronic disease. This is in contrast to what many see addiction as being simple, repetitive choices. We must grasp this concept as a faith community in order to approach, support, and speak about those who struggle with addiction. Understanding SUD as a disease—rather than a mere “choice” or moral failing—is key. It shifts our perspective; it deepens our empathy. What I am proposing here is a shift that is supported by both scientific and theological insights, inviting us to extend the same grace and compassion to those with SUD as we would to anyone managing a chronic illness.

Defining Substance Use Disorder (SUD)

At its core, SUD is a medical condition affecting the brain, behavior, and, ultimately, the entire life of a person. SAMHSA defines SUD as a condition in which the “recurrent use of alcohol and/or drugs causes clinically significant impairment,” impacting health, responsibilities, and relationships. Unlike occasional or social use, SUD disrupts a person’s ability to control their substance intake despite adverse effects on their physical, emotional, and social well-being. Diagnosing SUD typically involves a comprehensive assessment, often incorporating criteria such as the inability to limit use, increased tolerance, and, most significantly, interference with one’s daily life.

This distinction matters. By understanding that SUD is not merely excessive use but a disorder with measurable clinical implications, we’re better equipped to see beyond stereotypes. Ashford’s study notes, “Terms like ‘addict’ or ‘substance abuser’ reinforce stereotypes and elicit greater negative bias” (Ashford et al., 2018, p. 133). Using person-first language, such as “person with a substance use disorder,” acknowledges the humanity before the disease, highlighting the reality of the struggle while preserving the person’s dignity.

SUD as a Chronic Disease: The Science Behind the Model

The medical and scientific communities increasingly recognize SUD as a chronic disease—one influenced by a combination of genetic, neurological, psychological, and environmental factors. This disease model reveals that SUD, like other chronic conditions such as diabetes or heart disease, fundamentally alters the brain’s structure and function. These changes disrupt critical areas involved in decision-making, impulse control, and reward processing, making it extremely difficult for individuals to stop using substances even when they sincerely desire to do so.

Understanding SUD through the lens of the disease model changes our approach in significant ways. Just as we provide ongoing treatment, understanding, and accommodations for someone with diabetes, so too should we approach individuals with SUD with patience, treatment support, and empathy. Ashford’s research reminds us that shifting away from judgmental terminology could open doors to support systems and reduce the stigma that often prevents individuals from seeking help. He writes, “The language used to describe substance use disorders affects implicit and explicit biases, shaping public perceptions and the quality of care” (Ashford et al., 2018, p. 135).

The Disease Model vs. The Choice Model: Shifting Our Perspectives and Responses

In many circles, the choice model of addiction is still dominant. This model implies that individuals with SUD lack willpower or moral conviction, reducing their struggle to poor choices. Viewing addiction as a choice rather than a disease separates those suffering and those who are healthy; this isolation is much like a modern-day leprosy epidemic. When we attribute addiction to “bad decisions,” we risk stripping individuals of their dignity, making it easy to ignore their pain and deny their need for support.

By contrast, the disease model allows us to see addiction as an involuntary struggle—a condition beyond simple willpower. This shift in perspective leads to greater compassion and motivates us to extend accommodations as we do for other chronic conditions. In Matthew 9:12, Jesus says, “It is not the healthy who need a doctor, but the sick.” With these words, Jesus reminds us that those who are suffering—whether physically or spiritually—need compassion and care, not condemnation.

Theological Implications

A biblically informed faith calls us to extend compassion, particularly to those in need. As Christians, we strive to follow the example of Jesus, who welcomed and healed those whom society often disregarded. In the story of the Good Samaritan (Luke 10:25-37), Jesus illustrates that our compassion should transcend biases and stereotypes, reaching out to those in distress. When we accept the disease model of SUD, we align ourselves with this compassion, recognizing that individuals with SUD are, first and foremost, people in need of understanding and support.

Further, if we recognize SUD as a disease, our language and actions naturally begin to align with how we treat those with other chronic illnesses or disabilities. In a church setting, this perspective can shift everything—from how we pray for individuals with SUD to how we develop ministries to support them. Instead of seeing addiction as a moral failing to be “fixed,” we can extend grace, welcome, and practical assistance. Ashford’s study found that person-first language leads to more positive associations and reduced stigma (Ashford et al., 2018, p. 134). This evidence challenges us to rethink our approach, cultivating spaces where individuals feel safe to seek help and healing.

Implications of the Disease Model: A Call to Accommodate and Support

By embracing the disease model, we can view SUD with the same compassion and care as other illnesses, motivating us to provide appropriate accommodations. In our society, accommodations for disabilities are seen as necessary and just. We understand that certain conditions limit a person’s ability to function without support, so we make changes to enable them to live as fully as possible. Why, then, should it be different for someone with SUD? The Apostle Paul’s words in Galatians 6:2—“Bear one another’s burdens, and so fulfill the law of Christ”—compel us to support those around us, especially in their struggles. We are called to lift each other up, not judge, shame, or distance ourselves from those who carry heavier burdens.

In practical terms, this approach calls for us to be watchful with our language so that when we interact with people with SUD, they can find understanding, support, and resources for recovery. Ministries could focus on everything from providing access to resources like counseling and medical support to developing prayer groups that offer encouragement without judgment. By recognizing SUD as a disease, we align ourselves with concepts of imago dei.

In our journey as followers of Christ, we recognize the transformative power of words. The language we use to describe others—particularly those facing challenges like Substance Use Disorder (SUD)—shapes not only how they are perceived but also how they perceive themselves. For those of us rooted in a faith tradition that calls us to love our neighbors, our words should reflect God’s grace, compassion, and unwavering love. This is the first in a series of articles exploring the impact of compassionate, biblically grounded language on how we approach SUD and other struggles. In this series, I’ll be sharing deeper insights, tools, and theological reflections on how faith communities can shift their language to mirror the gospel’s message of redemption and dignity.

My friend Robert Ashford’s research on person-first language—referring to someone as a “person with a substance use disorder” rather than an “addict”—has deeply influenced my perspective on this topic. His work, highlighted in Drug and Alcohol Dependence, uncovers how terms like “substance abuser” and “opioid addict” fuel negative biases and reinforce harmful stereotypes. Ashford’s study found that “terms such as ‘substance abuser’ and ‘opioid addict’ have been shown to elicit greater negative explicit bias” (Ashford et al., 2018, p. 131). However, person-first language can diminish stigma and foster respect, something we’ll explore in detail in this series.

The Power of Words in Scripture

The Bible frequently emphasizes the significance of our words. Proverbs 18:21 tells us, “Death and life are in the power of the tongue, and those who love it will eat its fruit.” Our words can either uplift or condemn, show mercy or judgment. When we refer to someone facing addiction as an “addict” or “substance abuser,” we risk reducing them to a single struggle. By using person-first language, we intentionally acknowledge their humanity first instead of their disease first. This honors that each person is more than the challenges they face.

In Ashford’s study, people responded to terms like “substance abuser” or “addict” with more social distance and implicit bias, reinforcing damaging preconceptions. He writes, “The terms ‘substance abuser,’ ‘addict,’ ‘alcoholic,’ and ‘opioid addict’ were strongly associated with the negative” (Ashford et al., 2018, p. 133). This bias has lasting impacts, creating real barriers to the treatment and acceptance individuals with SUD deserve. In this series, we’ll explore how adopting a person-first approach to language can help us see individuals as God sees them—worthy of compassion, dignity, and love.

A Biblical Mandate for Compassion

The biblical command to love our neighbors as ourselves (Mark 12:31) compels us to respond with grace, not judgment. Jesus’ ministry was marked by compassion for the marginalized and the suffering. In Matthew 9:36, we see Jesus moved with compassion for the crowds “because they were harassed and helpless, like sheep without a shepherd.” When we encounter those struggling with SUD, this same compassion calls us to respond with empathy, knowing their journey is complex and often misunderstood.

The concept of imago Dei—the belief that every person is created in the image of God (Genesis 1:27)—reminds us of each person’s intrinsic worth and dignity. Using person-first language honors this divine image by placing humanity before affliction. Ashford’s study supports this, showing that person-first terms like “person with a substance use disorder” reduce implicit biases. He writes, “Both ‘medication-assisted recovery’ and ‘long-term recovery’ are strongly associated with the positive, and significantly different from the negative association” (Ashford et al., 2018, p. 135). Person-first language allows us to honor individuals as whole beings, reflecting the biblical call to love others without prejudice.

Language as a Reflection of Our Faith

Using compassionate language doesn’t deny the realities of substance use, nor does it gloss over the struggles of addiction. Rather, it allows us to speak words that extend grace, hope, and dignity—consistent with the heart of the gospel. Jesus’ teachings show us the transformative power of compassion. In John 8:10-11, he tells the woman caught in adultery, “Neither do I condemn you; go and sin no more.” This is a powerful example of Christian love: the desire to uplift without condemnation. Through person-first language, we offer respect, dignity, and a reminder of each person’s God-given worth, regardless of the hardships they face.

This article is just the beginning. In the coming pieces, I’ll dive deeper into the theological basis for person-first language and explore how it can change lives within our communities. We’ll discuss the theological, practical, and relational elements of person-first language. My goal is to equip the church with ways to offer true support for those affected by SUD and their families. We’ll also explore how person-first language can be woven into our worship, ministries, and interactions with one another in order to make our churches places of refuge and healing.