Why the word “drug” promotes a public bias in chronic pain treatment


by Jack Cain

In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain.  Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances.

Bias is extremely insidious and difficult to eradicate once in place.  It masquerades as common sense and logic.  It causes normally rational people to express themselves in illogical ways.  In this case, it results in bad policy as the medical use of the term “drug” is pulled into the media where the public has been conditioned to respond to this word as detrimental while the word “medication” is viewed as beneficial.

Here are some examples:

Our government has declared a “war on drugs”, not a “war on medication.”

There is a government position to coordinate this “war” filled by the “Drug Czar”, not the “Medication Czar.”

The media commonly reports on large “drug busts” when referring to seizures of illegal substances conducted by the DEA or Coast Guard.

The suppliers of large amounts of illegal substances are collectively known as “drug cartels.”

Finally, for decades the term “drug” has been associated with the word “abuse” when reporting the negative social results of the non-medical use of heroin, cocaine and methamphetamine.

Using only a dictionary and a thesaurus, the difference in perception between “drug” and “medication” is easily demonstrated.  At the Visual Thesaurus, entering the word “drug” shows a 1st order association with “doing drugs”, “being drugged by kidnappers” and “narcotic”.  Entering “medicine”, two of the large number of beneficial 1st order associations are “treating or alleviating disease” and “remedies”.  In the Free Medical Dictionary, the word “drug” is directly associated with “narcotic”, “recreational drug”, “designer drug”, and “any substance that can be abused”.  “Medicine” is associated almost exclusively with the legitimate “treatment of disease”.

In today’s social media culture, many details are lost when “The Twitter Effect” is applied to accurate and informative scholarly articles on this topic.  What is left are the emotional impressions of the topic rather than the complete analysis of the subject the author intended.  Therefore, the emotional content of words becomes much more important than the actual definition, especially when articles are quoted by the media or by public officials to justify one political or legislative position or another.

If medical professionals are going to claim “Primum non nocere” (First do no harm) as a guiding principle, they need to acknowledge when to use the word “drug” and when, to do no harm, to use the word “medicine”.

Jack Cain is a Pain Policy Advocate at the Consumer Pain Justice Cooperative.

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