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Last Friday, CJR published a piece I’d written—originally as a staff email—kvetching about what I claimed was the rampant misuse of the word opioid. Applied to compounds such as oxycodone and hydromorphone, the word, I wrote, made no sense. The suffix -oid means that something is like, but not actually, whatever is prepended to it—and these medications ultimately do rely on opium harvested from poppies. Thus, I had said, they are not “like” opiates; they actually are opiates.
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I’d intended to base this ruling on purely linguistic or lexical grounds, this being perhaps the sole area where I, lowly copy editor and inveterate word-nerd, might claim something approaching expertise. In fact, if I’m being totally honest, the other reason for my bias against opioid was simply that I hated to say it, or to hear it said; the word doesn’t have what you’d call a pleasant mouthfeel[1]. So I wrote the article pursuant to, and in consultation with, nothing other than what was in my head. I was soon reminded, however, that words reside not just within heads but between them, out in the world…
And that world hardly hesitated to assert itself. It took all of maybe ninety minutes of my post going live for various parties to begin roundly, in some cases roughly disabusing me of the notion that any of this was still up for debate. First came the members of the medical community, as well as neuroscience journalist and fellow CJR contributor Maia Szalavitz, on Twitter. They informed me that these terms had already been rigidly circumscribed—which I might have known had I bothered to actually talk to anyone about them.[2]
I’d like to say I was immediately magnanimous in response, but of course that wasn’t the case. Privately I could admit that nearly everyone who’d taken the time to tweet back at me might have had a point… Still, I couldn’t help but feel ganged up on. I watched myself adopt a defensive posture, digging heels in. Naturally, this accomplished little else besides compounding the charges of hubris being lobbed my way, reinforcing people’s sense of the article and its author as suffering from a fatal case of haughty glibness.
But by the end of the day a funny thing had happened. I stopped trying to defend myself or the post, allowed the tenor of my messages to soften—and watched in wonder as the Twittersphere turned downright kind. One person in particular even direct-messaged me to talk some of this stuff through—and, I’m pretty sure, also private-messaged some of the other participants[3]. People were now praising me for sticking around to hear everyone out. Is the internet getting nicer?
I was now listening more fully—and what I was hearing was that those who use these terms most, in their day-to-day lives, do so for good reason. Virtually everyone involved in or affected by this topic feels strongly about the terminology used in describing it. I know this now because I heard from a lot of them: from clinicians who agonize over the incidence of preventable death in this country; from researchers concerned with correcting the facile narrative around a supposed Rx-to-heroin pipeline; perhaps most of all from those benefiting from long-term opioid therapy, for whom there is a very real fear that criticism of Big Pharma will extend, undeservedly, to the medications that make their lives livable. Who am I to tell them how, in what terms, to talk about that struggle?
And so this is, in the end, a battle I will have deserted even faster than my campaign against the word trope[4]. I won’t pretend to have reconciled my inner grammatical fusspot to every last pointer shared with me—part of me still bristles at what one master of public health told me, that “all opiates are opioids”—but I definitely, definitely won’t insist, in my own day-to-day duties at the copy desk, on changing any writer’s use of either term.
As for the original post, I leave it up as a monument to and ward against hubris.
[1] Say it aloud: the tongue must trip, ever farther back from the teeth, across opioid’s three mealy syllables. The last of them you wind up practically swallowing.
[2] Szalavitz clued me in as to how the modern preference for opioid as the umbrella term came about as a result of a kind of back-formation: the discovery of receptors for opiates in the brain actually predated the discovery of the endogenous chemicals that would bind to those receptors—and of course, there being no such thing as an intracranial poppy plant, opiate seemed somewhat ill-suited to the task.
[3] I’m also pretty sure that this person, prior to DMing, ran something like a background check on me, digging through old posts on Twitter and expanding the inquiry to Facebook, to verify that we were aligned politically and that, on the basis of this social media evidence, I was at least a redeemable person (one with a cat who by all appearances loves him).
[4] Beyond being an insufferable vogue term, trope once referred to “the use of a word or expression in a different sense from that which properly belongs to it, for giving life or emphasis to an idea”—in other words, precisely the opposite of what today’s arts writers take it to mean (something between a trapping and a cliché).
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