Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias

Robert D. Ashford, Austin M. Brown, Brenda Curtis

Research output: Contribution to journalArticlepeer-review

123 Scopus citations

Abstract

Background: The general public, treatment professionals, and healthcare professionals have been found to exhibit an explicit negative bias towards substance use and individuals with a substance use disorder (SUD). Terms such as “substance abuser” and “opioid addict” have shown to elicit greater negative explicit bias. However, other common terms have yet to be empirically studied. Methods: 1,288 participants were recruited from ResearchMatch. Participants were assigned into one of seven groups with different hypothesized stigmatizing and non-stigmatizing terms. Participants completed a Go/No Association Task (GNAT) and vignette-based social distance scale. Repeated-measures ANOVAs were used to analyze the GNAT results, and one-way ANOVAs were used to analyze vignette results. Results: The terms “substance abuser”, “addict”, “alcoholic”, and “opioid addict”, were strongly associated with the negative and significantly different from the positive counterterms. “Relapse” and “Recurrence of Use” were strongly associated with the negative; however, the strength of the “recurrence of use” positive association was higher and significantly different from the “relapse” positive association. “Pharmacotherapy” was strongly associated with the positive and significantly different than “medication-assisted treatment”. Both “medication-assisted recovery” and “long-term recovery” were strongly associated with the positive, and significantly different from the negative association. Conclusions: Results support calls to cease use of the terms “addict”, “alcoholic”, “opioid addict”, and “substance abuser”. Additionally, it is suggested that “recurrence of use” and “pharmacotherapy” be used for their overall positive benefits. Both “medication-assisted recovery” and “long-term recovery” are positive terms and can be used when applicable without promoting stigma.

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalDrug and Alcohol Dependence
Volume189
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

Keywords

  • Addiction
  • Explicit bias
  • Health communication
  • Implicit bias
  • Language
  • Linguistics
  • Stigma
  • Substance use disorder

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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