Recovery Dialects: A Pilot Study of Stigmatizing and Nonstigmatizing Label Use by Individuals in Recovery From Substance Use Disorders

Previous research has found language used to describe individuals with a substance use disorder (SUD; e.g., "addict," "substance abuser") contributes to and elicits negative bias among the general public and health care professionals. However, the prevalence in which recovering individuals use these labels to self-identify and the impact of such labels are unknown. The current pilot study, a cross-sectional design, examined the usage of two labels ("addict," "person with a SUD") as well as the differences in recovery outcomes among individuals in recovery. Participants (n = 54) used both labels at high rates ("addict": 66.67%; "person with a SUD": 38.89%), though mutually exclusive use was lower ("addict" only: 35.19%, "person with a SUD" only: 7.5%). Common label use settings included mutual-aid recovery meetings, with friends and family, and on social media. Analysis of variance tests found no statistically significant differences between label groups for recovery capital, self-esteem, internalized stigma and shame, flourishing, or length in recovery. Descriptively, participants using only "person with a SUD" had more positive outcomes, although these individuals also had higher levels of internalized shame. Results suggest that language may have only a marginal impact on individuals in recovery, although professionals and the general public should continue to avoid using stigmatizing labels. Additionally, many individuals in recovery have the ability to discern context and setting, switching between positive and negative labels as appropriate. Future research is warranted given these pilot findings and should focus on long-term impacts of self-labeling and internalized stereotypes among individuals in recovery. Public Health Significance The current pilot study reports on the prevalence of both stigmatizing and nonstigmatizing labels ("addict," "person with a substance use disorder") among a cohort of individuals in recovery. While the labels individuals use for themselves do not seem to be associated with common recovery outcomes (e.g., recovery length, recovery capital, self-esteem, etc.), many individuals use both stigmatizing and nonstigmatizing labels depending on context. This level of discernment suggests individuals in recovery are aware of the potential for labels to elicit stigma and may attempt to moderate it by using less stigmatizing language in public settings, with friends and family, and their colleagues.