Use of stigmatizing language related to substance use disorders in media: A systematic review

Substance use disorder (SUD)-related stigma may contribute to delayed help seeking and undertreatment. Stigmatizing language ("substance abuse," "alcoholic," etc.) is a harmful component of stigma that implies moral failing and characterological weakness. Media portrayals of SUDs influence attitudes, public opinion, and support for public policies addressing SUDs. This review examined SUD-related stigmatizing language in print, broadcast, digital, and social media to understand shaping of public attitudes and inform future interventions.

This study was prospectively registered and conducted according to the Cochrane Handbook. Abstracts (n = 515) were identified through systematic searches across Medline, Embase, PyschINFO, Web of Science, and supplemented by hand searching bibliographies of included studies. English-language, peer-reviewed publications that examined stigmatizing language within media channels were included.

Thirteen studies focusing on print and digital news (n = 9), video-based (n = 2), and social (n = 4) media were included, of which two examined a combination of media types. With few exceptions, the use of stigmatizing language was frequent across locations and media types. Common terms included "addict," substance/drug "abuse(r)," and "junkie." While some studies found changes in stigmatizing language use over time, the direction and magnitude of changes varied by context and media type.

Stigmatizing language in media remains prevalent with a few exceptions. Broad-reaching stigma-reducing interventions such as public education and advocacy by medical and public health communities are critically needed. Additional studies are needed to examine other media types, explore differential use of stigmatizing language by substance discussed, and investigate how stigmatizing language influences perceptions of and attitudes toward SUDs.