Objective: Negative narratives regarding substance use disorders (SUDs) are frequently used in medical literature. Such narratives often reinforce persisting negative themes, have long-lasting impacts, and affect how SUDs are viewed by society. This study sought to increase awareness of pejorative language use in medical journals and contribute to a more compassionate and effective approach to understanding and treating those with SUDs.
Methods: This study used Fairclough’s 3-dimensional approach to critical discourse analysis (CDA) to explore the language used in substance use-related articles that were published in a general primary care medical journal. We retrieved 54 articles, published from 2003 – 2022, using key terms identified from National Institute on Drug Abuse language recommendations. Linguistic Inquiry and Word Count 2022 was then used to assess the frequency of stigmatizing terms and to analyze linguistic properties of the articles, including analytic thinking, clout, authenticity, and emotional tone.
Results: Findings showed that stigmatizing terms were used widely in 90% of articles, with an overall decrease in the use of stigmatizing terms over time (80% vs 66%, p = 0.10). The language conveyed in most substance use-related articles was that of pretentiousness, detachment, guardedness, and negative tone.
Conclusion: Pejorative language can have negative implications for those with SUDs, an already marginalized population of individuals. It is therefore imperative that authors, reviewers, and readers make deliberate efforts to use language that conveys respect, minimizes judgment, and avoids perpetuation of stigma for those with SUDs.

PDF (Download Full text)