The labels and models used to describe problematic substance use impact discrete elements of stigma: A Registered Report

Charlotte, R Pennington*, REBECCA MONK, Derek Heim, Abigail Rose, Thomas Gough, Clarke Ross, GRAEME KNIBB, Roshni Patel, Priya Rai, Halimah Ravat, Ramsha Ali, Georgiana Anastasiou, Fatemeh Asgari, Eve Bate, Tara Bourke, Jayme Boyles, Alix Campbell, Katie Toothill, Hin Kok Wong, Andrew Jones

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

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Objectives: Problematic substance use is one of the most stigmatised health conditions leading research to examine how the labels and models used to describe it influence public stigma. Two recent studies examine whether beliefs in a disease model of addiction influence public stigma but result in equivocal findings – in line with the mixed-blessings model, Kelly et al. (2021) found that whilst the label ‘chronically relapsing brain disease’ reduced blame attribution, it decreased prognostic optimism and increased perceived danger and need for continued care; however, Rundle et al. (2021) conclude absence of evidence. This study isolates the different factors used in these two studies to assess whether health condition (drug use vs. health concern), aetiological label (brain disease vs. problem), and attributional judgement (low vs. high treatment stability) influence public stigma towards problematic substance use. Methods: 1613 participants were assigned randomly to one of eight vignette conditions that manipulated these factors. They completed self-report measures of discrete and general public stigma and an indirect measure of discrimination. Results: Greater social distance, danger, and public stigma but lower blame were ascribed to drug use relative to a health concern. Greater (genetic) blame was reported when drug use was labelled as a ‘chronically relapsing brain disease’ relative to a ‘problem’. Findings for attributional judgement were either inconclusive or statistically equivalent. Discussion: The labels used to describe problematic substance use appear to impact discrete elements of stigma. We suggest that addiction is a functional attribution, which may explain the mixed literature on the impact of aetiological labels on stigma to date.
Original languageEnglish
Pages (from-to)1-12
JournalPsychology of Addictive Behaviors
Early online date11 May 2023
Publication statusPublished - 11 May 2023


  • problematic substance use
  • addiction
  • stigma
  • discrimination
  • vignettes
  • models of addiction
  • brain disease


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