Stigmatizing language related to substance use in grants decreases by half

February 17, 2025-- The use of stigmatizing terminology in National Institute on Drug Abuse (NIDA)-funded grant abstracts has decreased by over half since 2013 according to a new paper by researchers at Columbia University Mailman School of Public Health. However, one in four abstracts still contained a stigmatizing term in 2023. The researchers found accelerated decreases in stigmatizing terminology after high-level federal guidance in early 2017 to use non-stigmatizing language and continued decreases after NIDA issued similar guidance in 2021. The results are published in JAMA Network Open.

“This overall decrease may indicate that researchers largely recognize the harms of stigmatizing language, which is encouraging” said Evan Eschliman, PhD, lead author and post-doctoral research fellow in Columbia’s Department of Epidemiology. “But these terms are clearly still too common in our work, and as researchers we can easily change that. Institutions can take further steps to solidify their commitment to stigma reduction, too. For example, the proposed NIDA name change to 'National Institute on Drugs and Addiction' would be in line with NIDA's own guidance.”

Stigmatizing language related to substance use has negative consequences, and there have been many efforts to promote the use of more humanizing language. In 2013, the Diagnostic and Statistical Manual of Mental Disorders changed its formal diagnostic labels to “substance use disorders” and a variety of non-profits, policy, and funding organizations have issued guidance on non-stigmatizing language.

The researchers reviewed abstracts of NIDA-funded grants in 2017 and 2021, analyzing data on all 6065 NIDA-funded grants in their first year of support from fiscal years (FY) 2013 to 2023. They identified 9 stigmatizing terms from NIDA’s Words Matter guidance.

More than half of grant abstracts (54 percent) used one or more stigmatizing term in FY 2013, and one-quarter (25.5 percent) of abstracts in FY 2023 contained stigmatizing language. Stigmatizing terminology referring to substance use behavior was consistently more common than terminology referring to people who use substances.

“Future work should investigate other high-level efforts to reduce stigmatizing language and whether trends continue in future years,” said Pia Mauro, PhD, Columbia Mailman School assistant professor of Epidemiology, and senior author. “Changing the language we use in our writing is an important step to end stigma toward people who use substances.”

Co-authors are Haruka Kokaze, New York University; Long Jie Huang, State University of New York, Albany; Karen Choe, New York University School of Global Public Health.

The study is supported by the National Institutes of Health, National Institute on Drug Abuse, grant T32DA031099 and K01DA045224.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.