"Clean Addict": A "Semantic Warning Sign" and a Bridge to an Integrated Recovery Identity.

Abstract

In this qualitative study, we explored how professionals specializing in the treatment of substance use disorder (SUD) perceive and use SUD-related terminology. Thirty-two professionals from diverse disciplines (social workers, psychologists, and psychiatrists) were recruited using purposive sampling. Data were collected through individual semi-structured interviews conducted in person or via Zoom, and analyzed using the reflexive thematic method, grounded in the constructivist epistemological framework. The findings revealed that professionals utilize the terms "addict" and "clean addict" and perceive them as "semantic warning signs," intended to reinforce clients' vigilance by emphasizing the chronic nature of SUD. The interviewees also articulated the dual role of these terms in shaping clients' identity transition during recovery-supporting continuity of the "addict" identity while potentially limiting broader identity integration. These findings highlight SUD professionals' nuanced and context-sensitive approaches, as reflected in their choice of terminology, recognizing both its clinical utility and its limitations. They underscore the importance of professionals' perspectives in shaping therapeutic SUD terminology and reveal how professional terms serve as culturally embedded constructs that can carry stigmatizing connotations in some contexts while empowering recovery in others. This sheds light on the need for further cross-cultural research to explore these dynamics in diverse linguistic and cultural contexts.