A Qualitative Examination of Addiction Disclosure and Stigma among Recovering Adolescents.

Abstract

Background: The stigma attached to alcohol or other drug use (AOD) disorders can lead to poorer treatment outcomes. Adolescents, who are developing their social identity, may hesitate to disclose their disorder and are vulnerable to stigmatizing experiences. Adolescents' preferred ways of discussing AOD disorder have not been explored.

Methods: This study explores the experience of AOD disclosure in 16 adolescents with an AOD disorder (recruited nationwide in the United States from 2022-2023). Participants were 12-19 years old (M = 16.8; SD = 1.78; 56% Male, 31% Female, 13% Non-binary), had experienced problematic substance use, and used some form of treatment or recovery support. Participants completed an interview in which they reflected on their social network, their recovery, and experiences related to AOD disorder disclosure. The research team used constant comparative analysis to develop themes from the interview data.

Results: A primary theme was the level of control participants felt regarding the persons to whom they disclosed their AOD recovery, and how that information was disclosed. Although some participants felt supported, several felt that their peers/family were overly intrusive (e.g., by questioning actions). Some participants experienced enacted stigma in interactions with others.

Conclusions: These results support recommendations for family, peers, and youth-facing providers to engage youth in treatment. Future work should aim to increase disclosure skills and coping strategies for adolescents experiencing AOD recovery, and educational efforts for practitioners, families, and peers on ways to have conversations around AOD recovery with adolescents that best support their recovery.