Seven in Ten People With a Substance Problem Say They're in Recovery. The Ones Who Don't Are Carrying More Shame.

Most people who have had a drug or alcohol problem say they are in recovery. In a new paper in Stigma and Health, Melissa Schick and colleagues analyzed 5,260 U.S. adults from the 2023 National Survey on Drug Use and Health who reported a lifetime alcohol or drug problem, and 72.9% said they were in recovery.

The line between people who say “in recovery” and people who don’t is shame, not willpower.

Among people who said they needed treatment and hadn’t gotten it, those in recovery were far less likely to name stigma as the reason. The odds were about a quarter as high (adjusted odds ratio 0.25, which is a statistical way to say the gap is large even after accounting for age, sex and other differences). They were also much less likely to say they weren’t ready to change. And they had used more support: people in recovery were more likely to have used any treatment in the past year, driven mostly by support groups and peer support specialists.

Calibrate it, the way you would want a friend to. The sample is people who reported a lifetime problem, which is not everyone who has ever struggled. This is one survey taken at one moment, and “in recovery” is the person’s own label, so it can’t tell you which came first: that people who feel less shame go find peers, or that peers is what removes the shame. Probably both. The authors’ own conclusion is that stigma is the key distinguishing barrier and that interventions should target it.

If you are reading this and you have not been able to say the word recovery about yourself, that is not a verdict. It is common, it is measurable, and it points at something outside you. Nobody has to say the word before they walk into the room.

For program staff, one thing to change this week: look at how your intake forms and signage talk about people. If the only door is labeled treatment, consider a door labeled something a person can walk through before they are ready to say the word. The people in that room did not start by calling themselves anything.