Do Words Matter? A Vignette Study Exploring How Substance Use Descriptions Influence Perceptions of the Substance Involved in Police Encounters
Abstract
Background
Substance use is common in Canada, yet a focus on substance use disorders (SUD) reinforces stigma and barriers to care. Health-spectrum language has been proposed to reduce stigma’s impact. We explore how describing substance use across a health spectrum in a police encounter influences stereotypes associated with substance use, ethnicity, and gender.
Methods
Canadian adults (n=1049) completed a cross-sectional online survey. Participants were randomly assigned to one of five vignette conditions (no use, low risk, high risk, declining health, and SUD) and asked to identify the characteristics of the person described.
Results
Across all vignette conditions, participants primarily selected alcohol (57%), White (60%), and male (70%) identities. Compared to alcohol at the no use reference level, cannabis was significantly less likely to be selected across all other conditions (p<0.01), while Illicit substances were less likely to be selected in the low risk group (p<0.05). Black and Indigenous identities were about half as likely than White to be selected in declining health and low risk groups respectively, relative to no use (ps<0.05). Gender showed no significant differences (p>0.05).
Discussion
While White and alcohol were the default associations of illicit substances, Black and Indigenous identities with low risk or declining health suggests these groups remain implicitly linked to problematic use.