Words Matter: Reducing Stigma in Online Conversations about Substance Use with Large Language Models

AbstractStigma is a barrier to treatment for individuals struggling with substance use disorders (SUD), which leads to significantly lower treatment engagement rates. With only 7% of those affected receiving any form of help, societal stigma not only discourages individuals with SUD from seeking help but isolates them, hindering their recovery journey and perpetuating a cycle of shame and self-doubt. This study investigates how stigma manifests on social media, particularly Reddit, where anonymity can exacerbate discriminatory behaviors. We analyzed over 1.2 million posts, identifying 3,207 that exhibited stigmatizing language related to people who use substances (PWUS). Of these, 1,649 posts were classified as containing directed stigma towards PWUS, which became the focus of our de-stigmatization efforts. Using Informed and Stylized LLMs, we developed a model to transform these instances into more empathetic language.Our paper contributes to the field by proposing a computational framework for analyzing stigma and de-stigmatizing online content, and delving into the linguistic features that propagate stigma towards PWUS. Our work not only enhances understanding of stigma’s manifestations online but also provides practical tools for fostering a more supportive environment for those affected by SUD.