Analysis of 748 Reddit posts found 11 categories of behavior change techniques across recovery stages, with stigma present throughout all stages from pre-contemplation to maintenance.
Addiction counselors, digital health researchers, stigma reduction advocates
Stigma was present across all stages of recovery, from pre-contemplation through maintenance
What the researchers found
63.1% of narratives were in the action stage; 11 BCT categories identified; social support seeking and consequence awareness dominated early stages; action and maintenance stages showed more diverse strategies; stigma persisted across all stages.
Why it matters
Understanding how people naturally use behavior change techniques during recovery can inform more effective intervention design, while the persistence of stigma across all stages highlights it as a constant barrier.
The numbers in context
748 posts; 63.1% action stage; 11 BCT categories; 5 major stigma themes; social support became more commonly offered (vs sought) in maintenance stage.
How the study worked
Qualitative analysis of 748 Reddit posts from alcohol, cannabis, and opioid subreddits (2013-2019) using hybrid inductive-deductive coding for stages of change, behavior change techniques, and stigma themes.
What this study cannot tell us
Reddit sample biased toward action stage (actively seeking recovery); may not represent those not engaging online; subjective coding; cannot verify outcomes; same dataset as companion study.
How to read the evidence
Rigorous qualitative framework applied to large social media dataset, but self-selected online sample and subjective coding are inherent limitations.
When this study was published
Published 2025, data from 2013-2019
The bigger picture
Digital platforms reveal the organic recovery process, showing that people naturally employ evidence-based behavior change techniques and that stigma reduction should be embedded across the entire recovery continuum.
Questions still open
- Can digital interventions scaffold these naturally occurring behavior change techniques? Would stigma reduction at earlier stages accelerate progression through stages of change?
Common questions
What behavior change strategies do people use in recovery?
Does stigma go away as people recover?
Read the original research
Stigma and Behavior Change Techniques in Substance Use Recovery: Qualitative Study of Social Media Narratives.
JMIR formative research, 9, e57468
Citation
Chen, Annie T; Wang, Lexie C; Johnny, Shana; Wong, Sharon H; Chaliparambil, Rahul K; Conway, Mike; Glass, Joseph E. (2025). Stigma and Behavior Change Techniques in Substance Use Recovery: Qualitative Study of Social Media Narratives.. JMIR formative research, 9, e57468. https://doi.org/10.2196/57468
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