How Do Former Drinkers Share Their Non-drinking Identity?

There are estimated to be about 25 million people in the U.S. who formerly had a problem with alcohol or other drugs – some of whom identify as being “in recovery” or a “recovering alcoholic or addict.”

Not drinking may be seen as a departure from this norm, and individuals who do not drink may face stigma both because they are not participating in drinking behaviors and because of their prior drinking problem

WHAT PROBLEM DOES THIS STUDY ADDRESS?

There has been little research on how former problem drinkers (including but not limited to individuals “in recovery”) that no longer drink navigate the social experiences around disclosure or non-disclosure of their status as a nondrinker. In the current study, Romo and colleagues provided insight into this issue through qualitative interviews with 11 former problem drinkers who no longer drink.

HOW WAS THIS STUDY CONDUCTED?

Authors interviewed 11 problem drinkers, defined in the study as individuals who “self-described as recovering alcoholics or addicts, or acknowledged they quit drinking due to adverse effects, and/or because they were unable to control their alcohol consumption.” They were recruited as part of a larger study on individuals in the workforce who abstain from alcohol. Gender breakdown was 7 male and 4 female, all participants had between 1-19 years of sobriety, averaged 40 years old, and all participants were white.

The researchers conducted individual interviews, lasting between 25 and 75 minutes, either face-to-face or on the telephone. The original intent of this study was to understand how “nondrinkers discuss nondrinking” but authors decided the importance of disclosure emerged as the most salient and informative part of the discussion and focused on this experience in particular. They used a qualitative analysis approach called constant comparative techniques, resulting in themes and exemplars of themes from interview transcripts.

They used Communications Privacy Management Theory to guide the qualitative analyses. This theory suggests individuals maintain boundaries around their private, personal information. How rigid these boundaries are depends on cultural expectations and norms, and an evaluation of the benefits versus risks/costs of sharing this private information.

In the current study, the personal information of interest was participants’ status as a nondrinker or “recovering alcoholic” in some cases.

WHAT DID THIS STUDY FIND?

Results showed that 10 of 11 participants felt stigmatized due to their status as a nondrinker and acknowledged the behavior as “culturally deviant” (i.e., departing from their experience of what is typical in their social lives).

Participants’ disclosure was organized into three themes, two of which involved partial or non-disclosure and the third involving full disclosure:

To maintain privacy around their non-drinking status to fit in with the group. In situations where participants felt benefits of disclosure did not outweigh risks, they might refuse a drink offered to them without explicitly identifying as a nondrinker, and, in some cases, addressed any discomfort by “passing as a nondrinker” (e.g., putting a lime in their non-alcoholic beverage). Authors noted participants with more time in sobriety were less likely to attempt to pass as a nondrinker, though this was not analyzed statistically.
Crafting excuses to maintain privacy, including personal reasoning (e.g., offering to be the designated driver) or humor (e.g., describing extreme negative consequences that may occur if they drink).
Disclosing to do right by self and others. Individuals chose to disclose their status as a nondrinker when benefits outweighed risks/costs, including situations where they disclosed to potentially help others with a drinking problem, to maintain their identity as a nondrinker when they felt their sobriety may be threatened (e.g., at risk of feeling an urge to drink if they did not disclose), to build closer and more intimate relationships, and on a “need-to-know” basis. Some individuals disclosed their non-drinking status more readily because they felt better being completely honest and doing so allowed them to be “true to themselves.” Virtually all participants worked to convey an attitude of acceptance toward drinkers when faced with the decision to disclose. They did this to preemptively avoid the sense they might cause others to feel uncomfortable about drinking around them knowing their non-drinking status.

This study is rare and valuable as it attempts to understand a common challenge for individuals in recovery.

Results suggest individuals have a range of strategies they use to navigate situations where they have an opportunity to disclose their status as a nondrinker. These strategies may also vary across different contexts within the same individuals, depending on the benefits of doing so in those contexts (e.g., at work, at social gatherings, in relationships) relative to risks or costs.

In general, individuals are more likely to disclose if the benefits are greater than risks, and the likelihood of more open disclosure may increase as individuals become more comfortable with their non-drinking status over time.

WHY IS THIS STUDY IMPORTANT

This study may offer ideas for individuals in recovery to help them navigate the disclosure of their nondrinking status, informed by the direct experiences of a group of former problem drinkers.

This study’s results suggest former problem drinkers, with sobriety ranging from 1 to 19 years, have many ways they deal with situations where they may choose to disclose or not disclose their status as a nondrinker. It may be helpful to discuss with patients seeking recovery how they would like to manage these situations, and what the effects may be on their sobriety and sense of self.

In addition, virtually all participants experienced stigma due to their non-drinking status (e.g., feeling excluded or mocked). It may be important to prepare for this likely scenario by helping them to understand the true nature of their condition (i.e., that it is a health condition), to reinforce their reasons for abstinence and the importance of abstinence to reduce the risk of relapse (see here), and to find recovery-supportive social environments that support their efforts to abstain from alcohol and other drugs.

Finally, these data highlight one potential benefit of recovery mutual-help organization membership by way of identification as a mutual-help member and the cohesion and shared experience among members. There may be limited times in a nondrinkers’ day-to-day life where they can openly disclose their non-drinking status and still feel fully accepted.

Mutual help organizations may fully support and celebrate free expression of recovery status, which can boost self-esteem and confidence.

LIMITATIONS

This study was retrospective, asking participants to recount experiences from their past, which may be subject to bias (e.g., how they feel currently may influence how they remember events).
In addition, the sample was small and entirely White and employed, and therefore may not apply to all people in recovery.
Also, there is an even greater presence of alcohol in young adults’ social situations, and particularly those in college; these results may not generalize to the experience of young adult nondrinkers.
Finally, the samples’ participation in recovery activities, including mutual-help groups, for example, was not reported. More information on the sample could provide insight into how applicable this sample is to the entire population of former drinkers who quit because they had a problem.

NEXT STEPS

One possible direction for this research is to conduct similar qualitative interviews with a more representative group of former problem drinkers (i.e., of varying ethnic backgrounds and employment histories).

In addition, determining if nondrinkers can modify stigmatizing attitudes of their co-workers, friends, and family through disclosure of their non-drinking or recovery status is an interesting question for future investigation.

BOTTOM LINE

For individuals & families seeking recovery: One will likely be faced with situations where they are offered a drink or a drug. This study showed that there are a range of ways that former problem drinkers cope with these social situations, and in general, one will be more likely to disclose their non-drinking or recovery status if the benefits of doing so outweigh the risks.
For scientists: Communication of one’s non-drinking or recovery status is a relatively new area of investigation. The current study offered several hypotheses for future investigation, including the use of implicit cost-benefit analyses in choosing to disclose one’s non-drinking status, as well as greater likelihood of disclosing their non-drinking status with more years of abstinence.
For policy makers: Helping individuals in recovery navigate social stigma remains a challenge; consider funding research to identify strategies to address this problem.
For treatment professionals and treatment systems: It may be helpful to discuss with patients seeking recovery how to manage situations where they will be offered alcohol or another drug. Such a discussion may go beyond “drink refusal skills”, to a discussion of how they think about their status as a nondrinker, and whether and how to disclose their status as a nondrinker. In addition, virtually all participants experienced stigma due to their non-drinking status (e.g., feeling excluded or mocked). It may be important to prepare for this likely scenario, by helping them to understand the true nature of their condition (i.e., that it is a health condition), to reinforce their reasons for abstinence and the importance of abstinence to reduce the risk of relapse (see here), and to find recovery-supportive social environments that support their efforts to abstain from alcohol and other drugs.

CITATIONS

Romo, L. K., Dinsmore, D. R., & Watterson, T. C. (2015). “Coming out” as an alcoholic: how former problem drinkers negotiate disclosure of their nondrinking identity. Health Commun, 1-10. doi:10.1080/10410236.2014.954090