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Encouragement without shaming
A testing agreement can rebuild trust or quietly wear it down. Much of the difference is in the words and reactions around it. Here's what public health agencies say about stigma, and what that looks like day to day.
By the P in the Cup editorial team. Published 21 October 2026. Last reviewed 21 October 2026.
This article is general education, not medical, treatment or counseling advice. If you or someone you care about needs help, a healthcare professional or the SAMHSA National Helpline (listed below) can point you to support.
People usually agree to random testing because they want something good: to rebuild trust, to keep a personal promise, to stop the same argument happening every week. Shame works against all of those goals. The good news is that avoiding it is mostly a matter of habits anyone can learn.
Why the words matter
The U.S. Centers for Disease Control and Prevention (CDC) describes stigma as mistreating someone, or thinking badly of them, because of a behavior, characteristic or trait. CDC says stigma can prevent a person from getting help, and that the fear of it can stop people sharing a health condition, including with partners or family. CDC also lists treating substance use disorders as a moral issue, rather than a medical one, as a form of stigma, and stresses that substance use disorders are treatable.
The National Institute on Drug Abuse (NIDA) makes a similar point about language specifically. It notes that stigmatizing words are often used without any intent to harm, and that small changes in wording can reduce stigma. NIDA recommends person-first language, which describes the person rather than defining them by a condition. It also suggests letting people choose how they're described, and asking when you aren't sure.
Swaps worth making
These examples follow NIDA's guidance on preferred language.
| Instead of | Try |
|---|---|
| "Clean" or "dirty" test | Tested negative / tested positive (on a drug screen) |
| "Failed the test" | The screen was positive (and, for a home test, "we're getting it confirmed") |
| "Addict", "user", "junkie" | Person with a substance use disorder, or simply the person's name |
| "Former addict" | Person in recovery |
| "Habit" | Substance use disorder (where that's the accurate description) |
NIDA notes that words like "clean" and "dirty" may decrease a person's sense of hope and self-efficacy for change. That is the opposite of what an agreement is for.
Celebrate the part a person controls
On a scheduled day, the thing someone actually controls is following through: doing the test as agreed, on the day, in the way everyone agreed. That effort deserves to be noticed, every time. A few ideas:
- Say thank you. "Thanks for doing that today" is small and it counts.
- Notice streaks of follow-through, not just streaks of results.
- Keep milestones about participation and goals. Seven check-ins in a row, a month of keeping the agreement, a goal the person set for themselves.
- Keep it proportionate. Encouragement shouldn't become a performance, or a reason to bring the subject up constantly.
When a result is unexpected
This is where shame most often creeps in, and where a plan helps most. Remember that a home test is a screening test. The U.S. Food and Drug Administration (FDA) advises that a preliminary positive should be confirmed by a laboratory, and that no serious action should be taken until that result is back. Its page also lists foods, drinks and medicines among the things that can affect home results. So the first response to an unexpected screen isn't a verdict. It's "let's do what we agreed and get it confirmed."
Whatever the confirmed result, the conversation that follows will go better if it is calm, private and about what happens next rather than about who the person is. If you're finding that hard, it's a good moment to bring in a professional or a support service rather than working it out alone in the heat of the moment.
Hope is part of the plan
The Substance Abuse and Mental Health Services Administration (SAMHSA) describes hope, the belief that challenges can be overcome, as the foundation of recovery. SAMHSA also describes recovery as highly personal, happening through many pathways, built on a person's own strengths, and supported by peers, friends and family. That's a useful lens for any agreement. The schedule is one tool, the person is much more than their results, and there isn't only one right way forward.
Look after yourself, too
Supporting someone can be exhausting, and supporters sometimes carry worry that comes out as criticism. It's okay to need support of your own. SAMHSA's National Helpline, 1-800-662-4357, is free and confidential, and SAMHSA says it is open 24 hours a day, every day of the year. It doesn't offer counseling itself, but it provides referrals to local treatment facilities, support groups and community organizations.
Where P in the Cup fits
P in the Cup is a free scheduling and accountability service whose app is launching soon. Its goals, milestones and badges are designed around participation and consistency, never around a particular test result, and it makes no promises about sobriety. It doesn't sell or administer tests. The random scheduling and accountability service is free. Test kits and any laboratory testing are purchased separately.
Sources
- National Institute on Drug Abuse: Words Matter, preferred language for talking about addiction. Person-first language; preferred and avoided terms; effect of "clean/dirty" on hope and self-efficacy.
- Centers for Disease Control and Prevention: Stigma Reduction. Definition and effects of stigma; substance use disorders as treatable medical conditions.
- SAMHSA: About Recovery. Hope as the foundation of recovery; many pathways; strengths-based; supported by peers, friends and family.
- SAMHSA: National Helpline. Number, hours, confidentiality and referral service.
- U.S. Food and Drug Administration: Drugs of Abuse Home Use Test. Lab confirmation before serious action; factors affecting home results.
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