Being ‘clean’ refers to not using drugs and may be synonymous with abstinence. The definition of ‘clean’ is disputed in the same way as abstinence (see abstinence).

Clean is also a contested term because people may infer that people who are not ‘clean’ are somehow ‘soiled’ or ‘dirty’ and therefore the term may stigmatise people who use substances or have a substance problem.

For some people, the term clean is so contested that it is viewed as stigmatising in all situations. The term‘clean needle’is therefore viewed as stigmatising people who in certain circumstances are forced to use unsterile injecting equipment. The preferred terms are therefore sterile and unsterile injecting equipment.

Some people in abstinent recovery refer to their ‘clean time’ i.e. the length of time they have not used substances. For some people there is a great sense of achievement in this and ‘clean time’ is, for some people, a positive feature of having an identity as a ‘person in recovery’. Concern has been expressed that this creates hierarchies within recovery communities that, like all hierarchies, may be disempowering and unhelpful to some people. For others, this hierarchy means that people can seek and get support from people who have more experience in their recovery.