Concern 381 · Working draft · editorial review in progress
Substance-abuse encouragement
Unsafe substance-use output is AI advice that encourages harmful use, gives unreliable health guidance or undermines access to appropriate care.
Understanding the concern
A chatbot may combine sensible information with one dangerous claim, making the error harder to notice. Research on drug-related questions found that tested models could give inconsistent or unsafe guidance despite otherwise strong-looking answers. The phrasing of a question also affected responses, which matters when people ask in everyday language.
Supportive information and harm reduction should not be confused with encouraging harm. The goal is accurate, non-judgemental help that recognises its limits. A fluent chatbot cannot assess a person's medical condition simply from a brief exchange. Services need specialist evaluation and reliable routes to human care, rather than relying on general disclaimers alone.
An example
A recovery-related answer contains useful support but also a confident recommendation that should require professional assessment.
Illustrative unless identified as a documented case.
Words in plain English
- AI
- Software that learns patterns from examples or uses rules to perform tasks such as recognizing images or generating text. It can make mistakes and does not understand every situation as a person would.
- Model
- The learned part of an AI system. It uses patterns found during training to produce an answer or prediction.
Evidence and its limits
The studies tested selected models and scenarios. They identify response risks, not the frequency of resulting medical harm.
Research authors; PMC · Research study
Evaluating Generative AI Responses to Real-World Drug-Related Questions ↗ (opens in a new tab)Evaluation of selected models and questions; distinguishes answer quality from observed health outcomes.
Brewster and colleagues; JAMA Network Open · Research study
Characteristics and Safety of Consumer Chatbots for Emergent Adolescent Health Concerns ↗ (opens in a new tab)2025 simulated conversations and expert-rated responses, not a clinical trial measuring resulting injuries.
Broader frameworks and background
These resources provide context. They do not establish every claim in this concern.
A question to discuss
Who checks these responses for dangerous advice, and can the system recognise when professional care is needed?
Keep track of different views, what needs checking, and any next step in your own discussion notes.
Open discussion notes →Principles for the conversation
Before you finish · reflect together
Virtues and principles to consider
Virtues are qualities we practice in how we treat people and make choices. They are not scores for judging someone. Use these ideas to explore what a thoughtful response could look like.
Justice
Justice means fair treatment, fair procedures, and attention to who receives benefits and burdens. It asks whether people with less power can be heard and seek repair.
Look at outcomes across different groups and individual cases. Provide a usable way to challenge decisions and correct harm. Equal wording in a policy does not guarantee equal treatment in practice.
Ask together: Who benefits, who bears the cost, and who can challenge the decision?
Dignity
Dignity means recognizing each person's worth regardless of usefulness, status, or a system's score. People deserve respect and a voice in matters that affect them.
Explain important decisions, avoid humiliating treatment, and keep room for a person's story. Do not treat a prediction as a complete account of who someone is.
Ask together: Does this use treat each person as someone whose experience matters?
Listening
Listening means trying to understand someone's experience before preparing an answer. People who use a service, work with it, or are judged by it may notice problems its designers miss.
Invite people to describe what happened in their own words. Repeat back what you understood and let them correct it. A quiet person or a complaint that is hard to measure may still reveal something important.
Ask together: Whose experience have we not heard yet?
Editorial ratings
These are editorial judgments from the register, not measured probabilities or predictions about your situation.
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