Social networks amongst people with alcohol dependence who frequently attend hospital: an exploratory qualitative study

Social network interventions to support dependent drinkers are recommended by the National Institute for Health and Care Excellence in the UK and have been utilised within and outside of formal treatment. Social network factors that predict reduction in drinking include increasing contact with people in recovery, reducing pro-drinking networks and improving self-efficacy in high-risk situations.

Social networks are complex and diverse, yet social network interventions and questionnaires in alcohol dependence literature are limited in scope and have been developed without the input of people with lived experience.

This study aimed to explore social networks amongst people with alcohol dependence who frequently attend hospital to inform social network therapeutic approaches and questionnaires.

Interviews were carried out with 29 people who frequently attended hospital for alcohol related reasons. Interviews were mostly conducted in people’s homes and ranged from 45 to 160 minutes. Interviews were audio recorded, transcribed verbatim and analysed using iterative categorisation.

Many participants reported that they were isolated and felt lonely, whereas some participants reported having strong social networks and feeling connected. The structure, function and satisfaction of social networks were reported to be important for general well-being and recovery. Support for abstinence included practical, emotional, and problem-solving support.

This study highlighted other important factors including isolation and loneliness, stigma, locus of control, age, boundaries and guilt and shame. Furthermore, barriers to building abstinent social networks included depression and anxiety, physical health conditions, poor mobility, trauma and drinking status.

Limitations with existing social network questionnaires and therapeutic approaches are identified and specific considerations for supporting people who frequently attend hospital for alcohol related reasons are suggested. Findings are used to generate recommendations for social network interventions that may be more appropriate for different groups of people experiencing alcohol dependence.