Exploring social-environmental factors in recovery and reintegration of substance-related disorders: a scoping review
Introduction: The rising demand for substance-related treatments results in a persistent increase in human, social, health, and economic costs that affect not only individuals, but reverberates across families, communities, and societies. The social environment plays a crucial role in substance use, as it influences recovery pathways either by fostering drug-free behaviours or hindering them through control mechanisms and social pressure. This review aims to synthesise existing literature on the social-environmental factors that influence recovery and reintegration from substance-related disorders.
Methods: A comprehensive search was conducted in twenty-four databases and fourteen other sources from inception to 2023. Backwards and forward citation searches were conducted on selected databases. Quality appraisal of grey literature was assessed. Thematic analysis was conducted on the included studies.
Results: Forty-two studies were included for review. The social environment significantly impacts recovery, with factors such as employment serving as both incentive and support, providing a sense of purpose and new social roles beyond the substance milieu. Support networks, including social ties, family, partners, professionals, and artificial groups, play crucial roles in facilitating recovery. The dynamics within each network influence the recovery journey, with challenges such as dysfunctional relationships and substance availability impacting progress. Though breakaway from the substance milieu appears to be protective for recovering individuals, isolation can provide further hindrances as it may cause feelings of loneliness and alienation. The therapeutic setting plays a crucial role in recovery, balancing structure and flexibility. Meaningful activities, education, and social support enhance the process of recovery, with peers playing a fundamental role in reducing loneliness and sharing experiences. While external stigma from media and government can influence self-perception, internal stigma appears to originate feelings of shame, fear, and isolation.
Conclusion: The social factors that influence the recovery journey and the proximal networks should not be overlooked. Though not a single solution appears to apply to everyone’s recovery, the disregard for varying intersectionalities could result in the support provided being subpar to what is expected by the recovering individual. Therapeutic approaches to recovery should seek to be holistic and inclusive of every network that surrounds the recovering individual as a means to sustain the treatment’s success and facilitate reintegration.
