1Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
2Faculty of Medicine, Universitas Indonesia, Depok, Indonesia
3Faculty of Nursing Science, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia
Copyright © 2024 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Data Availability
The data examined and presented in this article originate entirely from the publicly available published literature.
Conflict of Interest
The authors have no conflicts of interest associated with the material presented in this paper.
Funding
This research is supported by HIBAH PUTI 2022, funded by the Directorate of Research and Community Engagement at Universitas Indonesia.
Author Contributions
Conceptualization: Setiawan A, Sahar J, Santoso B. Data curation: Syamsir SB, Setiawan A, Sahar J, Santoso B, Mansyur M. Formal analysis: Syamsir SB, Setiawan A, Sahar J. Funding acquisition: Setiawan A, Sahar J, Santoso B. Methodology: Syamsir SB, Setiawan A, Sahar J. Project administration: Setiawan A, Sahar J. Visualization: Setiawan A, Syamsir SB. Writing – original draft: Setiawan A, Sahar J, Santoso B, Mansyur M, Syamsir SB. Writing – review & editing: Setiawan A, Sahar J, Santoso B, Mansyur M, Syamsir SB.
Study | 1. Was there a clear statement of the aims of the research? | 2. Is a qualitative methodology appropriate? | 3. Was the research design appropriate to address the aims of the research? | 4. Was the recruitment strategy appropriate to the aims of the research? | 5. Were the data collected in a way that addressed the research issue? | 6. Has the relationship between researcher and participants been adequately considered? | 7. Have ethical issues been taken into consideration? | 8. Was the data analysis sufficiently rigorous? | 9. Is there a clear statement of findings? | 10. How valuable is the research? | CASP quality rating |
---|---|---|---|---|---|---|---|---|---|---|---|
Bjornestad et al., 2019 [30] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Nhunzvi et al., 2019 [31] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Appiah et al., 2018 [32] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Wangensteen et al., 2022 [35] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Stokes et al., 2018 [36] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Shaari et al., 2023 [37] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Pettersen et al., 2023 [38] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Yang et al., 2015 [39] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Iswardani et al., 2022 [40] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Dundas et al., 2020 [41] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Brunelle et al., 2015 [42] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Rettie et al., 2020 [43] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Martinelli et al., 2023 [44] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Study | Country | Research objective | Participants | Data collection | Design of the study | Method of data analysis | Main themes |
---|---|---|---|---|---|---|---|
Bjornestad et al., 2019 [30] | Norway | To investigate the subjective experiences of long-term recovery from SUD, focusing on functional and social factors | Thirty long-term recovered adult users of substance use treatment services | In-depth interviews | Phenomenological study | Semantic analysis | - Paranoia, ambivalence, and drug cravings: extreme barriers to ending use |
- Submitting to treatment: a struggle to balance rigid treatment structures with a need for autonomy | |||||||
- Surrendering to trust and love: building a whole person | |||||||
- A life more ordinary: surrendering to mainstream social responsibilities | |||||||
- Accepting personal responsibility and autonomy: it has to be me, it cannot be you | |||||||
Nhunzvi et al., 2019 [31] | Zimbabwe | To explore the journey of recovery from substance abuse among young adult Zimbabwean men | Three young adult men | Iterative in-depth narrative interviews | Qualitative narrative inquiry | Narrative analysis | - Substance abuse as our occupation |
- Recovery from substance abuse: an ongoing transition | |||||||
- Recovery from substance abuse: a change of occupational identity | |||||||
Appiah et al., 2018 [32] | Ghana | To explore relapse prevention strategies used by patients recovering from poly-substance use disorders in Ghana | Fifteen patients recovering from poly-substance use disorders | In-depth interviews using a semi-structured guide | Descriptive phenomenology | Content analysis | - Clinical-contextual strategies |
- Spirituality and religious engagements | |||||||
- Communal spirit and support network | |||||||
Wangensteen et al., 2022 [35] | Norway | To investigate patients’ reflections on their experiences in inpatient treatment for SUD 4 y after exiting treatment | Eleven former patients (6 women and 5 men), aged 30-45 y with a history of severe substance use issues | In-depth interview | Qualitative study | Interpretative phenomenological analysis | - Treatment content and relationships that were considered valuable |
- Treatment content and relationships that were considered useless or harmful | |||||||
Stokes et al., 2018 [36] | South Africa | To deeply understand how individuals recovering from SUD experience and maintain their recovery | Fifteen participants, including 9 men and 6 women | In-depth face-to-face individual interviews | Qualitative study with narrative and phenomenological design | Tesch 8-step data analysis process | - The transitions that led to the journey of sustained recovery |
- Psychological mindset as strategy to help sustain their recovery | |||||||
- Social support | |||||||
- External and environmental changes | |||||||
- Helping others | |||||||
Shaari et al., 2023 [37] | Malaysia | To explore the factors that motivate individuals in recovery from SUDs to remain in self-help groups | Five members of self-help groups currently recovering from SUDs | Online focus group | Qualitative study | Thematic analysis | - This group gives me support to sustain my recovery |
- This group empowers me to give back to society | |||||||
- This group has a leader who gives me hope | |||||||
Pettersen et al., 2023 [38] | Norway | To explore the experiences of former patients with SUD, focusing on the benefits and challenges of a reoriented identity and way of living after recovery | Ten participants who had completed treatment for SUD | Semi-structured interviews | Qualitative study | Content analysis | - Avoiding illegal drugs |
- Avoiding contact with substance use relations and milieu | |||||||
- Renewing non-addiction relationships and social network | |||||||
- Establishing an occupation | |||||||
- Discovering the value of the great, little things in everyday life | |||||||
Yang et al., 2015 [39] | China | To understand the experiences of individuals who use drugs during abstinent periods and explore the factors contributing to drug use relapse | Eighteen participants, with an average age of 33 y (range, 18-41); the average duration of drug use was 12 y (range, 3-19) | Face-to-face, in-depth interview | Qualitative study | Thematic analysis | - Ways of overcoming withdrawal and the driving force for abstinence |
- Experiences during periods of abstinence | |||||||
- “Why I relapse” | |||||||
Iswardani et al., 2022 [40] | Indonesia | To explore the process of meaning-making in individuals with drug addiction before, during, and after drug use and recovery | Five men in recovery from addiction, aged 26-49 y, who were abstinent for 4-17 y | In-depth interviews | Qualitative case study | Deductive thematic analysis | - Feeling that things make sense |
- Accepting the situation | |||||||
- Reattribution/having a causal understanding | |||||||
- Existence of the perception of growth or a positive change in life | |||||||
- Changing identity | |||||||
- Reassessing the meaning of the stressor | |||||||
- Changing global belief | |||||||
- Changing global purpose | |||||||
- Restoring/changing meaning in life | |||||||
Dundas et al., 2020 [41] | Norway | To explore how participants used a mindfulness-based program to reduce their long-term use of habit-forming prescription drugs and their post-intervention strategies for controlling medication intake | Eighteen participants | Semi-structured qualitative interviews | Qualitative study | Inductive semantic thematic analysis | - Increased present-moment sensory awareness: noticing all the things one usually takes for granted |
- Observing without controlling: managing to “uncouple” oneself from distressing thoughts | |||||||
- Self-acceptance: no longer hitting oneself over the head | |||||||
- Making conscious choices: reflecting before taking a pill, and sometimes not taking it | |||||||
- Non-judgmental self-guidance: what else might you do? | |||||||
- A sense of control: there is something I can do | |||||||
Brunelle et al., 2015 [42] | Canada | To understand the experiences of individuals with drug dependency and the sources that motivate them to change | A total of 127 adults with drug dependency | Focused semi-structured interviews | Qualitative study | Thematic content analysis | - Quality of life |
- Accumulation of services | |||||||
- The role of caseworkers | |||||||
- Collaboration between professionals | |||||||
Rettie et al., 2020 [43] | UK | To explore the personal experiences of individuals recovering from drug or alcohol dependency who participate in social-based recovery groups | Ten individuals recovering from drug dependency | Semi-structured interviews | Qualitative study | Interpretative phenomenological analysis | - The group’s role in recovery |
- Personal choice and flexibility in recovery | |||||||
- The group as an inclusive family unit | |||||||
- Active involvement in the recovery group | |||||||
Martinelli et al., 2023 [44] | The Netherlands | To understand the process of drug addiction recovery through direct experiences of individuals at various stages of recovery | Thirty participants, both men and women, in stages of drug addiction recovery | In-depth qualitative interviews | Qualitative study | Thematic analysis | - Recovery is a broad process of change because addiction is interwoven with everything |
- Recovery is reconsidering identity, seeing things in a new light | |||||||
- Recovery is a staged long-term process | |||||||
- Universal life processes are part of recovery |
Developed themes | Findings (themes, subthemes, or categories) from the original article | Participant quotation (from the original article) | Relevant study |
---|---|---|---|
Theme 1: Seeking of social support | Developing relationships with family and friends | “They made me aware of how important I am to my children… When you have children, you have an obligation to stay sober. I stay sober for my partner and my children.” | Wangensteen et al., 2022 [35] |
This group gives me support to sustain my recovery | “I am stronger today because I have support from him [group leader]. He teaches me how to make the right decisions to make sure I can keep my recovery in check.” | Shaari et al., 2023 [37] | |
Renewing non-addiction relationships and social network | “But having a healthy network is perhaps the most essential thing to stay clean.” | Pettersen et al., 2023 [38] | |
Family support | “So I had amazing family support, my dad as well. For them, like just seeing what the programme did for me, it was such a miracle… So my family is extremely supportive.” | Stokes et al., 2018 [36] | |
Theme 2: Psychological coping strategies | Utilizing only their own willpower | “You know, I tried to quit drugs for about two months using just my willpower in 2002, when I had just gotten addicted [to heroin]. During the first month [of abstinence], I didn’t eat anything at all, I would vomit all the food if I did.” | Yang et al., 2015 [39] |
Developing strategies for coping with stress and challenging emotions and situations | “They helped me with the anxiety and depression that I struggled with during the first 6 months of treatment. Suddenly, I started to cry, and I couldn’t stop. They taught me some methods that I still use when I get anxious at work.” | Wangensteen et al., 2022 [35] | |
Changing beliefs | “In the past, drugs saved me. Now that I have been infected with HIV, to survive, I must avoid taking drugs.” | Iswardani et al., 2022 [40] | |
Non-judgmental self-guidance | “Now I know that if I need to enter a setting that I used to need medication to enter, I can instead talk to myself and say, ‘You know, it’s actually all right that you might feel sad when in that situation, because it’s human, it’s totally okay, that [feeling].’ So that is, you know, a totally new way of thinking.” | Dundas et al., 2020 [41] | |
A sense of control | “I believe it’s possible to practice, so that you become calmer in your body, so that you have a greater control. I’ve become much more aware of being able to calm myself.” | Dundas et al., 2020 [41] | |
Clinical-contextual strategies: planned counseling and therapy sessions | “When I experience the feeling at the work place… and I resist… sometimes I become anxious and restless. I take a short break to do some PMR [progressive muscle relaxation] exercises I learnt from counselling. Now, I’m also able to turn down offers from my friends… gently. I don’t even go close to them anymore.” | Appiah et al., 2018 [32] | |
Theme 3: Spiritual experiences | The role of spirituality and religious faith in sustaining recovery | “In my recovery, it’s like God played a role, of giving me the strength to be sober, understand? I mean, God is planning everything. God is doing everything. He is helping me figure things out, you know, do this and that.” | Stokes et al., 2018 [36] |
Spirituality and religious engagements | “So my auntie took me to a prayer camp where we spent two weeks fasting and praying. It was difficult though… I had to fast and pray all the time. After a series of deliverances and prophetic utterances, the prophet told me I was free… and that was it.” | Appiah et al., 2018 [32] | |
Theme 4: Professional interventions | Participating in methadone maintenance treatment | “…I went to a clinic, requested some intravenous drips and some tablets, and then stayed at home and lay in bed all day long… in this way, I quit heroin without suffering much. People just never believe!” | Yang et al., 2015 [39] |
The influence of caseworkers | “Well, he [the caseworker involved in the referral] was always humane, he was understanding, and he suggested this [the treatment] to me, by sort of suggesting a decrease in my use, but not total abstinence.” | Brunelle et al., 2015 [42] | |
Theme 5: Enhancement of awareness | Accepting personal responsibility and autonomy: it has to be me, it cannot be you | “I dunno (laughs). I don’t think about it much anymore, I just kind of get up and start the day. I don’t have many fixed routines. I am very down to earth, I just get up and drink coffee, and then I’m off really.” | Bjornestad et al., 2019 [30] |
Personal choice and flexibility in recovery | “Everybody’s journey is different and you have to find what’s right for you.” | Rettie et al., 2020 [43] | |
Conscious decision and commitment to sustained recovery | “…but it is a decision [referring to sustained recovery] you need to have to make at the end of the day, to decide you are never going to have [another drug again]”. | Stokes et al., 2018 [36] | |
Personal development and further education | “So to rectify that I went to Mr Google and I started upping my professional skill, my knowledge about my work… I also start using Dr Google and learn about dependency because to help yourself you must know what you are challenging.” | Stokes et al., 2018 [36] | |
Adopting new occupations | “If I am to sustain my journey of recovery, I need to make many changes. To construct a new life in which recovery is possible, it is necessary for me to change choices, goals, roles, and expectations. Farming is the new thing now... and I am a changed-responsible father.” | Nhunzvi et al., 2019 [31] | |
Avoiding contact with substance use relations and milieu | “You cannot stay in the addictive subculture when you want to live in the ordinary society as sober. It is a matter of attitude, language, and ways of doing things.” | Pettersen et al., 2023 [38] |
Variables | Description | Search strategy |
---|---|---|
Sample | Individuals in the process of recovering from drug addiction | “Substance Related Disorder” OR “Substance Abuser” OR “Drug Dependence” OR “Substance Use” OR “Drug Abuse” OR “Drug dependency recovery” |
Phenomenon of Interest | Coping strategies used by individuals recovering from drug addiction | “Coping strategies” OR “Cognitive Coping” OR “Coping Skill” OR “Constructive Coping” OR “Social Coping” OR “Function Recovery” |
Design | Methods used to understand coping strategies in recovery from drug addiction | “Phenomenology” OR “Ethnography” OR “Narrative inquiry” OR “Case study” OR “Hermeneutics” OR “Grounded Theory” OR “Focus Group” |
Evaluation | Coping strategies reported during recovery from drug addiction | “Life Experience” OR “Perception” OR “Response” OR “Exploratory” |
Research type | Type of research used to explore the coping strategies employed by individuals recovering from drug addiction | “Qualitative research” |
Study | 1. Was there a clear statement of the aims of the research? | 2. Is a qualitative methodology appropriate? | 3. Was the research design appropriate to address the aims of the research? | 4. Was the recruitment strategy appropriate to the aims of the research? | 5. Were the data collected in a way that addressed the research issue? | 6. Has the relationship between researcher and participants been adequately considered? | 7. Have ethical issues been taken into consideration? | 8. Was the data analysis sufficiently rigorous? | 9. Is there a clear statement of findings? | 10. How valuable is the research? | CASP quality rating |
---|---|---|---|---|---|---|---|---|---|---|---|
Bjornestad et al., 2019 [30] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Nhunzvi et al., 2019 [31] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Appiah et al., 2018 [32] | Yes | Yes | Yes | Yes | Yes | Unclear | Yes | Yes | Yes | Yes | High |
Wangensteen et al., 2022 [35] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Stokes et al., 2018 [36] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Shaari et al., 2023 [37] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Pettersen et al., 2023 [38] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Yang et al., 2015 [39] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Iswardani et al., 2022 [40] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Dundas et al., 2020 [41] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Brunelle et al., 2015 [42] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Rettie et al., 2020 [43] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Martinelli et al., 2023 [44] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | High |
Study | Country | Research objective | Participants | Data collection | Design of the study | Method of data analysis | Main themes |
---|---|---|---|---|---|---|---|
Bjornestad et al., 2019 [30] | Norway | To investigate the subjective experiences of long-term recovery from SUD, focusing on functional and social factors | Thirty long-term recovered adult users of substance use treatment services | In-depth interviews | Phenomenological study | Semantic analysis | - Paranoia, ambivalence, and drug cravings: extreme barriers to ending use |
- Submitting to treatment: a struggle to balance rigid treatment structures with a need for autonomy | |||||||
- Surrendering to trust and love: building a whole person | |||||||
- A life more ordinary: surrendering to mainstream social responsibilities | |||||||
- Accepting personal responsibility and autonomy: it has to be me, it cannot be you | |||||||
Nhunzvi et al., 2019 [31] | Zimbabwe | To explore the journey of recovery from substance abuse among young adult Zimbabwean men | Three young adult men | Iterative in-depth narrative interviews | Qualitative narrative inquiry | Narrative analysis | - Substance abuse as our occupation |
- Recovery from substance abuse: an ongoing transition | |||||||
- Recovery from substance abuse: a change of occupational identity | |||||||
Appiah et al., 2018 [32] | Ghana | To explore relapse prevention strategies used by patients recovering from poly-substance use disorders in Ghana | Fifteen patients recovering from poly-substance use disorders | In-depth interviews using a semi-structured guide | Descriptive phenomenology | Content analysis | - Clinical-contextual strategies |
- Spirituality and religious engagements | |||||||
- Communal spirit and support network | |||||||
Wangensteen et al., 2022 [35] | Norway | To investigate patients’ reflections on their experiences in inpatient treatment for SUD 4 y after exiting treatment | Eleven former patients (6 women and 5 men), aged 30-45 y with a history of severe substance use issues | In-depth interview | Qualitative study | Interpretative phenomenological analysis | - Treatment content and relationships that were considered valuable |
- Treatment content and relationships that were considered useless or harmful | |||||||
Stokes et al., 2018 [36] | South Africa | To deeply understand how individuals recovering from SUD experience and maintain their recovery | Fifteen participants, including 9 men and 6 women | In-depth face-to-face individual interviews | Qualitative study with narrative and phenomenological design | Tesch 8-step data analysis process | - The transitions that led to the journey of sustained recovery |
- Psychological mindset as strategy to help sustain their recovery | |||||||
- Social support | |||||||
- External and environmental changes | |||||||
- Helping others | |||||||
Shaari et al., 2023 [37] | Malaysia | To explore the factors that motivate individuals in recovery from SUDs to remain in self-help groups | Five members of self-help groups currently recovering from SUDs | Online focus group | Qualitative study | Thematic analysis | - This group gives me support to sustain my recovery |
- This group empowers me to give back to society | |||||||
- This group has a leader who gives me hope | |||||||
Pettersen et al., 2023 [38] | Norway | To explore the experiences of former patients with SUD, focusing on the benefits and challenges of a reoriented identity and way of living after recovery | Ten participants who had completed treatment for SUD | Semi-structured interviews | Qualitative study | Content analysis | - Avoiding illegal drugs |
- Avoiding contact with substance use relations and milieu | |||||||
- Renewing non-addiction relationships and social network | |||||||
- Establishing an occupation | |||||||
- Discovering the value of the great, little things in everyday life | |||||||
Yang et al., 2015 [39] | China | To understand the experiences of individuals who use drugs during abstinent periods and explore the factors contributing to drug use relapse | Eighteen participants, with an average age of 33 y (range, 18-41); the average duration of drug use was 12 y (range, 3-19) | Face-to-face, in-depth interview | Qualitative study | Thematic analysis | - Ways of overcoming withdrawal and the driving force for abstinence |
- Experiences during periods of abstinence | |||||||
- “Why I relapse” | |||||||
Iswardani et al., 2022 [40] | Indonesia | To explore the process of meaning-making in individuals with drug addiction before, during, and after drug use and recovery | Five men in recovery from addiction, aged 26-49 y, who were abstinent for 4-17 y | In-depth interviews | Qualitative case study | Deductive thematic analysis | - Feeling that things make sense |
- Accepting the situation | |||||||
- Reattribution/having a causal understanding | |||||||
- Existence of the perception of growth or a positive change in life | |||||||
- Changing identity | |||||||
- Reassessing the meaning of the stressor | |||||||
- Changing global belief | |||||||
- Changing global purpose | |||||||
- Restoring/changing meaning in life | |||||||
Dundas et al., 2020 [41] | Norway | To explore how participants used a mindfulness-based program to reduce their long-term use of habit-forming prescription drugs and their post-intervention strategies for controlling medication intake | Eighteen participants | Semi-structured qualitative interviews | Qualitative study | Inductive semantic thematic analysis | - Increased present-moment sensory awareness: noticing all the things one usually takes for granted |
- Observing without controlling: managing to “uncouple” oneself from distressing thoughts | |||||||
- Self-acceptance: no longer hitting oneself over the head | |||||||
- Making conscious choices: reflecting before taking a pill, and sometimes not taking it | |||||||
- Non-judgmental self-guidance: what else might you do? | |||||||
- A sense of control: there is something I can do | |||||||
Brunelle et al., 2015 [42] | Canada | To understand the experiences of individuals with drug dependency and the sources that motivate them to change | A total of 127 adults with drug dependency | Focused semi-structured interviews | Qualitative study | Thematic content analysis | - Quality of life |
- Accumulation of services | |||||||
- The role of caseworkers | |||||||
- Collaboration between professionals | |||||||
Rettie et al., 2020 [43] | UK | To explore the personal experiences of individuals recovering from drug or alcohol dependency who participate in social-based recovery groups | Ten individuals recovering from drug dependency | Semi-structured interviews | Qualitative study | Interpretative phenomenological analysis | - The group’s role in recovery |
- Personal choice and flexibility in recovery | |||||||
- The group as an inclusive family unit | |||||||
- Active involvement in the recovery group | |||||||
Martinelli et al., 2023 [44] | The Netherlands | To understand the process of drug addiction recovery through direct experiences of individuals at various stages of recovery | Thirty participants, both men and women, in stages of drug addiction recovery | In-depth qualitative interviews | Qualitative study | Thematic analysis | - Recovery is a broad process of change because addiction is interwoven with everything |
- Recovery is reconsidering identity, seeing things in a new light | |||||||
- Recovery is a staged long-term process | |||||||
- Universal life processes are part of recovery |
Developed themes | Findings (themes, subthemes, or categories) from the original article | Participant quotation (from the original article) | Relevant study |
---|---|---|---|
Theme 1: Seeking of social support | Developing relationships with family and friends | “They made me aware of how important I am to my children… When you have children, you have an obligation to stay sober. I stay sober for my partner and my children.” | Wangensteen et al., 2022 [35] |
This group gives me support to sustain my recovery | “I am stronger today because I have support from him [group leader]. He teaches me how to make the right decisions to make sure I can keep my recovery in check.” | Shaari et al., 2023 [37] | |
Renewing non-addiction relationships and social network | “But having a healthy network is perhaps the most essential thing to stay clean.” | Pettersen et al., 2023 [38] | |
Family support | “So I had amazing family support, my dad as well. For them, like just seeing what the programme did for me, it was such a miracle… So my family is extremely supportive.” | Stokes et al., 2018 [36] | |
Theme 2: Psychological coping strategies | Utilizing only their own willpower | “You know, I tried to quit drugs for about two months using just my willpower in 2002, when I had just gotten addicted [to heroin]. During the first month [of abstinence], I didn’t eat anything at all, I would vomit all the food if I did.” | Yang et al., 2015 [39] |
Developing strategies for coping with stress and challenging emotions and situations | “They helped me with the anxiety and depression that I struggled with during the first 6 months of treatment. Suddenly, I started to cry, and I couldn’t stop. They taught me some methods that I still use when I get anxious at work.” | Wangensteen et al., 2022 [35] | |
Changing beliefs | “In the past, drugs saved me. Now that I have been infected with HIV, to survive, I must avoid taking drugs.” | Iswardani et al., 2022 [40] | |
Non-judgmental self-guidance | “Now I know that if I need to enter a setting that I used to need medication to enter, I can instead talk to myself and say, ‘You know, it’s actually all right that you might feel sad when in that situation, because it’s human, it’s totally okay, that [feeling].’ So that is, you know, a totally new way of thinking.” | Dundas et al., 2020 [41] | |
A sense of control | “I believe it’s possible to practice, so that you become calmer in your body, so that you have a greater control. I’ve become much more aware of being able to calm myself.” | Dundas et al., 2020 [41] | |
Clinical-contextual strategies: planned counseling and therapy sessions | “When I experience the feeling at the work place… and I resist… sometimes I become anxious and restless. I take a short break to do some PMR [progressive muscle relaxation] exercises I learnt from counselling. Now, I’m also able to turn down offers from my friends… gently. I don’t even go close to them anymore.” | Appiah et al., 2018 [32] | |
Theme 3: Spiritual experiences | The role of spirituality and religious faith in sustaining recovery | “In my recovery, it’s like God played a role, of giving me the strength to be sober, understand? I mean, God is planning everything. God is doing everything. He is helping me figure things out, you know, do this and that.” | Stokes et al., 2018 [36] |
Spirituality and religious engagements | “So my auntie took me to a prayer camp where we spent two weeks fasting and praying. It was difficult though… I had to fast and pray all the time. After a series of deliverances and prophetic utterances, the prophet told me I was free… and that was it.” | Appiah et al., 2018 [32] | |
Theme 4: Professional interventions | Participating in methadone maintenance treatment | “…I went to a clinic, requested some intravenous drips and some tablets, and then stayed at home and lay in bed all day long… in this way, I quit heroin without suffering much. People just never believe!” | Yang et al., 2015 [39] |
The influence of caseworkers | “Well, he [the caseworker involved in the referral] was always humane, he was understanding, and he suggested this [the treatment] to me, by sort of suggesting a decrease in my use, but not total abstinence.” | Brunelle et al., 2015 [42] | |
Theme 5: Enhancement of awareness | Accepting personal responsibility and autonomy: it has to be me, it cannot be you | “I dunno (laughs). I don’t think about it much anymore, I just kind of get up and start the day. I don’t have many fixed routines. I am very down to earth, I just get up and drink coffee, and then I’m off really.” | Bjornestad et al., 2019 [30] |
Personal choice and flexibility in recovery | “Everybody’s journey is different and you have to find what’s right for you.” | Rettie et al., 2020 [43] | |
Conscious decision and commitment to sustained recovery | “…but it is a decision [referring to sustained recovery] you need to have to make at the end of the day, to decide you are never going to have [another drug again]”. | Stokes et al., 2018 [36] | |
Personal development and further education | “So to rectify that I went to Mr Google and I started upping my professional skill, my knowledge about my work… I also start using Dr Google and learn about dependency because to help yourself you must know what you are challenging.” | Stokes et al., 2018 [36] | |
Adopting new occupations | “If I am to sustain my journey of recovery, I need to make many changes. To construct a new life in which recovery is possible, it is necessary for me to change choices, goals, roles, and expectations. Farming is the new thing now... and I am a changed-responsible father.” | Nhunzvi et al., 2019 [31] | |
Avoiding contact with substance use relations and milieu | “You cannot stay in the addictive subculture when you want to live in the ordinary society as sober. It is a matter of attitude, language, and ways of doing things.” | Pettersen et al., 2023 [38] |
CASP, Critical Appraisal Skills Program.
SUD, substance use disorder.