"You don't always get that in the city" Social relationships in rural alcohol and substance use recovery communities: Implications for recovery identity formation

Abstract

Purpose People in rural areas encounter unique challenges regarding alcohol and substance use recovery. Despite the fact that social relationships and community have long been considered important aspects of recovery, few studies have investigated how these factors may affect recovery in rural communities. This qualitative analysis was conducted with the aim of understanding how social relationships within recovery communities function in rural areas, and how this may expand the existing understanding of the importance of social relationships to recovery in general. Methods Thirty-four interviews, ranging from 60 to 90 minutes, were conducted with people either in recovery or who work in the recovery field in rural Minnesota. These interviews were transcribed verbatim, and coded first according to a framework of strengths and challenges of recovery in rural areas, then according to aspects of the social identity model of recovery (SIMOR; Best et al., 2016), which explains success in recovery as a transition from social relationships with people who use substances to relationships with others in recovery. Results We identified social and relational factors that facilitate the transition to recovery, including smaller meetings and a welcoming atmosphere, as well as those that create challenges in the transition to recovery, including sparse populations and social exclusion. We also identified social and relational factors that facilitate the maintenance of recovery, including neighborliness, recreation with others in recovery, economic and practical aid, and religious support, as well as those that challenge the maintenance of recovery, including stigma and judgment and religious exclusion. Conclusion Practitioners in the recovery field should consider how geographical factors may affect their clients’ recovery, as well as how the above-mentioned social and relational factors may affect their rural clients’ recovery. The social identity model of recovery is a helpful framework for understanding recovery, but should be tested in different social contexts, including urban and rural settings, to determine how the broader social context affects social identities in recovery.