Substance Use Treatment Professionals’ Views on Addressing Substitute Addictions: A Thematic Analysis of Open-Ended Questionnaire Responses

This study explores substitute addictions – the immediate or gradual replacement of an addiction or set of addictions that have been stopped or reduced by engaging with another addictive behavior – as a central concern in treatment-assisted recovery. Questionnaires were administered to 85 substance use disorder treatment professionals across 20 U.S. states, with qualitative items eliciting their views on why another addiction might replace the substance use disorder being treated; whether and how the facility educates service users about substitute addictions; how substitute addictions may help or hurt service users’ recovery efforts, and assessed general recommendations for addressing substitute addictions. Thematic analysis yielded three themes: (i) substitutes supporting recovery, (ii) substitutes precipitating relapse or worse quality of life, and (iii) treatment of substitute addictions. Given the high rates of post-treatment relapse, we make important strides in addressing treatment professionals’ rarely examined first-hand experiences, to inform service delivery.