Socioenvironmental Factors in Recovery of People with Substance Use Disorders: A Comprehensive Scoping Review

The rising demand for substance-related treatments results in a persistent increase in human, social, health, and economic costs that affect not only people but also reverberates across families, communities, and societies. Social environment plays a crucial role in substance use as it influences recovery pathways either by fostering drug-free behaviors or hindering them. This review aims to synthesize existing scientific evidence on the social-environmental factors that influence recovery from substance use disorders, excluding alcohol and tobacco. Following the methodological framework proposed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, a comprehensive search was conducted in 19 databases and other sources from inception to 2024. Forty-five studies met the inclusion criteria. A multitude of social-environmental factors were shown to influence recovery such as support networks, socioeconomic conditions (i.e., housing, education, employment), spirituality, drug availability in the substance milieu, stigmatization, and the therapeutic setting. The various support networks play a key role in facilitating recovery pathways, with dysfunctional relationships and substance availability hindering recovery progress. Factors that appear to play a protective role under some circumstances could also prove to be risk factors generating feelings of loneliness and alienation. A general lack of evidence directed at post-treatment integration failed to allow an exploration of results akin to other factors. This review highlights that not a single solution appears to apply to everyone's recovery, and continued disregard for varying intersectionalities could result in the support provided being subpar to what is expected by the person involved in a change process. Therapeutic approaches to recovery should seek to be holistic and inclusive of every network by recognizing and mitigating the systemic barriers that surround those in a process of change as a means to sustain treatment's success and facilitate post-treatment integration.