Qualitative Study Exploring Young Adults’ Perspective of Recovery Identifies Four Important Themes that Could Improve Treatment Engagement and Retention

Birds eye view of group of individuals engaged in a discussion in a clinical setting

Key findings:

  • Identified four themes framing how participants with substance use disorders (SUD) characterized “recovery”
    1. The desire to live a “normal” life not defined by recovery
    2. Included multiple components such as mental health and re-engagement in regular daily activities
    3. Incorporated individually motivated processes, having control in recovery decision making
    4. Lifelong pursuit 

According to SAMHSA’s 2019 National Survey on Drug Use and Health, young adults (18-29 years old) have the highest prevalence of substance and alcohol use compared to all age groups (2020). If this is the case, then why are engagement and retention treatment rates so low? One must consider that the concept of recovery and the current models that dominate the treatment world were developed with older adults in mind and do not resonate with young adults.

Young adults may identify with some concepts in the current models, such as recovery being an ongoing process and a focus on improving one’s quality of life. However, historically, traditional approaches put heavy emphasis on abstinence-based, 12-step, and chronic disease models. These approaches do not take into consideration that young adults may be hesitant to engage in treatment if abstinence and identification as an “addict” are required, as they do not match young adults’ expectations for recovery.

Through in-depth interviews, in their new article, ‘”My Life Isn’t Defined by Substance Use”: Recovery Perspectives Among Young Adults with Substance Use Disorder,’ Schoenberger et al. discovered that an important theme of recovery for these young adults was breaking the all-consuming cycle of substance use and moving towards achieving normalcy. The young adults voiced wanting to engage in the goals and age-related milestones that their substance use had stripped from them. These included going to school and graduating from college, sustaining healthy relationships, experiencing a purpose in life, and giving back to society in valuable ways. They further embraced that recovery was multifaceted and should incorporate several recovery-related components. These included access to counseling, medication-assisted treatment, job training, and a community of peers who do not use alcohol and drugs. 

Additional emerging themes for these young adults were that recovery was a self-motivated process and should be individualized as they create their own recovery story and identify a sense of self. They endorsed this process as a lifelong journey that requires continuous, consistent work. 

This research displays the urgency to develop personalized, comprehensive intervention and treatment structures that align with the multifaceted goals and expectations of one’s personal motivation for recovery. To improve engagement and retention, frameworks need to implement a range of services that incorporate identity development, behavioral and mental health treatment, and engagement in activities of daily living. Expanding beyond this body of research, more could be learned about how recovery resonates with different types of groups.


Schoenberger S.F., Park T.W., dellaBitta V., Hadland S.E., Bagley S.M. “My Life Isn’t Defined by Substance Use”: Recovery Perspectives Among Young Adults with Substance Use Disorder. Journal of general internal medicine : JGIM. 2021;37(4):816-822. doi:10.1007/s11606-021-06934-y

Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2020. Accessed 20 Jan 2021.