Substance use as a source of belonging, relief and recognition – a reflective lifeworld study in Sweden

BACKGROUND: Substance Use Disorder (SUD) is a public health concern with substantial consequences for health, well-being, and social functioning. Despite research, gaps remain in understanding how SUD develops within an individual's life context, particularly how early life experiences are understood in relation to later substance use. PURPOSE: To describe the meanings of early life experiences in relation to substance use among adults receiving care for substance use disorder. METHOD: Seven adults receiving outpatient addiction care in Sweden participated in in-depth interviews. Data were analysed using Reflective Lifeworld Research (RLR). Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: Substance use is described as becoming a familiar way of seeking relief, belonging, and recognition in the context of insecurity and insufficient support. Its everyday availability, experiences of being left without a meaningful response, and belonging with similar others are interrelated meanings. Relief and social connection coexist with vulnerability, suffering, and loss of control. CONCLUSIONS: Early life experiences in relation to substance use are characterised by the intertwining of familiarity, unmet needs for support, and the possibility of finding relief and belonging through substances. Care and prevention should attend to these meanings and support other sources of safety, recognition, and connection.