Main Paper

Qualitative Social Work

2024, Vol. 0(0) 1–19
Stories of building friendships © The Author(s) 2024

during long-term recovery from Article reuse guidelines:

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problematic substance use DOI: 10.1177/14733250241242028
journals.sagepub.com/home/qsw

Mariann Iren Vigdal 

Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway

Thomas Solgaard Svendsen

Centre for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway

Christian Moltu
Department of Psychiatry, District General Hospital of Førde, Førde, Norway
Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway

Jone Bjornestad
Department of Social Studies, University of Stavanger, Stavanger, Norway
Department of Psychiatry, District General Hospital of Førde, Førde, Norway

Lillian Bruland Selseng

Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway

Abstract
Background: Building friendship is crucial for attaining and upholding recovery from
problematic substance use. However, how people who have used substances prob-
lematically develop friendships needs to be investigated more from a first-person
perspective.
Aim: To provide insight into how people in long-term recovery find meaning in their
experience of building friendships.

Corresponding author:
Mariann Iren Vigdal, Department of Welfare and Participation, Western Norway University of Applied
Sciences, P.O. Box 7030, 5020 Bergen, Norway.
Email: mariann.iren.vigdal@hvl.no
2 Qualitative Social Work 0(0)

Method: In semi-structured interviews, 17 people in recovery drew network maps and

reflected on how friendships had developed during the long-term process. We analysed
the narratives by way of a thematic narrative approach.
Results: Participants presented the friendship-formation process through four distinct
storylines: (1) ‘I don’t make friends easily’; (2) overcoming barriers to building friendships;
(3) ‘birds of a feather flock together’; and (4) ‘having “regular” friends makes me feel like
an “average” person’.
Conclusion: People in long-term recovery from problematic substance use felt haunted
and hindered by past experiences when building friendships. These experiences created a
social divide between those who had experienced problematic substance use and those
who had not. The valuable insights that social workers can gain from this study can
support friendship development for people in long-term recovery on multiple levels. By
understanding someone’s self-perceptions and their perspectives on others, social
workers can engage with barriers when people in recovery enter social environments
such as work. We emphasise the significance of a long-term approach to overcoming
barriers to building new friendships.

Keywords
Friends, friendships, long-term recovery, narrative, substance use

Introduction
Building friendships is crucial for attaining and upholding recovery from problematic
substance use (Pettersen et al., 2019; Veseth et al., 2019; Vigdal et al., 2023). Building
relationships, expanding social roles, and gaining a sense of belonging to a broader
community are key to long-term recovery (LTR) (De Ruysscher et al., 2017).
The concept of LTR (Alastair et al., 2022) recognises that transitioning from a life
dominated by problematic substance use often requires significant social changes (Best
et al., 2016; De Ruysscher et al., 2017; Vigdal et al., 2022). Recovery capital, an es-
tablished concept within recovery research, refers to ‘resources and capacities that enable
growth and human flourishing’ (Best and Hennessy, 2022: 1140). The inter-individual
level is central to the recovery capital theory, with the domain of social capital being key to
overcoming alcohol and drug problems. Social capital ‘relates to all the instrumental and
expressive social capital accessible to the recovering individual through their relation-
ships and social networks’ (Bunaciu et al., 2023: 1).
To achieve and sustain recovery, people in LTR often distance themselves from friends
who engage in substance use, instead often seeking out social communities consisting of
others in recovery (Abram and Jane, 2020; Best et al., 2016; Bjornestad et al., 2019).
Building positive social connections and friendships with people who do not struggle with
substance use can help transform one’s life and identity during recovery (Best et al., 2015,
2016).
Vigdal et al. 3

Access to employment opportunities (Harrison et al., 2020; Vigdal et al., 2023) and
peer groups is essential to help individuals form new friendships (Vigdal et al., 2022).
Friends and a supportive network are crucial to have emotional, practical, and social
support and a companion for leisure activities during recovery (Veseth et al., 2019).
However, several challenges have been identified in building friendships and belonging as
part of the recovery process. Parker et al. (2019) observed that people in recovery face
challenges in managing relationships and building new support networks. Individuals in
LTR face numerous difficult transitions, including changing daily routines. These
challenges include entering new social communities, building new relationships, and
determining where to live (Best et al., 2015; Vigdal et al., 2023).
Understanding how friendships develop for those in LTR is crucial. Negative per-
ceptions, low self-esteem, and limited social opportunities can impede progress. To better
understand, a first-person perspective is needed (Bjornestad et al., 2020). This study offers
a narrative analysis of 17 participants’ experience of making friends during LTR and seeks
insight into key processes. Our research explores the following question: how do people
in LTR find meaning in their experience of building new friendships?

Material and methods

Design
We employed a qualitative methodology – a thematic narrative approach (Riessman,
2008) – to investigate participants’ experiences of how friendships developed during the
LTR process. Our approach is based on the understanding that storytelling – how the
speaker selects, organises, connects, and evaluates events – is a fundamental tool for
making sense of experience (Riessman, 2008). Since storytelling has many effects –
creation of group belonging, projection of possible futures, mobilisation of action, and
building of identity – the study of stories provides insights into a crucial social actor
(Frank, 2010; Riessman, 2008). Furthermore, storytelling shapes and is shaped by socio-
cultural context and differs in time and space. By examining storytelling, the analysis can
provide insight into the storytellers’ socio-cultural contexts and how these influence their
meaning-making. Using Riessman (2008) framework for thematic narrative analysis, we
explored participants’ stories of building new friendships during recovery. This thematic
narrative analysis focuses primarily on story content: what participants say about building
new friendships. We identified and examined detailed stories obtained through individual
interviews (Riessman, 2008) and network mapping (Fyrand, 2016). A key area of
narrative studies concerns human interactions in everyday life (Riessman and Quinney,
2005).

Ethics
The study was approved by the Regional Ethics Committee in Norway (ref. 131212)
and evaluated by the Norwegian Centre for Research Data (ref. 804223). The first
author had no relationship with the study participants before the interviews. At the
4 Qualitative Social Work 0(0)

beginning of each interview, the relevant participant signed a consent form and received
a gift card (NOK 400). An experienced secretary transcribed the audio recordings of the
interviews verbatim. Ethical considerations were taken into account throughout the
recruitment, interview, analysis, and data interpretation process. All authors have years
of experience working with individuals with problematic substance use or with in-
dividuals in LTR.

Sample and recruitment

We recruited the sample as part of the ongoing Stavanger project on trajectories of
addiction (the Stayer study) (n = 202), a prospective naturalistic, longitudinal study
of change trajectories and recovery processes following substance-use disorder in
Rogaland, Norway (Svendsen et al., 2017). From March 2012 to December 2015, the
Stayer team enlisted participants from outpatient and residential treatment facilities.
To be eligible for the Stayer study, individuals had to satisfy the following criteria:
starting a new treatment programme, meeting the criteria for substance-use disorder,
and being at least 16 years of age (Svendsen et al., 2017). From the Stayer study, we
recruited participants who had been in LTR for five years or longer. We defined LTR
from problematic substance use as being ‘characterised by voluntarily sustained
control over substance use which maximises health and well-being and participation
in the rights, roles and responsibilities of society’ (UKDPC, 2008: 6). See Table 1 for
characteristics of participants interviewed for this paper.
The second author (TSS) contacted 26 participants from the STAYER cohort who met
the criteria, provided them with verbal information about the study, and requested
permission to obtain their telephone numbers from the first author (MIV). After obtaining
consent, MIV contacted all 26 participants interested in participating in the study, of
whom 5 did not respond, 3 expressed concerns about participation due to their educational
or work commitments, and 1 declined without explanation. Eventually, our study ob-
tained a sample of 17 individuals. At the time of the interview, study participants were
either students or employed individuals who performed daily tasks related to parental
responsibilities, social interactions with peers, hobbies, and sports activities. Substance
use was measured upon participants’ admittance into the Stayer study. The mapping
showed harmful consumption of alcohol in 10 out of the 17 and a level indicative of high
risk of drug-use-related problems in 16. Of the 17 participants, 3 said they had used
hashish, cocaine, or benzodiazepines at social gatherings during 2021.

Measures
In the interview, we invited participants to draw a person-centred map with the in-
terviewer. Person-centred maps can show structural elements and quantifiable
qualities, such as number of relationships and types of relationships (Fyrand, 2016).
This map helped visually present the network and provided a basis for discussing their
experiences and developing various relationships. The map was consisted of five
zones: family in the same household, other family members, colleagues,
Vigdal et al. 5

Table 1. Characteristics of interviewed participants.

Characteristics Baseline Year 1 Year 2 Year 5 Year 8

Demographics
Age 25.2 (5.2) - - - -
Male/female 8/9 - - - -
Education, years 11.3 (1.6) - - - -
Substance use history
Age of initial use 13.3 (2.0) - - - -
Years of drug use 11.8 (5.6) - - - -
AUDIT sum score 13.4 (12.4) 3.7 (6.7) 2.3 (4.3)d 2.13 (3.32) 5.06 (9.77)
DUDIT sum score 30.5 (13) 7.4 (13.0) 2.9 (11.4)d 0 (0) 2.1 (5.9)
Treatment history
Previous treatment attempts, 0 (0 to 8) - - - -
median (range)
Outpatient at baseline, n (%) 8 (47.1) - - - -
Inpatient at baseline, n (%) 9 (52.9) - - - -
Self-help group at baselinea, n 7 (41.2) - - - -
(%)
Social variablesb
Permanent housing, n (%) 10 (58.8) 14 (82.4) 14 (82.4) 8 (47.1) 17 (100)
Stable income, n (%) 11 (64.7) 14 (82.4) 15 (88.2) 8 (47.1) 15 (88.2)
Employed/student, n (%) 14 (82.4) 14 (82.4) 15 (88.2) 8 (47.1)e 15 (88.2)
Abstinent friendsc, n (%) 12 (70.6) 13 (76.5) 14 (82.4) 8 (47.1)e 17 (100)
Mental health
SCL-90-R GSI 1.3 (0.7) 0.7 (0.7) 0.4 (0.3)d 0.4 (0.5) 0.4 (0.4)
SWLS, sum scored 17.2 (6.7) 21.4 (7.0) 25.2 (4.8) 26.3 (4.4) 27.2 (4.6)
BRIEF-A GEC, t-score 67.4 (11.9) 56.4 (12.9) 51.7 (10.7) 50.2 (10.1) 45.6 (8.9)

All data are mean (SD) unless otherwise specified. SCL-90-R GSI (Symptom Checklist-90 Revised Global
Severity Index T-score); BRIEF-A GEC (Behavioral Rating Inventory of Executive Function – Adult Version
Global Executive Composite T-score); SWLS (Satisfaction With Life Scale); AUDIT (Alcohol Use Disorders
Identification Test); DUDIT (Drug Use Disorders Identification Test).
a
Currently in self-help group, such as Narcotics Anonymous (NA)/Alcoholics Anonymous (AA) and the like.
b
Social variables are positive responses to yes/no questions.
c
Friends without a history of substance use.
d
Two participants did not complete this measure, N = 15.
e
Nine participants did not respond to this item.

professionals, and friends. Some referred to colleagues and partners as new friend-
ships that developed during recovery. See Table 2 in Vigdal et al. (2023) for details of
the size and composition of groups of friends in person-centred social networks.

Procedure
We developed an interview guide with an expert by experience employed at the Centre for
Alcohol and Drug Research at Stavanger University Hospital, which led to new follow-up
6 Qualitative Social Work 0(0)

questions being included in the interview guide. In the semi-structured interviews, we

focused on establishing a safe space to encourage participants to share their friendship-
building experiences. We approached the interviews as a relational practice between
interviewer and interviewee, inspired by Hydén’s (2014) teller-focused approach, which
supports and facilitates narratives (Hydén, 2014). Participants were invited to discuss their
experience of building friendships based on the following question: Can you please share
your experience of building a new friendship with me? MIV then used follow-up
questions to invite elaboration on meaning-making and concretisation in the
friendship-building story.
All interviews were conducted between August 2020 and December 2021 by MIV and
lasted an average of 45 minutes (37 to 120 minutes). Seven interviews were conducted
face to face and ten were conducted digitally on Teams or Zoom due to the COVID-19
epidemic.

Analysis
Storylines were employed as an analytic tool in the analysis. Bruce et al. (2016: 3) define
storylines as ‘a dominant thread running through several narratives’. We followed this
definition of storylines when exploring the dominant themes running through multiple
participants’ narratives. Another analytic tool used is positioning, referring to how in-
dividuals dynamically situate themselves and others through the words, images, and
metaphors they choose for their stories (Davies and Harré, 1990). We used these analytic
tools to explore the dominant themes in the interviews, the positions produced in dis-
cussion, and, thus, how rights, duties, similarities, and differences were created.
The steps were as follows: (i) MIVacquainted herself with the data by carefully reading
the transcribed interviews and forming an overall impression of participants’ experiences
of making new friendships and noting potential themes, such as ambivalence about
making friendships; (ii) MIV identified stories in the material about building friendships
and sorted these according to similarities and differences in what they presented as central
friendship-building themes; (iii) MIV and the fifth author (LBS) used storylines and
positions as analytic tools to identify themes running through the stories and explore the
positions the stories constructed; and (iv) all authors contributed to interpreting how
participants positioned themselves and investigating the storylines in the narratives. When
presenting the results, we provided participants with pseudonyms. Quotes in the results
section have been translated from Norwegian to English.

Results
Participants positioned themselves variously during the interviews, and their stories about
building new friendships offered different storylines. All participants offered stories about
needing to distance themselves from friends who struggled with substance use in order to
manage their recovery process. A core element of all stories told by participants included a
break-up with friends who still lived a life of problematic substance use. Some partic-
ipants said they ended friendships by informing friends that they had stopped using
Vigdal et al. 7

substances and could no longer have contact with them. Some said they had moved to new
geographic areas to ensure distance from old friends with substance-use challenges. Due
to this process of ending old friendships, most described a situation where they had few
friends and building new friendships was central. Analysis of how they discussed building
new friendships identified four predominant storylines recurring in the interview material:
(1) ‘I don’t make friends easily’; (2) overcoming barriers to building friendships; (), ‘birds
of a feather flock together’; and (4) ‘having “regular” friends make me feel like an
“average” person’. All participants narrated stories about making friends that aligned with
one or more of these storylines. The number of participants sharing similar stories about
building friendships is specified for each type of storyline.

‘I don’t make friends easily’

The ‘I don’t make friends easily’ storyline depicts difficulties making friends as described
by all participants, who indicated that their history of substance use created different
barriers. All participants discussed various obstacles to building friendships, including
stigma, shame, trauma, adapting to new social situations, and handling social drinking
situations. The difficulties they presented are linked to their own characteristics and
vulnerabilities or their history of problematic substance use. Participants said that they
struggled with negative thoughts and emotions from past experiences, which caused them
to distance themselves from others socially.
Some participants said lack of knowledge about politics and society was a barrier to
connecting and building friendships. Anne (in recovery for nearly ten years) described the
barriers she faced when contacting new people:

What is difficult is that you feel like you are entirely different. It’s not a hole, but it was a
crater (a knowledge gap) for me. When you were last in the world as a part of life, and until
you re-enter it. You jumped out when you were 16 and returned when you were 32. After all,
you get questions about what you’ve worked with in the past, so you feel embarrassed about
yourself, don’t have much to contribute, and are ashamed and afraid to say certain things and
be labelled. You don’t have much to contribute. The others know what has happened in
history and politics and you come in (into the world/society) and feel you know very little.

In her storytelling, her lack of knowledge about what has happened in history and
politics is an important barrier to building friendships. In the story, she positions herself as
someone who jumped out of life and the world when she was 16 and re-entered life when
she was 32. As a result, she positions herself as utterly different from others, with a crater
(knowledge gap). She felt embarrassed and ashamed about her limited understanding,
fearing judgement and labelling. In her story, a distinction is created between her and
those who have not used drugs. Others are positioned as knowing what has happened in
history and politics. Consequently, she feels ignorant and completely different.
In the interviews, 11 participants described their reservations about making new
friends. Some discussed personal limitations and concerns about friends possibly ex-
pecting more than they could provide. Some participants emphasised the importance of
8 Qualitative Social Work 0(0)

having alone time, while others found fulfilment in work relationships and spending time
with their families after work. Some talked about making friends more as coincidence
than deliberate effort, presenting their friendships as being the result not of their actions
but of luck or the persistence of friends who actively pursued them. Additionally, many
participants reported feeling drained after social gatherings. For instance, Kari (nine years
in recovery) discussed feeling exhausted in social situations:

I feel it physically when there are too many people around me. My social battery. Poof!!
Almost without warning, the social battery becomes empty. It physically hurts in my head.
I’ve tried to practise enduring social situations, but it reaches a limit, and then I must escape
the situation. I need to take a break, go for a walk or something.

Here, Kari describes herself as having a small social battery that runs out without
warning. Due to these limitations, she portrays herself as having limited social capacity
even though she has practised. Kari’s social battery runs out quickly when many people
surround her. This story places people as a source of physical pain, causing discomfort in
Kari’s mind. As a result, she describes feeling a limited ability to build friendships and
must escape from social situations and take breaks. Kari shared how she formed a
friendship with her partner despite her limited social battery:

I have always felt like I was on the outside (of the community) and very lonely to be who I
am. Knowing what is self-chosen and what I cannot tolerate is still challenging. Because
many have tried to form a friendship with me, but I have kept my distance. It was a co-
incidence that we met each other. We met in a digital discussion group. Then I noticed how he
responded to comments from others. There was something about his care for others, and I
thought he was a very good man. We started to talk about more personal subjects together.
After a few months, he invited me to visit, and I came to visit several times before we decided
that it would become something permanent. I am confident in myself and recognise that he is,
too, which allows us to tolerate each other.

In her storytelling, she depicts herself as having always felt she is on the outside and
lonely and disconnected from others. However, she is not entirely sure if this is self-chosen
due to her own choices. She portrays herself as someone hard to form friendships with
because she prefers to keep a distance. She describes the meeting with her partner as a
coincidence. Kari strengthened her connection with him by discussing more personal
subjects and portraying his caring nature. Kari describes herself and her partner as
confident in themselves, which allows them to tolerate each other, understood as ac-
ceptance of having small social batteries.
The storyline “I don’t make friends easily” reveals several barriers that participants
experienced in building friendships and how participants link the barriers to their own
personal characteristics and vulnerabilities. Connecting these barriers to personal char-
acteristics positions the participants as outsiders and as people with limitations. Linking
good experiences with luck and coincidence enhances the storyline and shows the process
of making friendships as involving many difficulties that the participants are positioned as
Vigdal et al. 9

having little agency to overcome. The stories appear to be influenced by a social and
cultural context where stigma and exclusion are associated with a history of problematic
substance use.

Overcoming barriers to building friendships

The second storyline, ‘overcoming barriers to building friendships’, shows how
16 participants discussed overcoming certain difficulties in forming friendships. These
stories address how engagement with peer groups, employment, and the acquisition of
communication skills facilitated friendship-building. In order to show more of the change
history, we present elements of Per’s stories. Per (in recovery for nine years) discussed
challenges of forming friendships and says he encountered social barriers during his
recovery process but found ways to overcome them. He related a change story where he
presents himself as someone who developed greater skills and vigour in recovery.
Speaking about the first part of his recovery process, he outlined the difficulties he
experienced and the distance he perceived between himself and those who had not
experienced substance-use difficulties. Per obtained communication skills training to
address his thoughts and feelings during substance-use treatment. He said:

You sit and talk about thoughts and feelings. You’re a man; you shouldn’t talk about that. You
live in a completely different society when you are using substances. You must not show
weakness! Opening up and talking about the thoughts and feelings inside. It feels naked. It is
not expected in the environment out there.

In his storytelling, he positions himself as someone who needed skills training to talk
about his thoughts and feelings to overcome barriers to building friendships. He describes
himself as coming from a completely different society, where you must not show
weakness. Interaction with people without experience of using substances is shown as
being in a completely different environment, where you must be different and talk about
thoughts and feelings. These different expectations make him portray himself as feeling
naked.
Later in the story, Per says that experiences and learning in the therapeutic group
processes gave him the confidence and skills to connect with new people. He illustrates
this self-development with a story from his first days at university:

In a way, I knew what kind of gender there would be most of in this bachelor’s study. There
was a large auditorium so that you can imagine: down here is the lecturer, and it was almost
filled with women, and then I see in the middle of all that chaos there – a person is sitting all
alone by himself – a male. I went towards him. I noticed that all the others saw. Then it was
like when you think of a predator. You see an easy target, and it is. I saw an easy opportunity! I
said to myself: Walk over and talk to him then. Then I immediately said: “Hi, my name is
XX.” And it was that simple. I just sat down and spoke with him. Then I was assigned to a
student group, and he was assigned to another student group. We exchanged numbers and
10 Qualitative Social Work 0(0)

Facebook accounts and all that. So, ever since the first orientation day, he and I have had a
friendship.

In the story, Per portrays himself as someone with more agency; he saw a fellow male
student and went towards him. Per spoke of the fellow male student as an easy target: he
saw an easy opportunity and said to himself, walk over to him and talk to him. Per
positioned himself as a predator in this story of friendship-building. By positioning
himself as a predator, the story indicates that he had a certain amount of confidence and
was in a position where he had agency to build friendships.
As exemplified by Pers’ story, the storyline ‘Overcoming barriers to building
friendships’ shows how the learning and new experiences acquired during recovery are
perceived as equipping them better to build friendships. Per’s story shows how he
connects his communication and relational skills training, along with support from peers
and therapists, to how he overcame obstacles to developing friendships. The change story
he presented was linked to his learning to communicate in ways suitable for his new
environment, a development he associates with greater opportunity and agency in the
friendship-building process.

‘Birds of a feather flock together’

The third storyline, ‘birds of a feather flock together’, includes 15 participants relating
how they built friendships with people they found they had something in common with
due to substance use. In this storyline, participants highlighted the importance of forming
friendships with those who had experienced similar struggles. The participants em-
phasised how valuable it was to have friends with whom they could share experiences and
feelings. They also said it was difficult to make friends outside of their peer community.
The analysis identified two variants of this storyline.
In one variant, participants wanted friends who had faced prior substance-use chal-
lenges. In these stories, participants indicated these friendships developed primarily when
they joined treatment or peer groups. Nils, a nine-year recovery participant, said he had
developed many friendships in peer groups. He positioned himself as preferring to have
only friends in recovery and explained his wish not to have friends without experience of
substance-use challenges as follows:

I’m not sure, they seem boring to me. But maybe they’re not boring. I just can’t put my finger
on it. You know what they say: similar children play best together. It’s been a tough journey,
but I’ve fought hard to change my personality positively. This work is fascinating, and there’s
often a lot of depth to it. Maybe it’s my fear, but I worry that our relationship might be boring
if we don’t have enough in common.

In his storytelling, he positions people without a history of substance-use challenges as

possibly boring and fears they don’t have enough in common. Having something in
common is linked to having a shared history of substance use and having been on a
challenging journey. In the extract, he refers to a well-known saying, similar children play
Vigdal et al. 11

best together, to support his point. In his story, he portrays himself as a hardworking
individual striving for positive change, which sets him apart from those not engaged in
self-improvement.
In another version of this storyline, participants spoke about reconnecting with
friends – and social arenas – among whom illicit drug use is commonly accepted and who
are positioned as hobby users or recreational drug users. They sought such friendships
and arenas because they had experience of feeling safer and more comfortable with these
people. Tone, (almost nine years in recovery) explained that she had used illegal drugs at
some social gatherings during her recovery but had now stopped. She positioned herself
as having difficulty building friendships with people who had never faced substance-use
challenges. In contrast, she positioned friends who still used illicit drugs as providing her
with a sense of security, which she explains as follows:

I grew up where people were using substances from the time I was 14. It isn’t easy to let them
go. They have been my entire network since I was little. They know what you’re thinking. I
don’t have to explain it to them. They don’t get mad at me when it comes to substance use
because they understand.

In her storytelling, she presents herself as someone who grew up where people were
using substances from the time she was 14, illustrating this by positioning people who use
illicit drugs as those she can feel comfortable with because they understand her, they do
not get mad at her when she uses drugs, and she doesn’t have to explain it to them. Anita
(also nine years in recovery) elaborated on her choice of friends who still use illicit drugs
as follows:

I stayed away from people who use drugs for all these years until last summer. Since then,
I’ve been with people using drugs; I call them hobby users because they use drugs at
weekends but not during the week. After all, they’re at work. Many hobby users are on the
same level as me, but none makes me feel behind. None of these relationships makes me feel
inferior. They haven’t settled down yet, so I can relate to that versus those (friends) who have
a partner they live with and kids and do not want to go out. Many of those in the group of
friends without substance (challenges) are ahead of me.

Anita portrays herself as someone who has tried to stay away from, and has avoided
associating with, people who use illegal drugs for years. However, she has formed new
friendships over the past year with people who use illicit drugs. Anita justifies that choice
by explaining that these friends are on the same level as her and do not make her feel
behind or inferior. They are contrasted with others who have a cohabitant and kids, do not
want to go out, and are ahead of me.
A theme running through the ‘birds of a feather flock together’ storyline is participants
building friendships with people they feel have a similar experience of substance use. This
choice is explained in terms of this similarity being central to feeling understood and
secure. Their emphasis on the similarity of substance use, as demonstrated in this
12 Qualitative Social Work 0(0)

storyline, provides insight into a meaning-making process that seems to influence future
actions and justify choices made when building friendships.

‘Having “regular” friends make me feel like an “average” person’

The storyline ‘having “regular” friends make me feel like an “average” person’ includes
stories about the value of friendships with people who have not experienced substance-
use problems. The analysis shows that eight participants told a variant of this storyline,
where forming new friendships with individuals without a history of problematic sub-
stance use could support the process of developing a new social identity. Kristin (nine
years in recovery) explains her decision to build friendships with those who had never
struggled with substance use as follows:

I wanted to be normal. I didn’t want to associate with those who were in peer groups. It
sounds selfish, but I just wanted ordinary, regular friends. I wanted to be normal. I tried to
build entirely new friendships, which saved me because I did not want to be influenced by
someone who had been using substances before. I wanted to avoid associating with those
who were in peer groups. I cut everyone that I had been around when using substances. That
was the priority for me. For me, it has been finding hobbies and activities. I was involved in
all kinds of activities. I found cycling, which I mastered and I cycled long distances. I was
being able to cope with others and create that bond. When people asked me what I did, I said I
rode a bike, and then it became a theme […] instead of saying that I have nothing. Then I got
some confirmation like “Oh, so good.” I felt a bit normal then. I had done something that not
many ordinary people could do. That was a big boost for me.

In her storytelling, Kristin presents herself as having a lot of agency to build new
friendships among people without a history of substance-use challenges. She positions
people without substance-use challenges as ordinary people. She presents the act of being
with them as having saved her and fulfilled her wish for a new identity as a normal person.
Activities such as cycling are presented as a means to gain a positive new identity that
allows her to tell others that she rode a bike with other people. In her story, she shows how
being able to bond with people positioned as ordinary, regular friends and doing activities
positioned as activities ordinary people can do gave her a basis for feeling a bit
normal then.
Mia (nine years in recovery) shared her experience of needing to change her ap-
pearance to fit in and make new friends without a history of problematic substance use.
‘It’s impossible to maintain a normal lifestyle without friends who have a normal lifestyle
around you’, Mia stated. She said that, to feel accepted, she went from having black hair
and wearing dark clothing to dyeing her hair blonde, sunbathing to obtain a tan, and
wearing what she called ‘more normal clothing’.
The storyline ‘having “normal” friends makes me feel like an “average” person’
reflects meaning-making that having friends without a history of problematic substance
use is helpful for creating a new social identity, which in turn is helpful for feeling more
Vigdal et al. 13

accepted as an equal citizen in society. In this storyline, building friendships with people
without a history of problematic substance use is linked to feeling normal.
In sum, we have explored how individuals in LTR perceive the process of building
friendships. The four storylines presented provide insights into how people in LTR make
meaning of their experience of friendship-building. The storylines also offer insights into
the meaning given to challenges and valued experiences during the friendship-building
process and into how participants understand themselves and their opportunities to in-
fluence the friendship-building process. A consistent finding in all storylines is the
significant role of participants’ problematic substance use in their efforts to find meaning
in their friendship-building experience, such as what creates challenges and what creates
equality, closeness, and security in friendship and in developing social identity.

Discussion
The study adds to existing knowledge by examining the processes and meaning-making
behind the formation of new friendships, shedding light on participants’ experiences and
how they interpreted these experiences. The way they spoke about the friendship-building
process can be categorised according to four main storylines: (1) ‘I don’t make friends
easily’; (2) ‘overcoming barriers to building friendships’; (3) ‘birds of a feather flock
together’; and 4() ‘having “regular” friends makes me feel like an “average” person’. On
the basis of these storylines, we would like to discuss two core topics that we merit
emphasis: (1) how participants created meaning through their stories and (2) how the
meaning-making process affects the way participants build friendships.

Social distance and self-blame

In all four storylines, all participants understood their drug-use experiences as a burden in
their social interactions with people without such experiences. Their past life experiences
are shown as causing them to fall short in ways that make them feel abnormal and
vulnerable. These shortcomings and vulnerabilities are presented as something that must
be overcome to create solutions for building friendships. In addition, our analysis
demonstrates how the various storylines build on and reinforce a social dividing line
between those who do or have used drugs and those who have not. Other social dif-
ferences, such as interests, personality traits, age, and other life experiences, are not
presented as important. Our analysis confirms the conclusions of Robertson et al. (2021)
as regards how individuals in recovery create meaning from their drug-use experiences, a
kind of meaning-making that leads to feelings of stigma, isolation from mainstream
society, shame, and self-blame among those in recovery (Robertson et al., 2021). The
storylines all show in different ways how participants’ meaning-making of social events
influences their self-perception. This supports and demonstrates the point made by Best
et al. (2016) that identity change linked to recovery is connected to one’s social expe-
riences. Best and Hennessy (2022) review the progress around the conceptualisation and
operationalisation of recovery capital and point to recovery capital knowledge gaps, one
being the lack of clarity about how recovery capital domains are interrelated entities. Our
14 Qualitative Social Work 0(0)

analysis helps to show how social conditions influence personal capacity. In particular,
our analysis of participants’ friendship-building stories reveals how dominant cultural
beliefs about those with drug problems and those without are internalised and influence
the interpretation of experiences and create expectations for what will come. Our analysis
thus shows how socio-cultural factors interact with personal capital such as low self-
efficacy or self-esteem.
Not only does our analysis emphasise other research indicating how stigma and
marginalisation obstruct the recovery process (e.g. Crapanzano et al., 2019; Krendl and
Perry, 2023), it also provides insight into how stigma and self-stigma affect interpretations
of social events in everyday life, which broadens our knowledge about how stigma and
marginalisation obstruct LTR. Our analysis also demonstrates how stigma influences
participants’ social interactions, how they position themselves and others, and what their
expectations are of what is to come and thus what actions they will take. The analysis
reveals how the dominant cultural assumptions about people who have been using drugs
create experiences of essential social differences between those who have used drugs and
those who have not faced substance-use challenges.
This assumption of fundamental social differences creates substantial barriers that
people in LTR must overcome to build new friendships. Although the literature suggests
that stigma is a determining factor in recovery from substance-use problems, studies on
this topic remain scarce. A review of interventions to reduce stigma related to people who
use drugs indicates a significant knowledge gap with regard to effective, evidence-based
strategies (Tostes et al., 2020). Our analysis supports the conclusion of Tostes et al. (2020)
that reducing the stigma towards this group is essential to easing their recovery process.

The relationship between friendship-building and meaning-making

Our research demonstrates that how participants find meaning in their friendship-making
process influenced their ability to form new friendships. Self-positioning and perceptions
of others also played a role in developing these relationships. Our analysis supports the
conclusions reached by Parker et al. (2019) and offers an additional understanding of the
difficulties in managing relationships during the recovery process. We discovered various
methods for forming friendships. Some individuals focused on improving communication
and relationship skills to overcome obstacles to creating connections. Others chose to
distance themselves from the stigma associated with ‘regular’ activities such as cycling by
undergoing a ‘social cleansing’ process. Another approach involved seeking out indi-
viduals who had gone through similar experiences with drug use to establish a sense of
equality and reduce feelings of insecurity and social isolation. In some stories, people who
have not dealt with substance use are sometimes viewed as uninteresting and thus avoided
as potential friends. Our analysis complements the comprehensive review by Bjornestad
et al. (2020) by clarifying the link between the meaning-making process and the cul-
tivation of friendships. Our findings contribute to a better understanding of elements that
can enhance social functioning following treatment. The efforts discussed regarding the
process of making friends and the tendency for social distance to arise between those with
problematic drug-use experience and those without it serve to emphasise the value of peer
Vigdal et al. 15

support. Additionally, the analysis shows the value of social workers as ‘community
connectors’ (McKnight and Block, 2011) and of a focus on community engagement (Best
et al., 2017). Our analysis also reveals how important meaning-making is for building
friendships and a sense of belonging. The stories identified show that creating friendships
and experiences of equality and belonging is a demanding, long-term process, which
emphasises the need to see recovery as a long-term process.

Strengths and limitations

In our view, the thematic narrative approach to analysing stories about building
friendships yields valuable insights into how friendships develop during the LTR process.
The researchers’ extensive experience of qualitative and narrative research and research
on LTR processes is a strength. However, their proximity to the research question may
have produced assumptions that influenced the focus of the interviews and the analysis.
Those in LTR are a heterogeneous group, but this heterogeneity is not reflected in our
participants, who were relatively young (average age 25.2) with an average of 11 years of
problematic drug use. As participants were recruited from a treatment centre, we were
unable to recruit people who had recovered from substance use without attending formal
treatment. It is possible that participants from the geographical area around the treatment
centre are overrepresented, which we did not investigate. Nor did we enquire about ethnic
background, but there is reason to believe that ethnic whites predominate in the sample, as
they are overrepresented in the Norwegian population generally.
Although digital interviews have a limited capacity to capture nonverbal communi-
cation and may miss out on nonverbal cues, we opted to use them during the pandemic.
Despite these limitations, the analysis provides valuable insights into how people in LTR
make meaning of their experience of building friendships. This is a relatively unexplored
area of study, and there is a demand for more research on LTR processes.

Implications for practice

Working with individuals and their social connections is crucially important in social
work practice. Prior research shows that establishing friendships is vital to one’s overall
health, well-being, and LTR (Alastair et al., 2022; Leamy et al., 2011). However, those in
LTR report that building new friendships can be challenging (Ness et al., 2014; Vigdal
et al., 2023). Social workers can be significant ‘community connectors’ (McKnight and
Block, 2011) on several levels. At the societal level, policymakers need to be informed
about how stigma and social distance challenge recovery processes and about the im-
portance of working with integration and creating inclusive arenas to promote LTR. At the
community level, it is essential to identify groups and arenas that offer meaningful
activities and communities for social inclusion and networking. To identify such com-
munity assets, methods such as asset-based community development, social identity
mapping, and assertive linkage may be useful (Best et al., 2017).
At the individual level, we suggest that social workers can gain valuable insights from
this study, which they can use to reflect on and discuss friendship development among
16 Qualitative Social Work 0(0)

individuals in recovery from substance-use issues. Learning about others’ friendship-

building experiences can offer new ideas and help normalise emotions that commonly
arise during this process. By understanding a person’s self-perceptions and their per-
spectives on others, social workers can address barriers that arise when people in recovery
enter new social environments, such as work, education, or social activities. We em-
phasise the importance of a long-term approach to overcoming the obstacles to building
new friendships. The analysis points to an awareness among social workers of how
friendship-building experiences are multifaceted and influence how the experiences are
interpreted. As such, it may be helpful for social workers to listen to the friendship-
building stories of people in LTR and offer to help them reflect on what their story is
telling and to participate in the eventual development of new stories.

Implications for research

To gain a deeper understanding of how people in LTR form friendships and find meaning
in their experiences, we recommend delving further into stories on this subject. It is
important to continue exploring the complexities of friendship development in different
contexts. A potentially valuable subject for research is how strategies for developing
friendships evolve and whether individuals in LTR adjust their positions and perceptions
of others during such processes. Additionally, more research is needed to explore how
social workers can support the development of friendship and a sense of belonging and
how to reduce stigma and experiences of social distance.

Conclusions
Participants’ stories about building friendships yield valuable insights into how people in
LTR make meaning of their friendship-building experiences. In the storylines identified,
the building of new friendships is experienced as a long-lasting process with several
barriers. These individuals’ relationship to substance use is found to be a key element in
their experiences of equality and belonging. However, their stories also show how ex-
periences of positive and inclusive social situations can strengthen their experience of
belonging and friendship and develop their faith in their abilities to build friendships.
By offering empirical insights into how people in LTR experience the friendship-
building process, this article emphasises and demonstrates social capital as a key domain
in the recovery process and supports the importance of understanding recovery as an LTR
process. Furthermore, the article indicates a need to recognise friendship-building and
belonging as an essential but demanding area of work for people in recovery and thus,
also, as a central area for social work.

Acknowledgements
We are grateful for the time and effort of the study participants, without whom we could not have
conducted this study. We are also grateful to the reviewers for their comprehensive and insightful
review. We would like to thank Professor Chyrell Bellamy, Director of the Yale Program for
Vigdal et al. 17

Recovery Services and Research (PRCH), for her valuable contribution to the discussion of the
results. We are also grateful to Aleksander Waagan Skaalevik for his time and effort in relation to
discussing the interview guide. We want to thank Aleksander H. Erga, the principal investigator in
the STAYER study and the head of research at the Centre for Alcohol and Drug Research, Stavanger
University Hospital, Stavanger, Norway, for designing Table 1, which addresses the characteristics
of participants interviewed.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/
or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or
publication of this article: This study is funded by Western Norway University of Applied Sciences,
Norway.

ORCID iD
Mariann Iren Vigdal  https://orcid.org/0000-0003-1913-7149
`

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