Table 4.

Formation and development of themes

Developed themes	Findings (themes, subthemes, or categories) from the original article	Participant quotation (from the original article)	Relevant study
Theme 1: Seeking of social support	Developing relationships with family and friends	“They made me aware of how important I am to my children… When you have children, you have an obligation to stay sober. I stay sober for my partner and my children.”	Wangensteen et al., 2022 [35]
	This group gives me support to sustain my recovery	“I am stronger today because I have support from him [group leader]. He teaches me how to make the right decisions to make sure I can keep my recovery in check.”	Shaari et al., 2023 [37]
	Renewing non-addiction relationships and social network	“But having a healthy network is perhaps the most essential thing to stay clean.”	Pettersen et al., 2023 [38]
	Family support	“So I had amazing family support, my dad as well. For them, like just seeing what the programme did for me, it was such a miracle… So my family is extremely supportive.”	Stokes et al., 2018 [36]
Theme 2: Psychological coping strategies	Utilizing only their own willpower	“You know, I tried to quit drugs for about two months using just my willpower in 2002, when I had just gotten addicted [to heroin]. During the first month [of abstinence], I didn’t eat anything at all, I would vomit all the food if I did.”	Yang et al., 2015 [39]
	Developing strategies for coping with stress and challenging emotions and situations	“They helped me with the anxiety and depression that I struggled with during the first 6 months of treatment. Suddenly, I started to cry, and I couldn’t stop. They taught me some methods that I still use when I get anxious at work.”	Wangensteen et al., 2022 [35]
	Changing beliefs	“In the past, drugs saved me. Now that I have been infected with HIV, to survive, I must avoid taking drugs.”	Iswardani et al., 2022 [40]
	Non-judgmental self-guidance	“Now I know that if I need to enter a setting that I used to need medication to enter, I can instead talk to myself and say, ‘You know, it’s actually all right that you might feel sad when in that situation, because it’s human, it’s totally okay, that [feeling].’ So that is, you know, a totally new way of thinking.”	Dundas et al., 2020 [41]
	A sense of control	“I believe it’s possible to practice, so that you become calmer in your body, so that you have a greater control. I’ve become much more aware of being able to calm myself.”	Dundas et al., 2020 [41]
	Clinical-contextual strategies: planned counseling and therapy sessions	“When I experience the feeling at the work place… and I resist… sometimes I become anxious and restless. I take a short break to do some PMR [progressive muscle relaxation] exercises I learnt from counselling. Now, I’m also able to turn down offers from my friends… gently. I don’t even go close to them anymore.”	Appiah et al., 2018 [32]
Theme 3: Spiritual experiences	The role of spirituality and religious faith in sustaining recovery	“In my recovery, it’s like God played a role, of giving me the strength to be sober, understand? I mean, God is planning everything. God is doing everything. He is helping me figure things out, you know, do this and that.”	Stokes et al., 2018 [36]
	Spirituality and religious engagements	“So my auntie took me to a prayer camp where we spent two weeks fasting and praying. It was difficult though… I had to fast and pray all the time. After a series of deliverances and prophetic utterances, the prophet told me I was free… and that was it.”	Appiah et al., 2018 [32]
Theme 4: Professional interventions	Participating in methadone maintenance treatment	“…I went to a clinic, requested some intravenous drips and some tablets, and then stayed at home and lay in bed all day long… in this way, I quit heroin without suffering much. People just never believe!”	Yang et al., 2015 [39]
	The influence of caseworkers	“Well, he [the caseworker involved in the referral] was always humane, he was understanding, and he suggested this [the treatment] to me, by sort of suggesting a decrease in my use, but not total abstinence.”	Brunelle et al., 2015 [42]
Theme 5: Enhancement of awareness	Accepting personal responsibility and autonomy: it has to be me, it cannot be you	“I dunno (laughs). I don’t think about it much anymore, I just kind of get up and start the day. I don’t have many fixed routines. I am very down to earth, I just get up and drink coffee, and then I’m off really.”	Bjornestad et al., 2019 [30]
	Personal choice and flexibility in recovery	“Everybody’s journey is different and you have to find what’s right for you.”	Rettie et al., 2020 [43]
	Conscious decision and commitment to sustained recovery	“…but it is a decision [referring to sustained recovery] you need to have to make at the end of the day, to decide you are never going to have [another drug again]”.	Stokes et al., 2018 [36]
	Personal development and further education	“So to rectify that I went to Mr Google and I started upping my professional skill, my knowledge about my work… I also start using Dr Google and learn about dependency because to help yourself you must know what you are challenging.”	Stokes et al., 2018 [36]
	Adopting new occupations	“If I am to sustain my journey of recovery, I need to make many changes. To construct a new life in which recovery is possible, it is necessary for me to change choices, goals, roles, and expectations. Farming is the new thing now... and I am a changed-responsible father.”	Nhunzvi et al., 2019 [31]
	Avoiding contact with substance use relations and milieu	“You cannot stay in the addictive subculture when you want to live in the ordinary society as sober. It is a matter of attitude, language, and ways of doing things.”	Pettersen et al., 2023 [38]