Pathways to recovery model of youth substance misuse in Assam, India

Anna Madill, Raginie Duara, Sangeeta Goswami, Rebecca Graber, Siobhan Hugh‐Jones

Research output: Contribution to journalArticlepeer-review


There are global calls for better understanding of substance use disorder (SUD) to inform prevention, risk reduction and treatment of this relapse-prone disorder. Our aim in this article is to understand the pathways to recovery of youth in Assam, India who have suffered SUD.

We recruited 15 participants (11 men and 4 women) via two rehabilitation facilities. All are addicts-in-recovery aged 19–24 years. Material was generated through photo-led interviews, analysed using an inductive variant of thematic analysis and the resulting model refined through expert and participant checks.

We present a multiroute, multidirectional pathway to recovery model. It has three phases, Recreational Use, Addiction (Relaxed, Chaotic, Strategic) and Supported Recovery, each phase consisting of cycling between, or transitioning through, a series of stages.

The model enhances psycho-socio-cultural insights into the experience of risk and recovery, and informs prevention and treatment for youth substance misuse in Assam. This is the first model of its kind and an important public health resource. We discuss the possible transferability of the model to a wider range of contexts.

Patient or Public Contribution
The model presented was generated through analysis of interviews with addicts-in-recovery. Four of these addicts-in-recovery, and two mental health and rehabilitation service providers, conducted participant and expert checks of the model leading to its improvement.
Original languageEnglish
Number of pages11
JournalHealth Expectations
Publication statusPublished - 9 Nov 2022


  • Public Health
  • Environmental and Occupational Health


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