Social exclusion can be a factor in the reoccurrence of addictive behaviours and or a recurrence of mental health symptoms. Substances provide an escape from feelings of worthlessness and the effects of marginalization. Addictions are at times a form of self-medicating but even when medications hold symptoms at bay, stigma and self-stigma can be obliterated temporarily through substances.

Reclaiming valued social roles is sometimes not an option for those with concurrent disorders. Creating a self-directed positive self-identity then becomes more challenging and precarious. In the recovery process, friendships, acquaintances and communities may need to be abandoned to maintain sobriety and incorporate a healthy lifestyle. This can be problematic in that it initially deepens social isolation. These instances can lead to a further withdrawal from social contact which creates challenges regarding self-image, self-esteem and overall social inclusion. If steps towards ‘social recovery’ lead to a reduction of symptoms, it is imperative for individuals who are susceptible to addiction to find meaningful relationships and supportive friendships.

With fewer options when it comes to interpersonal relationships the individual in recovery is prone to prodding the past in an attempt to reclaim valued social roles.  It is understandable that individuals with mental illness and or addictions attempt to return to some state of Eden; a time of better health or perceived ‘normalcy’. Unfortunately some of the individuals rooted in these times and places offer little more than an outdated and unhealthy identity that precede the more serious or institutional aspects of mental health difficulties. By associating with old ‘friends’ individuals are able to return to memories and unearth altered and destroyed status. Individuals can vicariously reclaim or re-experience a social identity by entering the illusion of  “I’m still that guy” or in being “one of the boys.” Addictions are often hidden within this short term and illusory construct.

For individuals with addictions, interpersonal relationships can be manipulations. Some addicts use not just substances but anyone they can to procure a ‘fix’. Those with mental health challenges or disabilities are susceptible to manipulation and may be eager to form relationships without much insight into the validity or health of those relationships. Relationships that occur through acting out addictions are a substitute or mirage of meaningful relationships. When dealers or other users accept you or you are known to them, it can be an affirmation of self. It can be a community albeit with a crumbling and precarious foundation. Standing outside these relationships we can see it is a temporary solution which exacerbates mental health and overall health but addiction by nature often renders the individual incapable of viewing themselves objectively. 

The capacity to create healthier relationships or return to mainstream existence is undermined by the ‘bliss’ experienced in altered states. Remedies and interventions often are weak alternatives to the experience of being ‘high’. It is a costly and temporary ‘bliss’ but it can be obtained with no skills, little effort and with proven or expected outcomes. What can be purchased ‘on a street corner’ is convenient, immediate and it does not require an appointment, an agency or a therapist. Substances provide temporary relief and comfort without real community. 

In Canadian culture to drink is an indoctrination into adulthood which lessens feelings of being treated as a child in healthcare. It can also be an expression of masculinity and a symbol of or celebration of hard work. For someone with a concurrent disorder it can be like jumping into a family photograph without being a relation. Essentially the individual can be more and feel less.