Table 2 Categories, themes, and subthemes

Recovery-specific challenges

 Adopting “recovery first” mindset

 Ecological changes

 Resisting triggers

 Recovery resources

 Struggle aligning with recovery goals

 Slips/return to use

72 (78.3%)

12-step recovery supports

 Higher power

 “Life was unmanageable”

 Mantras

 Meetings

 Sponsorship

 Step work

76 (82.6%)

Self-care and coping skills

 Communication/reaching out

 Exercise/physical activity

 Maintain/create balance

 Meditation/mindfulness

 Prayer

 Sober activities

 Stress management

 Time management

 Weekend activities

62 (67.4%)

External supports and community

 Campus-based community

 Community service

 Encouragement from others

 General social support

 Recovery community (CRP)/

 Sober network

 Sober housing

70 (76.1%)

Mental and behavioral health

 Addiction dependency symptoms

 Anxiety/depression

 Group and milieu therapy

 Other behavioral health challenges

 Substance use/mental health treatment

 Wanting to die

52 (56.5%)

College environment

 Academic challenges

 Academic successes

 Navigating social life in college

 Abstinence hostile environment

54 (58.7%)

Life challenges

 Feeling different

 Financial challenges

 Negative life events

 Sources of stigma

39 (42.4%)

Relationships with others

 Family dynamics (support and history of substance use)

 Helping others

 Re-establishing/repairing relationships

 Relational harm

Romantic relationships

36 (39.1%)

Personal motivations and attributes

 Accountability

 Desire for change

 Future orientation (life goals, purpose, new mindset)

 Honesty

 Self-efficacy

38 (41.3%)