Introduction: Substance Use Disorder (SUD) remains a critical public health issue due to high relapse rates, substantial individual and community costs, and persistent treatment gaps.
Purpose: This systematic review (2017-2025) examined how motivation, recovery capital, and systemic barriersinfluence sustained recovery from SUD, with implications for clinical practice and public health.
Method: Following PRISMA protocols, peer-reviewed studies were systematically identified, screened, and thematically synthesized. Inclusion criteria required studies that addressed recovery maintenance, relapse prevention, or long-term abstinence.
Results: Three key themes were identified. First, intrinsic motivation (personal growth, self-efficacy, and autonomy) strongly predicted sustained recovery, whereas extrinsic motivation often supported short-term change but lacked long-term stability. Second, recovery capital—spanning social, human, physical, and cultural resources—was consistently associated with resilience against relapse. Supportive networks, access to healthcare, financial stability, and positive self-concept emerged as critical protective factors. Third, barriers such as stigma, economic vulnerability, comorbid mental illness, and structural inequities undermined treatment engagement and long-term recovery. These barriers were especially pronounced in low-resource and high-prevalence contexts, including South Africa.
Conclusions: Findings suggest that recovery is strengthened when motivational enhancement strategies are integrated with asset-based approaches that expand recovery capital. Clinically, practitioners should focus on building intrinsic motivation and leveraging clients' social and community resources. From a public health perspective, reducing stigma, improving equitable access to services, and addressing socioeconomic inequalities are vital to sustainable recovery outcomes. This review highlights psychology's critical role in shaping both individual and systemic responses to SUD.