Snapshots From the “Edge” of Recovery: Using Photovoice for Community‐Based Participatory Research on Addictions in Rural Areas
Marissa D. Abram, Courtney Swinkels, Kari Bail, Chrisann Newransky, Dalton Barrett, Lemuel Scott, Devon NoonanABSTRACT
Purpose
To examine how multilevel factors shape substance use recovery in a rural North Carolina county and influence access and engagement with treatment and recovery services.
Methods
This qualitative participatory study used Photovoice and semi‐structured interviews with adults with lived experience of substance use recruited through local harm reduction and recovery organizations in rural North Carolina.
Findings
Four interrelated themes emerged: (1) place‐based safety, in which rural environments functioned as both protective and constraining; (2) trust‐centered care as foundational to engagement; (3) recovery as self‐determined and sustained through supportive relationships; and (4) punitive and fragmented systems that destabilized recovery trajectories.
Conclusions
Recovery in rural contexts is relational, place‐based, and structurally mediated. Strengthening rural recovery systems requires community‐informed approaches that reduce structural barriers and expand accessible, person‐centered care.