Dedicated Swedish Football Supporters’ Narratives about Alcohol and Drug Use and Treatment Needs: An Interpretative Phenomenological Analysis Interview Study

ABSTRACT

It is known that dedicated football supporters consume large amounts of alcohol, and sometimes drugs. Yet, studies have not examined how dedicated supporters perceive substance use, and what treatment needs they have. In this study, seven dedicated supporters were interviewed about their perceptions of supporter culture, the relational aspects of it, substance use patterns, and treatment needs. The interviews were analyzed using interpretative phenomenological analysis. The participants could not imagine supporter culture without alcohol. Three participants had experienced difficulties with substances. All were ambivalent about substance use patterns among supporters and understood the risks. Simultaneously, they appreciated the support, familiarity, and sense of being part of something larger that supporter culture provided. Some sensed that the companionship could be supportive for those struggling with substances. Others sensed that the closeness of the group hindered recovery. Participants underlined agency and responsibility and sensed that one needs to understand why one made the choice to be part of a group that was characterized by substance use patterns connected to traditional masculine ideals. Therefore, assessment and treatment need to be person-centered, acknowledge choices, the context, the gendered behaviors that are enacted through substance use, and whether the context could support or hinder recover.

KEYWORDS:

• alcohol
• cocaine
• football
• supporter culture
• masculinity

Football (soccer in the US) is a global phenomenon, attracting hundreds of millions of passionate supporters (Cleland & Cashmore, 2016). Football culture and alcohol use have been described as interrelated (Newson, 2019; Ostrowsky, 2018; Varela, 2014) and a significant part of the audience at football events is intoxicated, especially in the supporter section (Durbeej, Elgán, Jallin, Gripenberg, & Doran, 2017). The high level of alcohol use among football supporters has, for example, been examined in Brazil (Nepomuceno et al., 2017), Mexico (Varela, 2014), the UK (Pringle et al., 2011), and Sweden (Durbeej et al., 2017).

Football supporters can be divided into several groups. One group consists of supporters with a propensity for violence. The term hooligans is often used for them, and many, albeit not all, self-identify as hooligans (e.g. Grodecki & Kossakowski, 2021; Raadman, 2014; Spaaij, 2008). Some violent supporters belong to so-called firms, who fight each other in organized fights. Violence between firms can also erupt spontaneously, for example if supporters who belong to one firm is found in a geographical area controlled by another firm. There may also be disruptive behaviors and vandalism in urban areas, which can be described as mob violence (e.g. Nepomuceno et al., 2017; Newson, 2019; Pearson & Sale, 2011).

Violence, as well as alcohol and drug use among so-called hooligans has been thoroughly researched, whereas the significant group of loyal supporters without tendencies for violence, has not attracted the same level of interest (Cleland & Cashmore, 2016). Loyal supporters in turn consists of subgroups. Some support the violent supporters without being violent themselves. They have been called hoolifans (Rookwood & Pearson, 2010). Others enjoy watching the games and often dress in team merchandise. Among them are proportionately more women and families than in the other subgroups. Still others are so-called dedicated supporters who have strong emotional bonds to their team and to other dedicated supporters. They spend considerable time following their team and perceive their fandom as an intrinsic part of themselves and their lives (Cleland & Cashmore, 2016).

The present study concerns alcohol and drug use, onwards termed substance use (Kelly, Saitz, & Wakeman, 2016), among dedicated supporters in Sweden, a country that has been influenced by the British supporter culture, in which alcohol and drugs, specifically cocaine, has a central place (Adams, Coleman, & White, 2014; Ayres & Treadwell, 2011; Newson, 2019). The high level of alcohol use is a health risk for the supporters (Kingsland et al., 2015; Pringle et al., 2011). In order to reduce consumption, alcohol has at times been forbidden at arenas in some countries, not least in the UK. The effect of this intervention is, however, uncertain since people may drink in other places and before or after the games (Kingsland et al., 2015; Pearson & Sale, 2011; Purves et al., 2021).

There is also a link between football, alcohol, drugs, and violence (e.g. Cleland & Cashmore, 2016; Newson, 2019; Ostrowsky, 2018). It has been argued that relatively small groups of so-called hooligans enact violence and disturbances, and use drugs, whereas other researchers maintain that drugs, predominantly cocaine, are integrated into the whole supporter culture (Cleland & Cashmore, 2016; Newson, 2021; Rookwood & Pearson, 2010). It should be noted that alcohol intoxication can contribute to cocaine use (Guo, Ward, & Speed, 2020) and that individual alcohol use is influenced by the consumption of others (Bernhardsson, 2014; Ormerod & Wiltshire, 2009). The supporter culture is distinctly masculine, and stereotypical ideas about masculinity can foster substance use and violent behaviors (Burstyn, 1999; Cleland & Cashmore, 2016; Dunning, 1986; Van de Mieroop, 2009). Social context and relationships indeed influence the development, maintenance, and termination of SUD (Allen & Olson, 2016). Therefore, context and relationships need to be acknowledged in treatment aimed at persons with risky substance use, mild to severe AUD and/or SUD (American Psychiatric Association [APA], 2013).

Dedicated supporters develop tight social relationships with each other. They encounter each other regularly, when viewing games as well as on other occasions. Since alcohol tends to be consumed regularly, there is a risk of developing AUD. Having said this, it should be noted that football also means joy and community (Hirsch, Blumberg, & Watson, 2021) and may support young people with social difficulties to find meaning and connectedness (Smyth, 2014). Nevertheless, since alcohol and drugs (especially cocaine) are central to the supporter culture, it can be assumed that a significant number of supporters consume alcohol and/or drugs to such an extent that they develop AUD and/or SUD and need treatment. Alcohol- and drug-related conditions are increasing worldwide, and individuals with such conditions should be approached in non-stigmatizing ways and receive support and treatment (Kelly et al., 2016). Treatment and measures of substance use reduction need to be comparable and reliable so that it is assured that the patients receive effective interventions (Gidhagen et al., 2017). Simultaneously, treatment needs to acknowledge that patients use substances for a variety of reason, in a variety of contexts, and that substance use is intermingled with experiences of identity (Kellog & Tatarsky, 2012). Dedicated football or other sports supporters may benefit from specifically targeted treatment. To achieve this, knowledge about the supporter culture, patterns of substance use, and how supporters perceive substance use is needed (Purves et al., 2021). No other studies were found that have focused on providing dedicated supporters the opportunity to discuss patterns of risky substance use or treatment needs. Treatment aimed at supporters is an unexplored area. A search in the databases Cochrane Library, PsycINFO and PubMed with various combinations of the terms alcohol, cocaine, dependence, drugs, fans, football, hooligans, misuse, soccer, substance use, risky alcohol use and drug use, supporters, and treatment, performed in July 2022, yielded no results.

SUD treatment may indeed be effective. A multi-center study investigating the results of outpatient alcohol treatment showed that treatment is often successful, not least for clients with a relatively low level of alcohol use who strive for total abstinence (Haug & Schaub, 2016). Likewise, Gidhagen, Philips, and Holmqvist (2017) found that clients who receive treatment from social workers or psychotherapists often reduce their substance use and recover from psychological distress. Both studies however note that some clients are not improved. Moreover, people with AUD and SUD may terminate their use without professional treatment (Peele, 2016). Altogether, this indicates that for some groups of clients, treatment needs to be improved. For dedicated football supporters, addictive substances are often an integral part of their social life, yet their treatment needs are unexplored. Accordingly, the aim of this interview study was to obtain knowledge about substance use patterns and treatment needs among supporters. The participants were dedicated supporters who are central figures in the networks surrounding their respective teams. As central figures, they may be seen as guardians of traditions, norms, and behavioral codes and, thereby, they become role models for other supporters (Raadman, 2014). Accordingly, they are central in transferring traditions, norms and behavioral codes of the supporter culture to new generations, and they can provide rich information about the supporter culture and how alcohol and drugs are consumed in it.

Methods

Procedure and participants

Dedicated football supporters who are central figures in their supporter culture are not organized in formal associations but know each other through informal networks. Therefore, they are not easily recruited. Participants were recruited through a gatekeeper who knows many supporters of different teams. Contact with gatekeepers is an established method in research concerning groups that are difficult to reach (Poulton, 2012). The researcher must, however, consider that gatekeepers can influence the recruitment process (Crowhurst & kennedy-macfoy, 2013). The gatekeeper was informed that inclusion criteria were; (1) involvement in the dedicated supporter culture, (2) a wish to discuss substance use patterns among dedicated supporters, (3) stable life situation. Exclusion criteria were; (1) current risky alcohol or substance use (2) unstable life situation, mental health issues, or criminal activities. The gatekeeper was informed not to pursue participation from anyone.

To permit exploration of the participants’ narratives about their experiences, a small number of participants is appropriate in interview studies centered on understanding the participants perspectives and experiences (Robinson, 2014; Smith, Flowers, & Larkin, 2009). A minimum of six participants has been recommended (Schreier, 2018). Therefore, eight supporters were approached. One of them could not participate due to a high workload. Seven cisgendered, heterosexual men, aged 24–56 participated. Five had no tendencies toward violence, two had occasionally been involved in violence, but did not identify as hooligans. All were employed or self-employed. Six were in stable relationships or married and had children, one was single. One participant had studied at university, the others had graduated from upper secondary school. All lived in Gothenburg, the second largest town in Sweden, where football fandom is significant. To safeguard anonymity, no further details are provided.

No formal assessment of substance use was made. During the interviews it, however, came forth that all participants had consumed alcohol. All but one had used drugs, mostly cocaine, but occasionally also MDMA and amphetamine. None had been physically dependent on drugs, but three participants had, however, consumed considerable amounts and had experienced difficulties with substances. They had not sought health care treatment and accordingly they had not been diagnosed with AUD or SUD. To avoid substances, they had decided to be less active in the supporter culture. Two had sought treatment outside of the health care system. One had been in cognitive behavioral therapy and one in 12-steps treatment. None of them perceived treatment as helpful and both had discontinued it. Since no formal assessment of substance use was made in the present study, and since the diagnosis of AUD/SUD has not been in focus in prior research, the terms to define substance use were risky and misuse in this study. It should be noted that the substance use patterns the participants described are similar to descriptions of binge drinking Ormerod & Wiltshire, 2009).

Interview

This study concerns personal experiences of an unexplored phenomenon. Open interview questions are recommended in such studies, since they permit the participants to share their narratives and personal experiences in their own ways (Englander, 2020; Seidman, 2019). Thereby, unexpected aspects of the studied phenomenon may emerge and the participants can control what they want or do not want to share, which is ethically appropriate.

The interviews were performed by the author. At the beginning of each interview, the participant was asked to relate his perception of the supporter culture, and his part in it. Thereafter, the following topics were explored; (1) patterns of substance use and the motives for using alcohol and drugs, (2) social interactions and relationships among supporters, (3) the connections between supporter culture, substances, and violence/aggression, (4) suggestions for assessment and treatment. The questions and their ordering were adapted to each participant’s evolving narrative. During each interview, follow-up questions were asked to assure that the interviewer understood what the participant had conveyed, and that the topics were explored in depth.

The interviews were conducted in a place that suited each participant, such as his workplace or home. With the participants’ permission, the interviews were audio-recorded. The author transcribed the interviews verbatim, including pauses, laughter, and tone of voice. The interviews were 40 to 90 minutes long.

Analysis

The interviews were analyzed using interpretative phenomenological analysis (IPA). In IPA, the lived experiences of the participants are in focus. The aim is to understand how the participants understand the studied phenomenon in its context (Smith et al., 2009). The lived experiences are explored in detail which permits an understanding of topics and perspectives that are new to the researcher.

In this study, each interview transcript was first analyzed separately. Thereafter, similarities and differences across the interviews were examined. Thereby, shared as well as individual understandings of the studied phenomenon were scrutinized.

In the first step of the analysis, each interview was read, and codes were formulated for all statements that were relevant to aim of the study. The next step was to group these codes into subthemes. In the third step, subthemes from all interviews were analyzed together, creating the four themes that are to be presented. These themes were; Alcohol and substances as part of life, Masculinity and familiarity, Being “right,” and A closed group. This means that in the third step, the analysis moved from the idiographic level to a conceptual, interpretative level. The themes were repeatedly compared to the codes and the interview transcripts, to assure that the data had not been distorted. Thereafter, relevant quotes for each theme were identified. In the last step, the presentation was written, and it was assured that quotes from all participants were represented. To ensure anonymity, quotes have been slightly changed, without distorting the meaning of what the participant conveyed.

Personal and ethical considerations

I am a clinical psychologist and a researcher in social work and I have worked in treatment units within Swedish public health and social care, aimed at clients with AUD/SUD. There, I encountered several dedicated supporters who sought treatment. My impression is that we, and the methods we worked according to (structured assessment of substance use and psychiatric diagnosis, medication, and counseling/psychotherapy based on cognitive-behavioral or psychodynamic perspectives), were insufficient to support clients whose substance use was connected to an interest and a social life that also had many positive parts, and provided meaning and friendship. Since alcohol use among football supporters is known to be high (Kingsland et al., 2015) I sense that it is ethically important to obtain increased knowledge about substance use among supporters and how assessment and treatment could be adapted to their needs.

The participants were informed that they decided what they would like to share during the interview. They were also informed that no one except the author had permission to listen to or read their narratives, and that no one could be identified in the final report. Individuals with current difficulties with substances, mental health, or criminal activities were not included. Thereby, vulnerable individuals were not exposed to questions that could invoke overwhelming distress. The study was approved by the Regional Ethics Review Board, Gothenburg, number 2020–04658.

Results

Alcohol and substances as part of life

When the participants spoke about alcohol use, their own as well as the patterns of use among supporters, alcohol came forth as an ever-present part of life. Some participants expressed that it was only during the interview that they understood how ever-present alcohol had been. None of them could imagine supporter culture without alcohol. All participants expressed concern about the central position of alcohol and during the interviews they also could laugh at themselves and their consumption.

I have to laugh about it, even though I’m part of it and it’s important in my life. I mean, what’s the matter with us? Can’t we do anything else but drink beer (laughs). It’s not even alcohol. It’s beer. Some of us, now when we’re older, can enjoy wine. But not in connection with football.

The participants were indeed ambivalent about alcohol. Drinking was connected to joy and celebration, but simultaneously all but one participant had experienced phases in their life, when alcohol had been misused. They saw this as connected to their social context in which alcohol, and sometimes drugs, had been central. Simultaneously, they understood themselves as fully responsible for their substance use. The capacity to drink and to handle alcohol, was described as normative in supporter culture. It could be tolerated to occasionally lose control, but it was important not to ruin the reputation of oneself and of the supporters as a group. The participants related that some supporters they had known had developed alcoholism and, therefore, were not part of the supporter group anymore. Central figures had authority and could, therefore, sometimes tell others to slow down their drinking, but risky substance use, misuse, or treatment needs were seldom discussed in the supporter culture. The participants sensed that they probably could be better at supporting each other not to drink. Nevertheless, they said that a certain amount of risky substance and misuse will probably always be present in the supporter culture. Some sensed that drug use was in fact increasing. One of the younger participants said;

You who are a bit older don’t understand how much drugs there are among young people. Not only in the supporter culture but everywhere, also among girls. It’s too late … it’s impossible to stop. I don’t say this because I like it or excuse it. I’m just stating the facts.

None of the participants idealized drugs, downplayed their harmful effects, or excused their own alcohol or drug use. They said that they had made these choices and understood substances as a part of the supporter culture, which could get out of hand. The three participants who had used too much asserted that they knew what they were doing and could not blame anyone else or anything for their personal mistakes. They did not understand risky substance use or misuse as an illness but rather as a result of shortcomings connected to their life situation, to the context, and to a series of choices. One of these three participants expressed it in the following way;

I knew I was drinking too much and was too much into nightclubs and drugs. When I sought help, I wanted to understand why I made these choices, what was wrong in my life, so I could change it. Because things were wrong in my life. But the therapist only wanted to talk about how many beers I drank, as if drinking and partying was something that could be distanced from the rest of my life.

The participants proposed that if r alcohol and drug use among supporters is to be decreased, authorities and practitioners need to cooperate with representatives from the teams and the supporters. One participant said that “The supporter group could be supported to support people.” Campaigns were understood as meaningless. The participants did, however, sense that they themselves could be better at supporting each other to refrain from alcohol and drugs and engage in activities that are not connected to substances.

They also sensed that practitioners who encounter football supporters who want to reduce or terminate their substance use need to discuss the client’s social network during assessment as well as during treatment.

I think you should ask all clients about their social life, very carefully. Supporter culture is imbued with alcohol but I guess there are many other subcultures in which people drink a lot. You need to address this when someone asks for help, and follow up on it.

Masculinity and familiarity

When asked to describe his perception of the supporter culture, and his part in it, one participant exclaimed “I love male companionship!.” The other participants were less explicit in this respect, but they all understood supporter culture as an inherently masculine form of companionship. The socialization into supporter culture was equally described in terms of male companionship. Below is an example;

I didn’t have a very good relationship with my father. One of the few things we did together was to watch football. When I’d grown up, we re-connected and we did this through football.

Supporter culture was described as “easy” and “safe” since the activities and ways of socializing were familiar. Dedicated supporters meet at the same places, drink beer, dress in the same way and talk about the same topics. This provides a safe, calm space in which one does not have to accommodate unexpected demands. Everybody knows what is expected and everybody wants the expected. This means that there is a sense of connection with the past and with something that is larger than oneself. This experience was understood as valuable.

The participants also expressed a striving to support each other, if someone for example went through troubles at work or at home. The support was direct; a hug, a hand on the shoulder, some comforting words, and an assurance that others understood what one went through. During the interviews, the participants could laugh at themselves, their longing for familiarity, and their portrayal of themselves as stereotypical men who did not talk very much. Simultaneously, they appreciated the tendency not to talk too much. There are other ways to communicate, they said. One participant explicitly said that he enjoyed supporter culture and other forms of male companionship precisely because ideas about “talking things through” were lacking. Some years ago, he had experienced a difficult time in his life. When he went to the games, he told his friends how he felt. After a while one of them said “Don’t think about it anymore. Here, have a beer.” He sensed that this was a form of support that he needed in order to stop ruminating. He felt cared for, but simultaneously he understood this as an example of how alcohol is too important in the supporter culture.

All participants but one were self-critical concerning the dominance of men in supporter culture. They appreciated that young women are increasingly becoming dedicated supporters but sensed that something in supporter culture is inherently masculine. They expressed no derogatory views about women or female supporters. There were, however, some ambivalences, since they appreciated their male, familiar zone, and its predictability. Some participants found this somewhat embarrassing. One said that he was “not proud of it. But it’s the way it is.”

Being “right”

The participants described that the part of supporter culture they belong to is intermingled with other lifestyle choices, esthetics, and subcultures. Therefore, one is eager to wear the “right clothes” and listen to the “right music.” One subgroup of dedicated supporters is even called “dressers.” Dressers have the “right clothes” and wear them in the “right ways.” Certain brands are popular among dedicated supporters, but the “true dressers” are beyond these popular brands and rather introduce new expensive brands without well-known logotypes. All but one participant discussed the importance of brands and esthetics as a form of commercialization of supporter culture. The commercialization was also connected to pop culture and participants were influenced by the lad culture of the nineties (even though some of them were not old enough to have been part of this culture when it flourished). This culture developed in the UK, when successful rock musicians who engaged in sometimes provocative, hedonistic behaviors also expressed their interest in football. The connection between supporter culture and the “right” music”, nightlife, people, and places became pronounced. What was understood as “right” was, however, not easily defined. One participant said; “You just know. And you can immediately spot when someone thinks he’s right but is not.”

The interest in fashion, music, and nightlife was connected to ideas of belonging to an “elite.” When one belonged to the “elite” (as participants did), it was equally important to distance oneself from what was not right, such as supporters dressing in team merchandise and ordinary people who enjoy watching the world championship. Belonging to the laddish subculture included a hedonistic lifestyle in which drugs, specifically cocaine, were central. Cocaine was perceived as a marker of being exclusive, non-ordinary. The participants who had used cocaine could laugh at the lad-culture, and their own ideas of belonging to an “elite,” yet it was or had been important to them. They were aware of the dangers of cocaine and were critical of the tendencies to glorify this drug. Simultaneously, they sensed that occasional use of cocaine should not be problematized too much since alcohol could cause more problems, not least since alcohol is harder to avoid because it can be found anywhere in society. It should also be noted that some participants regretted their involvement in the “shady” aspects of supporter culture. One participant said;

Since we are role models for younger fans, they did what we did. They looked up to us and started using drugs because they wanted to be part of this core. Some couldn’t handle it. Drug use has never affected me, but it sure affected some younger supporters. It’s not pleasant to have contributed to that.

The importance of pop culture, and alcohol, also appeared in football arenas. Parts of the arena sometimes had bars and disc jockeys. These parts were not open to everyone. Even though the participants enjoyed this they were also critical of it. One participant said;

When I was a boy, before football was cool and connected to pop culture, and clothes and everything … It was easy. People were there, having fun together, having a cup of coffee or a hot dog … In many ways it was better. I sometimes miss it.

A closed group

The participants understood themselves as part of a closed group in which loyalty is central. This loyalty includes not revealing too much about the lifestyle and the supporter culture to outsiders. During the interviews, some participants spoke openly about drug use while others occasionally did not relate any details about drug use and the nightlife they had been involved in.

It also became apparent that those who belong to the closed “elite” group of supporters tend to be perceived as authorities who can approve of, and control, others. A supporter with tendencies to get too intoxicated and to misbehave could not be part of the “elite” the participants belonged to. Those who got too heavily drunk on a regular basis were understood as embarrassments and they attracted attention that the group wanted to avoid.

One had to earn one’s place in the group. Through participating for longer periods of time, being loyal, contributing, and adhering to the norms and hierarchies, one could become accepted. The group was supportive but also demanding. One needs to prove one’s commitment, for example by prioritizing the group and its activities over other parts of life, and by not questioning the norms and activities, including drugs and violence. One participant said; “If you’re in this group, you don’t need to do drugs but you cannot be opposed to them. You must accept them.”

The closeness could indeed hinder a person from refraining from substance use. The participants, therefore, suggested that practitioners who encounter supporters who seek out substance use disorder treatment need to understand that it might be necessary to change and perhaps abandon one’s whole social life, which is difficult.

Some participants pondered how football clubs and supporter groups could contribute to those who experienced difficulties with risky substance use or misuse. One suggestion was to find responsibilities or tasks to fulfill in the club, so that those who experienced difficulties with substances could benefit from the sense of connectedness that characterizes supporter culture, but without being close to bars or games, where substances are consumed. Other participants understood it as impossible to be part of supporter culture if one had developed substance misuse, since the context is too imbued with alcohol. It also came forth that it can be difficult for dedicated supporters to seek help, and probably difficult for others to help them, since they want to be a bit of outsiders. There is a tendency to try to solve difficulties without involving others outside of the group. This tendency has benefits, as people can support each other, but it also has disadvantages. Since the group is closed and the ways of interacting are so established it is, according to participants, difficult to find new ways of interacting and difficult to avoid alcohol and illicit substances. The participants understood it as important to sort out what is truly one’s own ideas and preferences from what is part of the supporter culture, which one may have to leave in order to reach sobriety. One participant who had experienced difficulties with substances expressed it in the following way;

I had to quit. It was too risky for me. I’ve found other groups to be part of. We can have one beer or two but drinking is not central to the activities and the group is not so closed, it’s more open.

Discussion

During the interviews, the participants reflected on themselves, their choices, their substance use, and the supporter culture they had been, or were, part of. They appreciated most parts of this culture, not least the friendship, joy, and familiarity it provided. Simultaneously, they were ambivalent about the omnipresent substance use and often laughed about themselves and the culture to which they belonged. Fashion, pop culture, commercialization, and hedonism were recurrent topics, and participants underlined that these topics must be acknowledged in order to understand the patterns of substance use. The participants’ positions in the supporter culture and their knowledge about the right styles, music, and nightclubs meant that they belonged to the core of dedicated supporters. This was connected to a sense of responsibility toward other supporters, specifically young persons who could imitate authorities and, for example, consume drugs in order to be part of the core. The friendships and the closeness of the group provided support, joy, and a sense of tradition and being part of something that was larger than oneself. Simultaneously, the closeness and the familiarity could fuel hedonistic ideals and substance use that was difficult to terminate. It was also difficult to sort out the ideals of the group from the ideals of oneself, and to seek treatment.

It was understood as normative to drink, to control oneself and one’s intoxication, and to control others, not least to diminish the risks of drawing attention to the group. The tendencies to control oneself and each other, as well as the hierarchal structures of the group and the avoidance of attention, are similar to tendencies among violent supporters (Cleland & Cashmore, 2016; Spaaij, 2008). The participants were, however, nonviolent, and one can wonder why control and avoidance of attention were so important to them. Tentatively, these tendencies can be understood with respect to the use of cocaine, which is illegal, but they can also be understood with respect to wishes to be a closed “elite” group, which can be seen as a traditional masculine form of socialization (Dunning, 1986; Raadman, 2014; Rookwood & Pearson, 2010).

Some participants understood the friendship, familiarity, and closeness of the group as a possible source of support for someone struggling with risky alcohol or substance use or AUD/SUD. Others sensed that the group should be avoided since substances are ever-present and, therefore, sobriety and recovery are difficult to achieve. It should be noted that men, as a group, have an increased risk of substance misuse (Bernhardsson, 2014). Based on the results from the present study, it may be suggested that substance use patterns among men, their motives for drinking, and the potential possibilities and risks associated with male companionship need to be addressed in assessment and treatment. For example, it should be considered whether peers could support recovery or whether they should be avoided, at least until stable sobriety has been reached. This is reasonably relevant, not only for football supporters, but also for members of other subcultures in which substance use is normative.

Cocaine use is established among so-called hooligans and some researchers describe cocaine use as established in the supporter culture as a whole, not only among violent supporters (Cleland & Cashmore, 2016; Newson, 2021; Rookwood & Pearson, 2010). The results from this study indicate that cocaine use is well-established also among nonviolent dedicated supporters. Accordingly, practitioners who encounter football supporters who seek treatment need to take both alcohol and drugs into consideration. The participant who described that his therapist only wanted to talk about beer, illustrates the need for proper assessment and for considering the context, a variety of substances, the gendered behaviors that are enacted through substance use, and the life situation of the client. Otherwise, there is a risk that treatment becomes ineffective, and/or that the clients discontinue, as the two participants who had tried cognitive behavioral therapy and 12-step treatment respectively. These and other forms of treatment are beneficial for many clients (Gidhagen et al., 2017; Haug & Schaub, 2016). What comes forth in the present study is that treatment should, however, not be provided as a routine, or as a technical act, but should be adapted to the specific needs of the client, and the client’s context.

Participants of this study did not understand substance misuse as a disorder or an illness, but rather as a result of a series of bad choices, a troubling situation, the lifestyle one had adopted, and the hedonism that was intertwined with commercialization, ideas about masculine behaviors, and male socialization. It is important for persons struggling with AUD or SUD to find their own agency and see what choices they can make in order to obtain sobriety (Peele, 2016). Prior studies have shown that alcohol use is influenced by norms about drinking as well as by the use of others (Bernhardsson, 2014; Guo et al., 2020; Ormerod & Wiltshire, 2009). In line with this, participants acknowledged the importance of norms and contexts for their own substance use. Simultaneously, participants, including those who had experienced difficulties with substances, acknowledged their own choice to be part of this context and to use substances. They underlined that they knew what they did, and the risks connected with it. This means that they express a sense of agency and responsibility, which could be a starting point for person-centered treatment interventions that recognize both personal understanding of substance use and misuse, and how choices that support recovery can be made. Thereby, the treatment interventions acknowledge the social contexts and relationships that influence the possible maintenance or termination of alcohol and drug use (Allen & Olson, 2016).

The results from this study suggest that dedicated sports supporters who seek AUD or SUD treatment benefit from a thorough assessment that recognizes a variety of substances as well as their contexts and friendships, including how friendships may support or hinder the capacity to refrain from substances. Assessment and treatment should examine the client’s understanding of prior choices as well as the capacity to make nondestructive choices, currently and in the future. Thereby, interventions become person-centered and support agency. It also seems relevant for practitioners to examine, together with their client, whether the context can be supportive, or whether the client should avoid the context, at least until stable recovery is achieved. When doing this the practitioner should be mindful about possible patterns of binge drinking (Ormerod & Wiltshire, 2009).

Assessment and treatment interventions that acknowledge the context and whether it can hinder or strengthen recovery are likely relevant also for persons (men, women, transgendered persons, and those who identify as non-binary) of other subcultures in which substances are ever-present. To sort out the choices and preferences that are sincerely one’s own from the choices and preferences that are connected to norms and expectation of one’s social context is relevant not only for dedicated supporters. Perhaps it is relevant for anyone, given that norms and expectations about substances influence all of us, albeit to varying degrees. Thanks to the participants, the importance of the context, the norms, and the expectations have been elucidated and may be usefully applied to other cohesive group situations, such as exist for US football, baseball and basketball.

Limitations and future studies

This study is limited by the low number of participants and by the possible biases connected to the recruitment process. Dedicated football supporters are difficult to reach, and this was one possibility. Future studies could involve dedicated supporters who are outside of the core groups the participants belong to. Likely, they are easier to reach, and they may contribute additional perspectives on substance use patterns among supporters, and treatment needs. Based on the results from this study, it is only possible to give suggestions on how assessment and treatment can be improved. In order to gain further knowledge about treatment needs and what kinds of interventions are effective, dedicated supporters who are in treatment should be interviewed and followed for progress. It is also important to understand what kind of knowledge practitioners have and what they need in order to provide relevant treatment to clients who belong to subgroups and contexts in which alcohol and illicit substances are ever-present parts of life. Future studies should include substance use patterns and perspectives of female supporters.

Acknowledgments

I would like to thank Professor Cornelia Wächter for her support during the preparation of this paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.