INTRODUCTION: Music therapy supports individuals with substance use disorders (SUD) in their recovery. Although robust quantitative research exists on the topic, research on subjective experiences of people with SUD is scarce. This qualitative study offers a retrospective perspective on clients with SUD at treatment centers, exploring the impact of music consumption and music therapy on their recovery process, examining the varying experiences of participants from treatment centers providing music therapy and participants from treatment centers not providing music therapy. METHODS: This phenomenological study included semi-structured interviews with 23 clients with SUD from treatment centers in Israel. Six participants came from treatment centers providing music therapy. Participants from treatment centers without music therapy consisted of two groups: those from treatment centers with a policy prohibiting all music (n = 4), and those from treatment centers allowing all types of music (n = 13). RESULTS: Content analysis revealed that at treatment centers providing music therapy, participants completed a 4-stage process: 1) developing awareness of problematic music as a trigger to possible relapse
2) avoiding problematic music
3) finding alternative music genres to enjoy
4) developing tolerance to problematic music. At treatment centers without music therapy and having a policy prohibiting all music, participants developed anxiety towards music, and consequently one person relapsed. At treatment centers not providing music therapy but allowing all types of music, some participants achieved stages 1 to 3, some did not, and two participants relapsed. CONCLUSIONS: At treatment centers providing music therapy, participants completed a four-stage process in which they developed tolerance to problematic music. At treatment centers not providing music therapy, participants failed to develop tolerance and some relapsed. The ability to develop tolerance to musical triggers seems crucial for rehabilitation, as music is fundamental for human life and cannot be completely avoided outside treatment. The current study calls policy makers in the field of treating clients with SUD to incorporate music therapy in treatment programs.