Background: Hospital readmissions are often viewed as negative healthcare outcomes. However, readmissions to substance use disorder treatments are common, integral to the recovery process, and poorly understood in terms of influencing factors and contextual realities, including whether they signify a negative outcome.

Objective: To evaluate the risk factors associated with substance use disorder treatment readmission and explore the contextual factors influencing this risk in the Chilean population. Method: Using a mixed parallel convergent design, we analyzed 107,559 treatment episodes among 85,048 patients (2010–2019) to assess readmission risks. Additionally, we conducted 14 in-depth interviews to explore contextual triggers, including social relationships, family support, and readmission decisions. A joint display integrated qualitative and quantitative findings.

Results: We found that patients who completed a residential treatment are not at lower risk of readmission. Patients declared being unprepared for post-discharge challenges, particularly when returning to areas with presence of drug trafficking. Women experienced higher readmission risks (vs. men) in both ambulatory and residential settings. Women felt family and societal pressures to return to treatment, especially when they had children. Participants experienced a shift in motivation for treatment, transitioning from external pressures to personal well-being.

Conclusion: Recovery is frequently a nonlinear process, thus, substance use disorder treatment readmission is not always a bad outcome. In certain scenarios, it may underscore a patient's proactive commitment to health, even if they face relapses.