At the same time, it is important to recognize that the experience of solitude can be sought-after, and that this itself can provide a motivation of substance use. Recent theorisation of solitude has challenged its inevitable characterization as pathological (13), highlighting the importance of time spent alone for well-being (14, 15). Moreover, collective desire for solitude can itself be a source of shared experience (16). It is therefore necessary to distinguish between solitude as deliberate withdrawal, and isolation as an involuntary loss (or non-existence) of social ties, implying an absence of or alienation from social relationships. The state of being alone can be intentional or unintentional; destructive or restorative; situational or existential