Drug use is an ancient practice in human history, varying according to social contexts. This study investigates the impact of proximal processes during both childhood/adolescence and adulthood on substance use, considering the role of Therapeutic Communities (TCs) in the reception and recovery of individuals. The qualitative research was conducted with residents of TCs in the state of Rio de Janeiro. The instruments used included the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and a sociodemographic inventory, with results analyzed descriptively. Data collected through semi-structured interviews were analyzed using the requalify.ai software. The categorical analysis included environmental, familial, and individual factors related to substance use. The results indicate that most participants began using drugs during adolescence, with risk factors including peer influence, dysfunctional family environments, and a family history of drug use. Social support emerged as a protective factor within TCs, contributing to the reduction of relapse in substance use. The sample showed an overrepresentation of Black and Brown individuals, highlighting the racial dimension in the history of drug use in Brazil. The study also identified a shortage of TCs focused on women and the frequent use of religious practices as a therapeutic resource. The research suggests that proximalrelationships are decisive in the development ofsubstance use disorders. Dysfunctional family environments and the generational transmission of violence are risk factors. Reception inTCs can act as a protective factor. The study emphasizes the need for inclusive, evidence-based public policies for the treatment and prevention of drug use in Brazil.