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Drazdowski TK, Castedo de Martell S, Sheidow AJ, Chapman JE, McCart MR. Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults With Polysubstance Use: Protocol for a Feasibility, Acceptability, and Appropriateness Study of Launch. JMIR Res Protoc 2024; 13:e60671. [PMID: 39037768 DOI: 10.2196/60671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Emerging adults (aged 18-26 years) are the most at-risk yet underserved age group among people with substance use disorder, especially rural emerging adults, and polysubstance use is common. Recovery capital is lower among emerging adults than older adults, and evidence-based treatments are typically unavailable or not developmentally tailored, especially in rural areas. Both supportive parents (or parental figures) and peer recovery support services (PRSS) can be leveraged to better support these emerging adults. Previous research indicates parents can be engaged to deliver contingency management (CM), an extensively researched evidence-based intervention for substance use. OBJECTIVE This protocol describes a funded pilot of Launch, a novel, scalable service package that pairs web-based coaching for parents to deliver CM for emerging adults (CM-EA) at home and in-person PRSS with educational and vocational goal setting. Specifically, this protocol describes feasibility, acceptability, and appropriateness testing (implementation-related outcomes) and steps taken to prepare for a future large-scale trial of Launch. METHODS Upon the recruitment of 48 emerging adult and parent pairs from sites serving primarily rural clients, participants will be randomized into 1 of 3 conditions for this randomized controlled trial: virtual parent coaching to deliver CM-EA, in-person PRSS for emerging adults, or both sets of services. Emerging adult eligibility includes polysubstance use, a substance use disorder, and availability of a consenting parent. Emerging adults will be interviewed at baseline and 6 months about substance use, quality of life, recovery capital, parental relationship, and Launch implementation-related outcomes (6-month follow-up only). Parents, peer workers delivering PRSS, and parent CM-EA coaches will be interviewed about implementation-related outcomes at the end of the study period. Peer workers and CM-EA coaches will be asked to complete checklists of services delivered after each session. Finally, payers and providers will be interviewed for additional insights into Launch implementation and to identify key outcomes of Launch. Data analysis for emerging adult outcomes will be primarily descriptive, but parent CM-EA training adherence will be assessed using nested mixed-effects regression models of repeated measures. RESULTS Launch is currently ongoing, with funding received in August 2023, and is expected to end in September 2025, with data analysis and results in December 2026. Participants are expected to begin enrolling in June 2024. CONCLUSIONS While this pilot is limited by the small sample size and restriction to emerging adults with an involved parent, this is mitigated by the study's strengths and is appropriate for the pilot stage. Launch uses an innovative combination of existing strategies to generate better outcomes for emerging adults while remaining scalable. This pilot will provide insights into the feasibility and acceptability of Launch from the perspectives of service recipients, providers, and payers to inform a larger-scale effectiveness trial. TRIAL REGISTRATION ClinicalTrials.gov NCT06414993; https://clinicaltrials.gov/study/NCT06414993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/60671.
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Affiliation(s)
- Tess K Drazdowski
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | | | - Ashli J Sheidow
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | - Jason E Chapman
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
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Galanter M, White WL, Khalsa J, Hansen H. A scoping review of spirituality in relation to substance use disorders: Psychological, biological, and cultural issues. J Addict Dis 2024; 42:210-218. [PMID: 36772834 DOI: 10.1080/10550887.2023.2174785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Spirituality is a construct encompassing a diversity of strongly held beliefs and pursuits related to life's meaning and purpose. Empirical studies in key domains of spirituality related to substance use disorder (SUD) can be valuable in guiding research, and potentially clinical care. OBJECTIVES To conduct a scoping review of research on the psychological, biological, and cultural dimensions of spirituality and their role in relation to SUD. To identify limitations in empirical findings within these domains and identify promising areas for related research. DATA SOURCES, STUDY APPRAISAL, AND SYNTHESIS METHODS Illustrative studies available in the empirical literature are reviewed in order to characterize these three key domains. RESULTS Certain areas of importance stand out: On Psychology, attribution of SUD to a spiritual outlook; spiritual awakening; the relation of spirituality to drug craving; and spirituality in the context of psychedelic-assisted psychotherapy. On Biology, heritability of traits related to shared spiritual experience; neurophysiologic correlates of spiritually related experiences; and correlates in brain imaging; On Culture, spiritual aspects of SUD in different cultural settings; distinctions between spiritual and religious phenomena; roles that international organizations play; and context of acquiring recovery capital. The need for further research in each area is defined. CONCLUSIONS There is utility in examining the diversity of findings in the roles of psychology, biology, and culture in the SUD field. Further research, particularly applying randomization and clinical controls, would be useful in improving the effective application of the construct of spirituality in clinical care.
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Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Jag Khalsa
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Helena Hansen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Headid RJ, Doane TC, Cohen BD, Smith EC, Redden D, Stoner AM. Identifying components of recovery capital that support substance use disorder treatment completion. Addict Behav Rep 2024; 19:100538. [PMID: 38495390 PMCID: PMC10940757 DOI: 10.1016/j.abrep.2024.100538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose Individuals who do not complete substance use disorder treatment (SUDT) have similar outcomes to the untreated. Recovery capital (RC) is the collection of one's resources that contribute to the initiation and maintenance of sobriety. The aim of this paper was to identify individual measures of RC that are associated with SUDT completion. Methods RC data for 69 residents from a men's recovery center was obtained from questionnaires administered to residents at intake and after SUDT graduation or dismissal. Participant data was divided into two groups, Graduates (n = 39, age 35.87±10.83) and Non-Graduates (n = 30, age 34.35±14.44), and retrospectively analyzed to compare RC between groups at various points during SUDT and which RC measures are associated with SUDT completion. Results At baseline all participants reported limited RC and there was no significant difference in RC between groups. At graduation, Graduates reported significantly more RC in all measures when compared to baseline and Non-Graduates at dismissal. Non-Graduates reported a significant increase in Checking and Savings at dismissal but no other measure. Conclusion Baseline levels of RC in both groups were limited and not significantly different which limited the capacity of the study to identify measures of RC associated with SUDT completion. A lack of RC at onset of SUDT did not preclude SUDT completion and obtaining RC during SUDT was associated with completion as only Graduates reported increases in RC. Future study designs should include participants with variable amounts of RC when entering SUDT.
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Affiliation(s)
- Ronald J. Headid
- Edward Via College of Osteopathic Medicine-Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
| | - Trevor C. Doane
- Edward Via College of Osteopathic Medicine-Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
| | - Brett D. Cohen
- Edward Via College of Osteopathic Medicine-Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
| | - Emma C. Smith
- Edward Via College of Osteopathic Medicine-Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
| | - David Redden
- Edward Via College of Osteopathic Medicine-Auburn Campus, 910 S Donahue Dr., Auburn, AL 36832, USA
| | - Alexis M. Stoner
- Edward Via College of Osteopathic Medicine-Carolinas Campus, 350 Howard St., Spartanburg, SC 29303, USA
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Lewandowski ME, Delawalla CN, Butcher TJ, Oberlin BG. Changes in substance use, recovery, and quality of life during the initial phase of the COVID-19 pandemic. PLoS One 2024; 19:e0300848. [PMID: 38776315 PMCID: PMC11111065 DOI: 10.1371/journal.pone.0300848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/05/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted lives on a massive scale. While the pandemic appeared to worsen mental health outcomes broadly, its effects on alcohol/substance use and recovery are unclear. Many studies convolved the sociopolitical unrest beginning in May 2020 with the pandemic. We assessed pandemic-related changes in substance use, recovery involvement, and quality of life among US adults at two specified time periods that isolated pandemic effects from potentially confounding sociopolitical factors. OBJECTIVES We tested the following hypotheses: the pandemic and consequent policies (1) increased use of alcohol and illicit substances in active users; (2) increased use of alcohol/substances among people in early recovery; (3) reduced participation in recovery activities among those in early recovery, and that (4) use amount and use events correlated with impulsivity in both groups and that (5) substance use and abstinence correlated with resilience. METHODS We recruited 1,685 participants through Amazon's Mechanical Turk (MTurk). We assessed demographics, quality of life, alcohol/substance use, recovery activities, and measures of impulsivity and resilience at two time points, pre-pandemic and (early) during-pandemic. Only n = 45 (Active Users; males n = 32) and n = 34 (Recovery; males n = 20) passed data quality checks and were included in the primary analyses. RESULTS Among Active Users, weekly alcohol consumption and days spent using alcohol and illicit substances decreased during the pandemic. Resilience negatively correlated with pandemic-related substance use in early recovering participants. Significant reduction in the quality of life was coincident with a trend of lower recovery activity participation (31% decline) during the pandemic. CONCLUSIONS The reduced alcohol/substance use and participation in recovery activities might be expected from conditions that promote social isolation. The high prevalence of low-quality data from MTurk cautions for careful use of online data sourcing.
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Affiliation(s)
- Megayn E. Lewandowski
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Colette N. Delawalla
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
- Department of Psychological Science, Ball State University, Muncie, Indiana, United States of America
| | - Tarah J. Butcher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Brandon G. Oberlin
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States of America
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Kane L, Benson K, Stewart ZJ, Daughters SB. The impact of spiritual well-being and social support on substance use treatment outcomes within a sample of predominantly Black/African American adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 158:209238. [PMID: 38061630 PMCID: PMC10947916 DOI: 10.1016/j.josat.2023.209238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/22/2023] [Accepted: 11/30/2023] [Indexed: 03/18/2024]
Abstract
INTRO Substance use and associated problems often return following treatment for substance use disorder (SUD), which disproportionally impact Black/African American (AA) individuals. Social support and spiritual well-being are sources of recovery capital identified as particularly important among Black/AA adults. Social support and spiritual well-being are also posited mechanisms in 12-step; thus, this study tested the effects of social support and spiritual well-being on substance use outcomes over time, distinct from 12-step involvement, among Black/AA adults post-SUD treatment. The study hypothesized that social support and spiritual well-being would demonstrate significant interactions with time, respectively, on substance use frequency and substance use consequences, above the effect of 12-step involvement. METHOD The study drew data from a study of 262 adults (95.4 % Black/AA) entering residential SUD treatment (NCT#01189552). Assessments were completed at pretreatment and at 3-, 6-, and 12-months posttreatment. Two generalized linear mixed models (GLMM) tested the effects of social support and spiritual well-being, above the effect of 12-step involvement, on substance use frequency and substance use consequences over the course of 12-months posttreatment. RESULTS Higher spiritual well-being predicted significantly less frequent substance use during recovery (β = 0.00, p = .03). Greater 12-step involvement predicted significantly fewer substance use consequences during recovery (β = 0.00, p = .02). In post hoc analyses the effect of spiritual well-being and 12-step involvement dissipated by 3.5- and 6.6-months posttreatment, respectively. The study found no significant effects of social support over time. DISCUSSION Spiritual well-being and 12-step involvement are associated with lower substance use and substance use consequences, respectively, in the early months of posttreatment recovery among Black/AA adults. These findings contribute to the growing recovery capital literature informing paths to recovery and sources of support outside of 12-step affiliation. However, these effects diminish over time.
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Affiliation(s)
- Louisa Kane
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States of America.
| | - Katherine Benson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States of America
| | - Zachary J Stewart
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States of America
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States of America
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Byrne KA, Roth PJ, Cumby S, Goodwin E, Herbert K, Schmidt WM, Worth S, Connolly K, Uzor O, Eiff B, Black D. Recovery Barrier Characterizations by Hospitalized Patients with Substance Use Disorders: Results from a Randomized Clinical Study on Inpatient Peer Recovery Coaching. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:93. [PMID: 38248556 PMCID: PMC10815630 DOI: 10.3390/ijerph21010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Patients hospitalized with medical complications from substance use disorder (SUD) encounter unique health problems that may complicate their recovery. Recovery barriers are not well understood in this population. The study objective is to characterize recovery barriers in this patient population. Participants (n = 96) in this six-month longitudinal study were randomized to a peer recovery coaching intervention or standard of care. The primary outcome measures were qualitative, open-ended questions addressing factors interfering with participants' recovery. Data were analyzed using content analysis. Themes were identified a priori using past research on recovery capital domains; these seven barriers were (1) psychological health difficulties, (2) physical health challenges, (3) lack of social support, (4) insufficient treatment or recovery support to maintain sobriety, (5) environmental and housing concerns, (6) deficits in coping skills, and (7) lack of meaningful activities. At baseline, the most common recovery barriers were in the environment and housing (28.1%), psychological health (27.1%), and social support (22.9%) domains. At six-month follow-up, participants were asked to describe barriers they felt they had made improvement in over the last six months. The primary themes that participants reported improvements in were treatment and recovery support to maintain sobriety (52.1%), coping skills (35.4%), and social support (27.1%). Hospitalization and participation in a randomized controlled trial may be a turning point in which to address recovery barriers for patients hospitalized with complications from SUD.
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Affiliation(s)
- Kaileigh A. Byrne
- Department of Psychology, Clemson University, Clemson, SC 29634, USA; (B.E.)
| | - Prerana J. Roth
- Greenville Memorial Hospital, Prisma Health, Greenville, SC 29605, USA
| | - Sam Cumby
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Eli Goodwin
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Kristin Herbert
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - William Michael Schmidt
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Samantha Worth
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Kyleigh Connolly
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Onye Uzor
- Greenville Campus, University of South Carolina School of Medicine, Greenville, SC 29605, USA; (S.C.); (W.M.S.); (S.W.)
| | - Brandi Eiff
- Department of Psychology, Clemson University, Clemson, SC 29634, USA; (B.E.)
| | - Dominique Black
- Department of Psychology, Clemson University, Clemson, SC 29634, USA; (B.E.)
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Pettersen G, Bjerke T, Hoxmark EM, Eikeng Sterri NH, Rosenvinge JH. From existing to living: Exploring the meaning of recovery and a sober life after a long duration of a substance use disorder. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:577-589. [PMID: 38045010 PMCID: PMC10688400 DOI: 10.1177/14550725231170454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Aim: The study explores how former patients with substance use disorder (SUD) experience the benefits and challenges of a reoriented identity and way of living. Methods: Semi-structured interviews were conducted with 10 participants who had completed treatment for SUD and considered themselves either recovered or in an ongoing rehabilitation process. Interview transcripts were analysed using the content analysis approach. Results: The analysis furthers our understanding of several purposeful aspects of a reorientation towards a sober life in terms of: (1) avoiding illegal drugs, (2) avoiding contact with the substance use relations and milieu, (3) renewing relations and social network, (4) daily occupation, (5) discovering the value of the great, little things in everyday life, (6) new coping strategies, and (7) developing a new identity. Conclusion: The study indicates that rehabilitation from SUDs should take a broader focus than just sobriety. With attention to the present findings, a focus on psychosocial aspects of recovery could contribute to a more overarching framework for SUD treatment.
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Affiliation(s)
- Gunn Pettersen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT – The Arctic University of Norway, Tromsø. Norway
| | - Trond Bjerke
- University Hospital of North Norway, Tromsø, Norway
| | | | | | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT- The Arctic University of Norway, Tromsø, Norway
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Kaplan GB, Thompson BL. Neuroplasticity of the extended amygdala in opioid withdrawal and prolonged opioid abstinence. Front Pharmacol 2023; 14:1253736. [PMID: 38044942 PMCID: PMC10690374 DOI: 10.3389/fphar.2023.1253736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Opioid use disorder is characterized by excessive use of opioids, inability to control its use, a withdrawal syndrome upon discontinuation of opioids, and long-term likelihood of relapse. The behavioral stages of opioid addiction correspond with affective experiences that characterize the opponent process view of motivation. In this framework, active involvement is accompanied by positive affective experiences which gives rise to "reward craving," whereas the opponent process, abstinence, is associated with the negative affective experiences that produce "relief craving." Relief craving develops along with a hypersensitization to the negatively reinforcing aspects of withdrawal during abstinence from opioids. These negative affective experiences are hypothesized to stem from neuroadaptations to a network of affective processing called the "extended amygdala." This negative valence network includes the three core structures of the central nucleus of the amygdala (CeA), the bed nucleus of the stria terminalis (BNST), and the nucleus accumbens shell (NAc shell), in addition to major inputs from the basolateral amygdala (BLA). To better understand the major components of this system, we have reviewed their functions, inputs and outputs, along with the associated neural plasticity in animal models of opioid withdrawal. These models demonstrate the somatic, motivational, affective, and learning related models of opioid withdrawal and abstinence. Neuroadaptations in these stress and motivational systems are accompanied by negative affective and aversive experiences that commonly give rise to relapse. CeA neuroplasticity accounts for many of the aversive and fear-related effects of opioid withdrawal via glutamatergic plasticity and changes to corticotrophin-releasing factor (CRF)-containing neurons. Neuroadaptations in BNST pre-and post-synaptic GABA-containing neurons, as well as their noradrenergic modulation, may be responsible for a variety of aversive affective experiences and maladaptive behaviors. Opioid withdrawal yields a hypodopaminergic and amotivational state and results in neuroadaptive increases in excitability of the NAc shell, both of which are associated with increased vulnerability to relapse. Finally, BLA transmission to hippocampal and cortical regions impacts the perception of conditioned aversive effects of opioid withdrawal by higher executive systems. The prevention or reversal of these varied neuroadaptations in the extended amygdala during opioid withdrawal could lead to promising new interventions for this life-threatening condition.
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Affiliation(s)
- Gary B Kaplan
- Mental Health Service, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Department of Pharmacology and Experimental Therapeutics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
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Bormann NL, Weber AN, Arndt S, Lynch A. Improvements in recovery capital are associated with decreased alcohol use in a primary opioid use disorder treatment-seeking cohort. Am J Addict 2023; 32:547-553. [PMID: 37132067 DOI: 10.1111/ajad.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/23/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Comorbid substance use can negatively impact multiple aspects of treatment for patients with an opioid use disorder (OUD). We investigated if treatment for OUD led to improvements in patients' recovery capital (RC) overtime, and whether there were associated changes in co-occurring alcohol use. METHODS Participants (n = 133) were patients with OUD seeking outpatient treatment, who completed the Assessment of Recovery Capital (ARC) and reported drinking days per 30-day period thrice over the 6-month study. No specific treatments targeting alcohol were used. Two different models were employed to assess changes in total ARC score and adjusted odds ratio (aOR) for past 30-day abstinence. RESULTS Baseline mean ARC scores were 36.6 and significantly increased to mean score of 41.2 at study end. Ninety-one participants (68.4%) reported no alcohol use at baseline, and 97 (78.9%) reported no use in the previous 30 days at study endpoint. For each increase in ARC, there was an aOR 1.07 (confidence interval [CI]: 1.02-1.13) for past 30-day abstinence. Considering ARC standard deviation of 10.33 over all measurements, this equates to an aOR of 2.10 (CI: 1.22-3.62) for past 30-day abstinence. DISCUSSION AND CONCLUSIONS We saw significantly increased aOR for past 30-day abstinence as RC improved in an OUD treatment-seeking population. This difference was not caused by differences in ARC between study completers and noncompleters. SCIENTIFIC SIGNIFICANCE Showcases how RC growth may be protective of past 30-day alcohol use in an OUD cohort and adds specific aOR for abstinence per ARC increase.
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Affiliation(s)
- Nicholas L Bormann
- Department of Psychiatry, Indiana University, Indianapolis, Indiana, USA
| | - Andrea N Weber
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
| | - Alison Lynch
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Department of Family Medicine, University of Iowa, Iowa City, Iowa, USA
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Brillhart R. Recovery- and sobriety-support groups in a music community: An ethnographic study of Phish, the Phellowship, and the sensorium of sobriety. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 154:209120. [PMID: 37451518 DOI: 10.1016/j.josat.2023.209120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/13/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE/INTRODUCTION This article provides an ethnographic account of members of the Phellowship, a group of sober concert goers who connect and sometimes attend informal meetings at Phish concerts. The work attends to the ways this group is meaningful for people's sobriety and livelihoods. The overall purpose of this article is to provide a rich description of a novel approach to the creation and extension of a culture of recovery and sobriety through music and music communities. METHODS This article utilizes two years of ethnographic data collected from interviews with roughly 20 participants and conversations from participant observation with people who are generally representative of the demographics of this group and fanbase (25-55, white, about half male and female presenting). The ethnographic data were physically coded into emergent themes and analyzed to highlight the important facets of participation and experience of members of the Phellowship. This method of qualitative analysis utilizes aspects of phenomenological inquiry, in that the subjective experiences of individuals are described and analyzed, to meet the larger aims of an ethnographic analysis that explicates the understandings and cultural practices of this community in their own words. RESULTS Thematic results include the performative and oral importance of narration at meetings, the semiotics of recovery and their community, the extension of sobriety beyond their "programs" or health-related arenas, and, most importantly, the role of connection and community. Each topic and result includes first-person accounts from interviews and participant observation to explicate how these thematic areas were chosen and have become meaningful for members of the Phellowship. DISCUSSION This nonprogrammatic approach to recovery and sobriety that focuses more on cultural practices and salient versions of people's everyday identities, rather than "healing" and process seems to be a promising and novel addition to better the lives of people with substance use disorders. This group, and the network of these groups that exists in the jam band music scene at large, could act as a model for person-first approaches to recovery that incorporate different elements of sociality, community, and creative expression.
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Affiliation(s)
- Ross Brillhart
- Indiana University, 800 E 3rd St, Bloomington, IN 47405, United States of America.
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Bormann NL, Weber AN, Miskle B, Arndt S, Lynch AC. Recovery Capital Correlates With Less Methamphetamine Use and Crime in the Community. J Addict Med 2023; 17:e361-e366. [PMID: 37934526 DOI: 10.1097/adm.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Reentry postcorrectional involvement is a high-risk time for patients with a history of addiction. We investigated whether participation in an addiction medicine clinic with active case management led to improvements in patients' recovery capital and whether there were associated changes in criminal activity and co-occurring methamphetamine or alcohol use. METHODS Participants (n = 136) were patients with an opioid or stimulant use disorder who had Department of Corrections involvement in the preceding year, who completed the Assessment of Recovery Capital (ARC) and reported criminal activity and days of methamphetamine or alcohol use twice over a 6-month study. Three logistic regression models were used to assess changes in total ARC with criminal activity, alcohol use, and methamphetamine use over the previous 30 days. RESULTS Baseline mean (SD) ARC scores were 34.1 (11.1) and increased to a mean (SD) score of 40.3 (9.4) at study end. A 1-SD shift in ARC was significantly protective across outcomes, with adjusted odds ratios of 0.32, 0.18, and 0.34 for any past 30-day criminal activity, alcohol use, or methamphetamine use. There was no significant difference in baseline ARC, crimes committed, days of alcohol use, or days of methamphetamine use for study completers versus noncompleters; however, unmeasured confounders may have had a differential impact on retention. CONCLUSIONS Recovery capital provides an additional framework to help address patients' substance use and criminal activity in a multifaceted way, which is especially important in the postincarceration community. Recovery capital is dynamic and has multiple areas to target psychosocial interventions.
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Affiliation(s)
- Nicholas L Bormann
- From the Department of Psychiatry, Indiana University, Indianapolis, IN (NLB); Department of Psychiatry, University of Iowa, Iowa City, IA (ANW, BM, SA, ACL); Department of Internal Medicine, University of Iowa, Iowa City, IA (ANW); Department of Pharmacy, University of Iowa, Iowa City, IA (BM); Department of Biostatistics, University of Iowa, Iowa City, IA (SA); Department of Family Medicine, University of Iowa, Iowa City, IA (ACL)
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12
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Bormann NL, Weber AN, Miskle B, Arndt S, Lynch AC. Recovery Capital Gains May Precede Craving Reduction in Opioid Use Disorder. Subst Abuse Rehabil 2023; 14:113-118. [PMID: 37818109 PMCID: PMC10561754 DOI: 10.2147/sar.s433350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
Purpose Cravings for drugs and alcohol have been significantly associated with worse treatment outcomes. We investigated if improvements in recovery capital (RC) (eg, a measure of social capital/network, financial resources, education, and cultural factors) over time were associated with decreased reported cravings. Patients and Methods The original cohort consisted of 133 participants (63 females) with opioid use disorder seeking outpatient treatment, who completed the Assessment of Recovery Capital (ARC) (range 0 to 50) and the Brief Addiction Monitor (BAM) thrice over the 6-month study. Intervention was medication and case management. Analysis included one-way mixed models testing change over time for ARC total scores and single question craving rating (5-point Likert scale). Cross-lagged panel estimates used structural equation models with variables z-scored, allowing for path coefficient evaluation as standard deviations (sd). Results Total ARC significantly increased over the study (χ2 = 33.77, df = 2, p < 0.0001), with baseline of 36.6 (n = 114, sd = 11.1) and 6-month of 41.2 (n = 107, sd = 9.5). Craving also changed significantly (χ2 = 8.51, df = 2, p < 0.015), with baseline of 1.1 (n = 101, sd = 1.2) and 6-month of 0.9 (n = 107, sd = 1.1). The cross-lag from baseline RC to 3-month craving was significant (β = -0.28, SE = 0.11, z = -2.53, p < 0.011). The converse was not true; baseline craving did not affect later RC. Results were similarly significant when comparing 3-month to 6-month. The majority of sample was on buprenorphine. Conclusion As RC improves, the reported cravings at both 3- and 6-month study time points are significantly reduced. When evaluated inversely, there was not a significant association with baseline cravings and follow-up RC. Significant path coefficients provide an estimation of a directional effect from increased RC towards craving reduction.
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Affiliation(s)
- Nicholas L Bormann
- Psychiatry and Psychology, Mayo Clinic Health System, Albert Lea, MN, USA
| | - Andrea N Weber
- Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Internal Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Benjamin Miskle
- Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Pharmacy, University of Iowa, Iowa City, Iowa, USA
| | - Stephan Arndt
- Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Biostatistics, University of Iowa, Iowa City, Iowa, USA
| | - Alison C Lynch
- Psychiatry, University of Iowa, Iowa City, Iowa, USA
- Family Medicine, University of Iowa, Iowa City, Iowa, USA
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13
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Bormann NL, Weber AN, Miskle B, Arndt S, Lynch AC. Sex Differences in Recovery Capital Gains Post-Incarceration. Subst Use Misuse 2023; 58:1839-1846. [PMID: 37702512 DOI: 10.1080/10826084.2023.2257303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND People with substance use disorders are highly prevalent in the carceral system. Recovery capital (RC) is the resources available to an individual to initiate or maintain substance use cessation. Sex differences have been identified in RC during both active substance use and recovery in the general population, however, less is known about these sex differences in the post-incarceration population. METHODS Participants (n = 136) were those with an opioid or stimulant use disorder with past year involvement with the Iowa criminal justice system (USA), who completed the Assessment of Recovery Capital (ARC) twice over a six-month cohort study. Participants were involved in an addiction clinic that utilized active case management. Analysis of covariance evaluated changes in ARC during the study. Separate models compared total ARC and individual ARC domains, with sex as the independent variable of interest. Model means were generated for interpretation based on sex, comparing baseline and study endpoint ARC scores. RESULTS There were no baseline sex differences in total ARC. ARC increased significantly for the group, however, males showed disproportionate growth. Females ended the study with a mean ARC of 37.8 (SD= 9.3) and males finished at 41.6 (SD= 9.3), which was a significant difference (p = 0.044); this significant difference was driven by ARC subdomains of 'Psychological Health' and 'Physical Health.' CONCLUSIONS People post-incarceration are at high risk for return to substance use. Treatment that is informed by sex-based differences may have the potential to decrease the differing rates of growth in RC between sexes.
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Affiliation(s)
| | - Andrea N Weber
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Benjamin Miskle
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Alison C Lynch
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Family Medicine, University of Iowa, Iowa City, IA, USA
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14
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Amiri H, Aminizadeh M, Rezapour M, Tavan A, Aminizadeh M. The impact of Covid 19 pandemic on life satisfaction and health of Iranian bank employees. Heliyon 2023; 9:e19088. [PMID: 37662794 PMCID: PMC10474419 DOI: 10.1016/j.heliyon.2023.e19088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 09/05/2023] Open
Abstract
Background COVID-19 pandemic has affected various aspects of human life. Bank employees who are more in contact with people are more likely to be infected during the pandemic situation. Moreover, mental, physical and social impacts of COVID-19 are more intense among these employees.Objective: this study aims to determine the effect of COVID-19 pandemic on bank employees' health and life satisfaction in Iran. Methods This cross-sectional study was conducted during the fifth wave of COVID-19 from July to October 2021. The population included all the employees of Tejarat Bank in 20 provinces of Iran, 350 of whom were selected using the multi-stage cluster sampling method. The data were collected by demographic questionnaire, 12-item short-form (SF-12) personal health assessment survey and satisfaction with life scale (SWLS). The objective of the study was examined by the structural equation modeling (SEM). Results The results showed the two default models of health function (CFI = 0.95) and life satisfaction (CFI = 0.99) had acceptable fit. Assessing the bank employees with COVID-19 revealed this disease had no direct impact on life satisfaction (β = -0.05, P = 0.28) and health function (β = 0.04, P = 0.48). However, it had a direct impact on physical function (β = -0.18, P = 0.001) and, consequently, an indirect impact on life satisfaction. Moreover, low mental function reduced life satisfaction. Conclusion COVID-19 infection had no direct impact on life satisfaction. However, it had an indirect and positive impact on it. Considering gender showed COVID-19 infection had a direct and positive impact on life satisfaction among women. The employees who recovered from COVID-19 infection reported higher life satisfaction after returning to work for various reasons than those who never got it.
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Affiliation(s)
- Hadis Amiri
- Department of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Maysam Rezapour
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Asghar Tavan
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Aminizadeh
- Department of Psychology, Azadshahr Branch, Islamic Azad University, Azadshahr, Iran
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15
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Osborne B, Kelly PJ. Substance use disorders, physical health and recovery capital: Examining the experiences of clients and the alcohol and other drug workforce. Drug Alcohol Rev 2023; 42:1410-1421. [PMID: 37254643 DOI: 10.1111/dar.13689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/17/2023] [Accepted: 05/09/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Challenges associated with the integration of physical health within alcohol and other drug (AOD) treatment services persist. The construct of recovery capital has gained currency within the sector, however, its potential in understanding the integration of physical health within AOD treatment has not been examined. This study explores the role of physical health in the process of recovery, examining the potential of 'recovery capital' frameworks to enhance integrated care. METHODS Interviews were conducted with residential and outpatient AOD services across New South Wales, Australia. Qualitative data was collected from clients (n = 20) and staff (n = 13) and transcribed. Data were systematically coded and analysed using the iterative categorisation method. RESULTS Unmanaged physical health issues compromised recovery, particularly when associated with hopelessness and pain. Improved physical health ameliorated sources of negative recovery capital such as boredom, social isolation and mental health symptoms. When addressed during treatment, physical health facilitated recovery capital resources through knowledge and skill acquisition, increased autonomy, enjoyment and immersive experience. Benefits extended to domains of 'social capital' (social connection) and 'cultural capital' (physical appearance). DISCUSSION AND CONCLUSIONS Physical health offers variegated pathways for building recovery capital. Findings support calls for a more assertive approach to addressing physical health when AOD treatment occurs outside of primary care settings. Future research should examine the potential of recovery capital as a heuristic for optimising care of physical health issues and health-related behaviour within AOD treatment services.
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Affiliation(s)
- Briony Osborne
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
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16
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Schacht RL, Wenzel KR, Meyer LE, Mette M, Mallik-Kane K, Rabalais A, Berg SK, Fishman M. A pilot test of Written Exposure Therapy for PTSD in residential substance use treatment. Am J Addict 2023; 32:488-496. [PMID: 37329251 DOI: 10.1111/ajad.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/28/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES: Posttraumatic stress disorder (PTSD) is highly comorbid with substance use disorders (SUD) and can impede SUD recovery. Residential SUD treatment is a crucial opportunity to address PTSD. However, PTSD treatment is lacking in residential SUD care. METHODS We conducted a nonrandomized feasibility study of Written Exposure Therapy (WET), a brief, evidence-based treatment for PTSD, with patients in residential SUD treatment. We assessed attitudes towards treatment (Credibility and Expectancy Questionnaire, Barriers to Treatment Participation Scale) and mental health indicators (PTSD Checklist for DSM-5, Trauma Coping Self-Efficacy, Difficulties in Emotion Regulation-Short Form, and Brief Assessment of Recovery Capital). RESULTS Thirty of 49 eligible participants completed WET (61%) and 92% (n = 45) attended at least one WET session. Paired sample t-tests revealed significant posttreatment improvement across all mental health indicators, with medium to large effect sizes. DISCUSSION AND CONCLUSIONS Attendance and completion rates compared favorably to prior exposure-based treatment for PTSD in SUD settings. Although causality cannot be inferred without a randomized controlled trial, mental health indicators, including PTSD, improved significantly following WET. SCIENTIFIC SIGNIFICANCE These findings provide evidence that PTSD can be successfully treated in short-term residential care using brief exposure-based interventions, which is a crucial clinical need that has been minimally studied in the past.
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Affiliation(s)
- Rebecca L Schacht
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - Kevin R Wenzel
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
- Maryland Treatment Centers, Baltimore, Maryland, USA
| | - Laurel E Meyer
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - Meghan Mette
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | | | | | - Samantha K Berg
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - Marc Fishman
- Maryland Treatment Centers, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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Martinelli TF, Roeg DPK, Bellaert L, Van de Mheen D, Nagelhout G. Understanding the Process of Drug Addiction Recovery Through First-Hand Experiences: A Qualitative Study in the Netherlands Using Lifeline Interviews. QUALITATIVE HEALTH RESEARCH 2023; 33:857-870. [PMID: 37279186 PMCID: PMC10426251 DOI: 10.1177/10497323231174161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Understandings of drug addiction recovery are still being debated. Research on perspectives from first-hand experiences with recovery is rare and often contains short-term experiences in the context of a treatment setting. We aim to gain further understanding of recovery by analyzing autobiographical data from persons in different stages of drug addiction recovery who are not linked to any specific treatment service. We conducted 30 in-depth qualitative interviews with participants from various parts of the Netherlands. Participants self-identified as being "in recovery" or "recovered" from drug addiction for at least 3 months. Men and women are equally represented, and the sample consists of an equal number of participants in early (<1 year, n = 10), sustained (1-5 years, n = 10), and stable (>5 years, n = 10) recovery. We undertook a data-driven thematic analysis. Participants described that recovery is a broad process of change because addiction is interwoven with everything (theme 1); that recovery is reconsidering identity, seeing things in a new light (theme 2); that recovery is a staged long-term process (theme 3); and that universal life processes are part of recovery (theme 4). Thus, Drug addiction recovery is experienced as an interwoven long-term process, including identity change and common or universal life processes. Policy and clinical practice should therefore be aimed at supporting long-term tailored recovery goals and disseminating first-hand recovery experiences to enhance long-term outcomes and reduce stigmatization.
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Affiliation(s)
- T. F. Martinelli
- IVO Research Institute, Den Haag, Netherlands
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - D. P. K. Roeg
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Kwintes Housing and Rehabilitation Services, Zeist, Netherlands
| | - L. Bellaert
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - D. Van de Mheen
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - G.E. Nagelhout
- IVO Research Institute, Den Haag, Netherlands
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands
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18
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Rubio G, Esteban Rodríguez L, Sion A, Ramis Vidal L, Blanco MJ, Zamora-Bayon A, Caba-Moreno M, Macias-Molina AI, Pérez-Sánchez D, Rubio-Escobar E, Ruiz-Diez J, Marin M, Arias F, Lora D, Jurado-Barba R. How, when, and to what degree do people with alcohol dependence recover their psychological wellbeing and quality of life? The Madrid Recovery Project. Front Psychiatry 2023; 14:1130078. [PMID: 37398602 PMCID: PMC10313403 DOI: 10.3389/fpsyt.2023.1130078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery. Method A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender. Results In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables. Conclusion Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.
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Affiliation(s)
- Gabriel Rubio
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Primary Care Research Network on Addictions (RIAPAd), Madrid, Spain
| | | | - Ana Sion
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Psychology Faculty, Complutense University of Madrid, Madrid, Spain
| | - Lilian Ramis Vidal
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | - María J. Blanco
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | | | - Marta Caba-Moreno
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | | | | | | | - Joaquín Ruiz-Diez
- Alcoholics Federation of the Community of Madrid (FACOMA), Madrid, Spain
| | - Marta Marin
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
| | - Francisco Arias
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
| | - David Lora
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Faculty of Statistical Studies, Complutense University of Madrid, Madrid, Spain
| | - Rosa Jurado-Barba
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, Madrid, Spain
- Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
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Romo LK, Obiol ME. How People in Recovery Manage the Stigma of Being an Alcoholic. HEALTH COMMUNICATION 2023; 38:947-957. [PMID: 34583598 DOI: 10.1080/10410236.2021.1983339] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although stigma can jeopardize the recovery efforts of people who formerly misused substances, potentially leading to relapse, how people in recovery for alcoholism manage stigma has not been comprehensively or systematically examined. Using stigma management communication theory (SMC) and in-depth interviews of 22 adults in recovery, this investigation uncovered the six main strategies participants used to negotiate the stigma of being an alcoholic. Consistent with the tenets of SMC, interviewees accepted, evaded responsibility for, reduced offensiveness of, avoided, denied, and/or ignored/displayed the stigma, depending on whether they accepted or challenged that the stigma of being an alcoholic applied to themselves and/or the public's perception. Findings inform practical strategies to help individuals in recovery effectively manage stigma while sustaining their sobriety. The study also suggests ways programs such as Alcoholics Anonymous and treatment centers can use communication to break down recovery barriers.
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Affiliation(s)
- Lynsey K Romo
- Department of Communication, North Carolina State University
| | - Mary E Obiol
- Department of Communication, North Carolina State University
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20
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Francis MW, McCutcheon VV, Farkas KJ. Social processes during recovery: An expansion of Kelly and Hoeppner's biaxial formulation of recovery. ADDICTION RESEARCH & THEORY 2023; 31:416-423. [PMID: 38283612 PMCID: PMC10812146 DOI: 10.1080/16066359.2023.2195641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 03/22/2023] [Indexed: 01/30/2024]
Abstract
Recent conceptualizations frame addiction recovery as a complex process involving changes across behavioral, physical, psychological, and social domains. These broad conceptualizations can be difficult to apply directly to research, making detailed models of individual dimensions necessary to guide empirical work and subsequent clinical interventions. We used Kelly and Hoeppner's (2015) biaxial formulation of recovery as a basis for a detailed examination of social processes in recovery using social network approaches. We delineated how appraisal of situational risks and social network resources result in coping actions, and how repeated iterations of this process change a person's social recovery capital over time. In addition, we incorporated the experience of interpersonal trauma and structural oppression, and demonstrated how the model accommodates the complex issues often encountered during recovery. We present a measurable framework that can guide empirical testing of how social processes and social recovery capital change over time during recovery. The model presented here illuminates key factors in the recovery process that have the potential to support trauma- and social-network-informed interventions. We call for research that empirically tests this model in ways that will result in practical, trauma-informed social network interventions for people in recovery.
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Affiliation(s)
- Meredith W. Francis
- Washington University in St. Louis, Brown School of Social Work, St. Louis, MO
| | | | - Kathleen J. Farkas
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH
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21
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Logan TK, Cole J. Mental Health and Recovery Needs Among Women Substance Use Disorder Treatment Clients With Stalking Victimization Experiences. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231159307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This study examined mental health and recovery needs at substance use disorder (SUD) program entry and at follow-up ( n = 2064) among: (1) women with no stalking victimization; (2) women with lifetime stalking victimization experiences; and (3) women with recent stalking victimization experiences (within 12 months of program entry). Stalking can be defined as a repeated pattern of behavior that creates fear or concern for safety or extreme emotional distress in the target. Women who experienced any stalking victimization, and particularly recent stalking victimization at program entry, had more recovery needs and increased mental health symptoms. At follow-up, women with any stalking victimization experiences continued to have more recovery needs with few differences between the lifetime and recent stalking victimization groups. Stalking victimization experiences were significantly associated with depression and anxiety symptoms in the multivariate analysis. Addressing stalking victimization during SUD treatment may be important to facilitate recovery.
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Affiliation(s)
- TK Logan
- University of Kentucky, Lexington, KY, USA
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22
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Kitzinger RH, Gardner JA, Moran M, Celkos C, Fasano N, Linares E, Muthee J, Royzner G. Habits and Routines of Adults in Early Recovery From Substance Use Disorder: Clinical and Research Implications From a Mixed Methodology Exploratory Study. Subst Abuse 2023; 17:11782218231153843. [PMID: 36798446 PMCID: PMC9926005 DOI: 10.1177/11782218231153843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/20/2022] [Indexed: 02/13/2023]
Abstract
The purpose of this exploratory, non-experimental mixed methods study was to analyze the habits and routines of adults in early recovery (>3 months) from substance use disorder (SUD). Participants (N = 14) were recruited from an intensive outpatient treatment (IOP) program for substance use disorders. Data collection consisted of a demographic survey, a researcher developed Daily Occupational Questionnaire (DOQ), and follow-up semi-structured interviews with 5 randomly selected participants. Quantitative results indicate rest as the most frequently engaged in activity on the most busy (31.0%) and least busy day (36.6%). There was no significant difference, t(13) = 0.117, P = .909, between newly established activities on the most busy and least busy day. Qualitative themes included 1. The most difficult time of day is often related to patterns of unused time. 2. When there is a lack of structure or unoccupied time, they return to their previously established positive supports. 3. There is a need for consistency and structure for developing anticipated/perceived routines. Implications for all healthcare and clinical providers working with this population, as well as research suggestions, are outlined.
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Affiliation(s)
- Robert H Kitzinger
- Department of Counselor Education, Kean
University, Union, NJ, USA,Robert H Kitzinger, Jr., Department of
Counselor Education, Kean University, 1000 Morris Ave, East Campus, Union, NJ
07083, USA.
| | | | - Mariann Moran
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
| | - Carly Celkos
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
| | - Nicole Fasano
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
| | - Eric Linares
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
| | - Joyce Muthee
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
| | - Gabby Royzner
- Department of Occupational Therapy,
Kean University, Union, NJ, USA
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23
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LaBelle O, Hastings M, Vest N, Meeks M, Lucier K. The role of mindfulness, meditation, and peer support in recovery capital among Recovery Dharma members. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 145:208939. [PMID: 36880913 PMCID: PMC9992926 DOI: 10.1016/j.josat.2022.208939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/31/2022] [Accepted: 12/30/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Recovery Dharma (RD) is a Buddhist-based peer support program for the treatment of addiction that incorporates mindfulness and meditation into meetings, program literature, and the recovery process, creating the opportunity to study these variables in a peer-support program context. Mindfulness and meditation are beneficial for people in recovery, yet we know little about their relationship to recovery capital, a positive indicator of recovery outcomes. We explored mindfulness and meditation (average length of sessions and average frequency per week) as predictors of recovery capital and examined perceived support in relation to recovery capital. METHODS The study recruited participants (N = 209) through the RD website, newsletter and social media pages for an online survey that included measures of recovery capital, mindfulness, perceived support, and questions about meditation practices (e.g., frequency, duration). Participants' mean age was 46.68 years (SD = 12.21), with 45 % female (5.7 % non-binary), and 26.8 % from the LGBTQ2S+ community. The mean time in recovery was 7.45 years (SD = 10.37). The study fitted univariate and multivariate linear regression models to determine significant predictors of recovery capital. RESULTS As anticipated, multivariate linear regressions indicated that mindfulness (β = 0.31, p < .001), meditation frequency (β = 0.26, p < .001), and perceived support from RD (β = 0.50, p < .001) were all significant predictors of recovery capital when controlling for age and spirituality. However, longer time in recovery and the average duration of meditation sessions did not predict recovery capital as anticipated. CONCLUSIONS Results indicate the importance of a regular meditation practice for recovery capital rather than engaging in prolonged sessions infrequently. The results also support previous findings, which point to the influence of mindfulness and meditation on positive outcomes for people in recovery. Further, peer support is associated with higher recovery capital in RD members. This study is the first examination of the relationship between mindfulness, meditation, peer support, and recovery capital in recovering people. The findings lay the groundwork for the continued exploration of these variables as they relate to positive outcomes both within the RD program and in other recovery pathways.
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Affiliation(s)
- Onawa LaBelle
- Department of Psychology, University of Windsor, Canada.
| | | | - Noel Vest
- School of Medicine, Stanford University, United States of America
| | - Matthew Meeks
- Department of Psychology, University of Windsor, Canada
| | - Krista Lucier
- Department of Psychology, University of Windsor, Canada
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Athamneh LN, King MJ, Craft WH, Freitas-Lemos R, Tomlinson DC, Yeh YH, Bickel WK. The Associations between Remission Status, Discounting Rates, and Recovery from Substance Use Disorders. Subst Use Misuse 2023; 58:275-282. [PMID: 36622296 DOI: 10.1080/10826084.2022.2161312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Recovery from substance use disorders (SUDs) requires sustained and purposeful support to maintain long-term remission. Methods: This study investigated the association between assessment of recovery capital, household chaos, delay discounting (DD) and probability discounting (PD), and remission status among individuals in recovery from SUD. Data from 281 participants from the International Quit & Recovery Registry (IQRR), an ongoing online registry that aims to study the recovery process, were included in the analysis. Results: Lower DD rates and higher recovery capital were found among those in remission compared to those not in remission after controlling for demographics. In contrast, the association of household chaos and PD with remission status were insignificant. Overall, DD accounted for 20% of the total effect between the recovery capital and the remission status. Conclusion: This study contributes to the understanding of recovery as a multidimensional process, supports DD as a behavioral marker of addiction, and suggests areas for future research.
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Affiliation(s)
- Liqa N Athamneh
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - Michele J King
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - William H Craft
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - Roberta Freitas-Lemos
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - Devin C Tomlinson
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - Yu-Hua Yeh
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
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Majer JM, Jason LA, Bobak TJ. Understanding recovery Capital in relation to categorical 12-Step involvement and abstinence social support. ADDICTION RESEARCH & THEORY 2022; 30:207-212. [PMID: 36275074 PMCID: PMC9585994 DOI: 10.1080/16066359.2021.1999935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 05/28/2023]
Abstract
Background Although recovery capital represents various resources for persons recovering from substance use disorders, measures of this construct examine components that might not necessarily reflect the recovery goals of individuals who base their recovery through involvement in 12-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). It is not clear whether 12-step involvement is related to recovery capital, particularly among individuals living in recovery homes who utilize social networks of recovering peers for their recovery. Thus, categorical involvement in a set of 12-step activities was examined in relation to recovery capital and abstinence social support. Methods Differences in terms of general (recovery capital scores, retention rates) and abstinence-specific (abstinence social support) resources were examined in relation to recovery home residents who were (n = 395) and were not (n = 232) categorically involved in their 12-step recovery. Results Residents with categorical 12-step involvement reported significantly higher levels of recovery capital and abstinence social support, and there was no significant difference observed in retention rates between residents who were/were not categorically involved in 12-step groups. Conclusions Findings suggest community resources such as recovery homes and categorical involvement in 12-step groups are important recovery capital components that help individuals who use a 12-step approach to their recovery. Recovery capital among those involved with 12-step fellowships such as AA and NA should be assessed by examining abstinence-specific components such as representative involvement in 12-step groups and social support that is abstinence-specific.
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Affiliation(s)
- John M. Majer
- Social and Behavioral Sciences Department, Harry S. Truman College, Chicago, IL, USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Ted J. Bobak
- Center for Community Research, DePaul University, Chicago, IL, USA
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Lynch T, Rodriguez W, Eddie D. Education and careers were our way out. J Subst Abuse Treat 2022; 142:108869. [PMID: 36088738 DOI: 10.1016/j.jsat.2022.108869] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/17/2022] [Accepted: 08/25/2022] [Indexed: 12/14/2022]
Abstract
Stigma thrives in vacuums of awareness where stereotypes are allowed to persist. When those of us with lived experience of addiction and addiction recovery stay in the shadows, we miss an opportunity to challenge a harmful narrative-that people with addiction are fundamentally different from other people and don't get better. Here, we three addiction treatment professionals share our lived experience of overcoming substance use disorder, highlighting how education and careers have formed the cornerstones of our recoveries. We also link our experiences to the emerging recovery capital literature, which speaks to the importance of employment in the SUD recovery process, while highlighting how systemic racism and the crimes against humanity committed in the name of the war on drugs remain barriers to many pursuing education and new careers.
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Affiliation(s)
- Toby Lynch
- Department of Psychiatry, Massachusetts General Hospital, USA; Department of Psychiatry, Harvard Medical School, USA
| | | | - David Eddie
- Department of Psychiatry, Massachusetts General Hospital, USA; Department of Psychiatry, Harvard Medical School, USA; Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, USA.
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Protective Factor Predictors of Abstinence and Retention in Patients Receiving Methadone Treatment for Opioid Use Disorder. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00893-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Chiang SC, Knapp KS, Bai S, Cleveland HH, Harris KS. Examining Within- and Between-Person Facets of Negative Affect and Associations with Daily Craving Among Young Adults in Substance Use Disorder Recovery. ADDICTION RESEARCH & THEORY 2022; 31:52-59. [PMID: 37009164 PMCID: PMC10061576 DOI: 10.1080/16066359.2022.2102611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 06/19/2023]
Abstract
The role of negative affect in precipitating drug craving and relapse among young adults in recovery from substance use disorder (SUD) is well documented. However, most studies focus on negative affect as a trait-level congregate of multiple negative emotion states. The present study examined the associations between specific facets of negative affect, college stressors, and craving among young adult college students in SUD recovery. Data were drawn from a three-week daily diary study of 50 students participating in a collegiate recovery community at a U.S. university (M age = 21.42, 76% males). At the within-person level, craving was higher on days when young adults experienced higher than usual anger, fear, and sadness, but not guilt. At the between-person level, individuals higher in agitation reported greater levels of craving on average. Moderation analyses further showed that college stressors heightened the within-person association between anger and craving. Findings demonstrate that negative affect is not monolithic and that its different aspects are uniquely associated with craving at both between- and within-person levels. Findings from this study could guide collegiate SUD recovery programs that wish to provide greater support to their members by helping them identify both individual- and time-specific relapse risks, such as generally high levels of agitation or days when anger, fear, or sadness are higher than usual for a particular individual. Our findings also suggest that future research should consider distinct features and implications of affective structures at between- and within-person levels, and how these may be uniquely associated with craving.
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Affiliation(s)
- Shou-Chun Chiang
- Department of Human Development and Family Studies, The Pennsylvania State University
| | - Kyler S. Knapp
- Department of Human Development and Family Studies, The Pennsylvania State University
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University
| | - Sunhye Bai
- Department of Human Development and Family Studies, The Pennsylvania State University
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Patients' experiences of continued treatment with extended-release naltrexone: a Norwegian qualitative study. Addict Sci Clin Pract 2022; 17:36. [PMID: 35850782 PMCID: PMC9290197 DOI: 10.1186/s13722-022-00317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background The opioid antagonist extended-release naltrexone (XR-NTX) in the treatment of opioid use disorder (OUD) is effective in terms of safety, abstinence from opioid use and retention in treatment. However, it is unclear how patients experience and adjust to losing the possibility of achieving an opioid effect. This qualitative study is the first to explore how people with opioid dependence experience XR-NTX treatment, focusing on the process of treatment over time. Methods Using a purposive sampling strategy, semi-structured interviews were undertaken with 19 persons with opioid use disorder (15 men, four women, 22–55 years of age) participating in a clinical trial of XR-NTX in Norway. The interviewees had received at least three XR-NTX injections. Qualitative content analysis with an inductive approach was used. Findings Participants described that XR-NTX treatment had many advantages. However they still faced multiple challenges, some of which they were not prepared for. Having to find a new foothold and adapt to no longer gaining an effect from opioids due to the antagonist medication was challenging. This was especially true for those struggling emotionally and transitioning into the harmful use of non-opioid substances. Additional support was considered crucial. Even so, the treatment led to an opportunity to participate in society and reclaim identity. Participants had strong goals for the future and described that XR-NTX enabled a more meaningful life. Expectations of a better life could however turn into broken hopes. Although participants were largely optimistic about the future, thinking about the end of treatment could cause apprehension. Conclusions XR-NTX treatment offers freedom from opioids and can facilitate the recovery process for people with OUD. However, our findings also highlight several challenges associated with XR-NTX treatment, emphasizing the importance of monitoring emotional difficulties and increase of non-opioid substances during treatment. As opioid abstinence in itself does not necessarily equal recovery, our findings underscore the importance of seeing XR-NTX as part of a comprehensive, individualized treatment approach. Trial registration: Clinicaltrials.gov # NCT03647774, first Registered: Aug 28, 2018.
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Shircliff K, Liu M, Prestigiacomo C, Fry M, Ladd K, Gilbert MK, Rattermann MJ, Cyders MA. Mixed methods prospective findings of the initial effects of the U.S. COVID-19 pandemic on individuals in recovery from substance use disorder. PLoS One 2022; 17:e0270582. [PMID: 35776699 PMCID: PMC9249176 DOI: 10.1371/journal.pone.0270582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
The beginning of the U.S. COVID-19 pandemic interrupted integral services and supports for those in recovery from substance use disorders. The current study used qualitative and quantitative data to identify 1) pandemic-related barriers/stressors, 2) coping strategies employed, and 3) how the stressors and strategies predicted subsequent substance use frequency. Participants were 48 adults (40.5% female; 90.2% White) between 26 and 60 years old (M = 42.66, SD = 8.44) who were part of a larger, multi-year longitudinal study of individuals in recovery from substance use disorders. Individuals completed two interviews, one during the six weeks of initial stay-at-home orders in the state in which data were collected and the second within six to twelve months of their initial interview. Common barriers to recovery included cancelled support meetings, changes in job format (i.e., being fired or furloughed), and lack of social support. Common coping strategies included self-care, leisure activities/hobbies, taking caution against exposure, and strengthening personal relationships. The relationship between cravings at baseline and substance use at follow up was stronger for those who experienced worsening of their mental health (B = 21.80, p < .01) than for those who did not (B = 5.45, p = 0.09), and for those who were taking caution against exposure (B = 24.57, p < .01) than for those who were not (B = 1.87, p = 0.53). Those who engaged in self-care (B = 0.00, p>.99) had lower rates of substance use at follow-up than those who did not employ self-care as a coping mechanism (B = 16.10, p < .01). These findings inform research priorities regarding prospective effects of the pandemic on treatment endeavors, particularly emphasizing treating mental health and encouraging self-care strategies.
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Affiliation(s)
- Katherine Shircliff
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Melissa Liu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Christiana Prestigiacomo
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Melissa Fry
- Department of Sociology, Indiana University Southeast, Indianapolis, Indiana, United States of America
| | - Kevin Ladd
- Department of Psychology, Indiana University South Bend, Indianapolis, Indiana, United States of America
| | | | - Mary Jo Rattermann
- Research & Evaluation Resources LLC, Indianapolis, Indiana, United States of America
- Community Fairbanks Recovery Center, Indianapolis, Indiana, United States of America
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
- * E-mail:
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Radic M, Parlier-Ahmad AB, Wills B, Martin CE. Social determinants of health and emergency department utilization among adults receiving buprenorphine for opioid use disorder. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3:100062. [PMID: 35783992 PMCID: PMC9248991 DOI: 10.1016/j.dadr.2022.100062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with opioid use disorder (OUD) use the emergency department (ED) at high rates. Medication treatment for OUD (MOUD) is associated with reduced ED utilization. However, individuals receiving MOUD still utilize ED services at higher rates than the general population. The objective of this study is to compare the psychosocial and clinical characteristics of those who do and do not utilize ED services based on the Healthy People 2030 framework regarding social determinants of health (SDoH) among a sample of individuals receiving MOUD. METHODS Participants receiving buprenorphine for OUD at an outpatient addiction clinic completed a cross-sectional survey between July and September 2019. A 6-month prospective medical record review was conducted. The primary outcome was ED visit (yes/no) during the 6-month study period. Demographic, psychosocial, and clinical characteristics were gathered from survey measures and chart abstraction. Chi square and T-tests tested differences by ED utilization. RESULTS Participants (n=142) were 54.9% female and 68.8% Black, with an average age of 43.2 years (SD=12.5). Of the participants, 38.7% visited the ED in the study period, primarily for infectious or musculoskeletal causes. Participants with an ED visit were more likely to be Black (p=.011), have less social support (p=.030), more medical comorbidities (p=.008) including chronic pain (p=.045), and more visits with an addiction provider in the study period (p=.009). CONCLUSIONS Factors associated with ED utilization among individuals receiving buprenorphine for OUD include low social support and medical comorbidities, including chronic pain. More research is needed on modifiable SDoH that influence ED utilization.
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Affiliation(s)
- Maja Radic
- Virginia Commonwealth University School of Medicine, 1201 E Marshall St, Richmond, VA 23298, USA
| | - Anna Beth Parlier-Ahmad
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin St., Richmond, VA 23284, USA
| | - Brandon Wills
- Department of Emergency Medicine, Virginia Commonwealth University, 1250 E. Marshall St., Richmond, VA 23298, USA
| | - Caitlin E. Martin
- Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, 1250 E. Marshall St., Richmond, VA 23298, USA
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Lee BK, Ofori Dei SM. Changes in Work Status, Couple Adjustment, and Recovery Capital: Secondary Analysis of Data From a Congruence Couple Therapy Randomized Controlled Trial. Subst Abuse 2022; 16:11782218221088875. [PMID: 35645564 PMCID: PMC9130820 DOI: 10.1177/11782218221088875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Purpose Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU). Method Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (n = 17) and CCT (n = 21) were analyzed. Results Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran's Q = 5.429, P = .066) or TAU (Cochran's Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group. Conclusion Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.
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Affiliation(s)
- Bonnie K Lee
- Faculty of Health Sciences, University of
Lethbridge, Lethbridge, AB, Canada
| | - Samuel M Ofori Dei
- Faculty of Health Sciences, University of
Lethbridge, Lethbridge, AB, Canada
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Substance and Behavioral Addictions, and Their Consequences among Vulnerable Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106163. [PMID: 35627700 PMCID: PMC9141345 DOI: 10.3390/ijerph19106163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023]
Abstract
"Vulnerable populations" in health behavior research, practice and policy is generally used to refer to groups that, due to their life circumstances, may require extra consideration, reasonable accommodation, and legitimized protection [...].
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Wnuk M, Charzyńska E. Involvement in Sexaholics Anonymous and life satisfaction: The mediating role of meaning in life and hope. J Behav Addict 2022; 11. [PMID: 35583964 PMCID: PMC9295246 DOI: 10.1556/2006.2022.00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/10/2022] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background and aims Some people are preoccupied with their sexual urges and fantasies and lose control over their sexual behaviors, which can cause adverse consequences for their health and well-being. One of the options available for individuals seeking treatment for compulsive sexual behavior disorder (CSBD) is a self-help group based on the twelve-step program. The main purpose of the current study was to examine the direct and indirect (through meaning in life and hope) relationships between involvement in Sexaholics Anonymous (SA) and life satisfaction. Methods The sample consisted of 80 Polish members of SA (72 men and 8 women) with a mean age of 38.96 years (SD = 10.56). The Sex Addiction Screening Test-Revised, the Meaning of Life Questionnaire, the Herth Hope Index, the Satisfaction with Life Scale, and items adapted from the Alcoholics Anonymous Involvement Scale were used to measure the study variables. Results Path analysis showed a direct positive relationship between SA involvement and life satisfaction. Moreover, the relationship between these variables was mediated by the presence of meaning in life and hope. Simultaneously, more severe symptoms of CSBD were related to lower levels of the presence of meaning in life and higher levels of the search for meaning in life, which, in turn, predicted lower levels of life satisfaction. Discussion and conclusions The results suggest that finding meaning in life and restoring hope partly underlie the relationship between SA involvement and life satisfaction.
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Affiliation(s)
- Marcin Wnuk
- Department of Work and Organizational Psychology, Adam Mickiewicz University in Poznań, Szamarzewskiego 89, 60-568, Poznań, Poland
| | - Edyta Charzyńska
- Faculty of Social Sciences, University of Silesia in Katowice, Bankowa 12, 40-007, Katowice, Poland
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Francis MW, Bourdon JL, Chan G, Dick DM, Edenberg HJ, Kamarajan C, Kinreich S, Kramer J, I-Chun Kuo S, Pandey AK, Pandey G, Smith RL, Bucholz KK, McCutcheon VV. Deriving a Measure of Social Recovery Capital From the Important People and Activities Instrument: Construction and Psychometric Properties. Alcohol Alcohol 2022; 57:322-329. [PMID: 35356964 PMCID: PMC9086804 DOI: 10.1093/alcalc/agac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 11/14/2022] Open
Abstract
AIM This study presents a measure of Social Recovery Capital (SRC) derived from the Important People and Activities instrument (IPA). METHODS The sample comprised young adults who participated in the Collaborative Study on the Genetics of Alcoholism, a high-risk family study of alcohol use disorder (N = 2472). Exploratory and confirmatory factor analysis identified influential items and factor structure, adjusting for family relatedness. The final scale was tested for reliability and validity. RESULTS Factor analysis retained 10 items loading on three factors (Network Abstinence Behaviors, Basic Network Structure and Network Importance) that together explained 42% of the variance in SRC. The total model showed adequate fit (Comparative Fit Index = 0.95; Tucker Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Squared Residual = 0.05) and acceptable reliability (α = 0.60; McDonald's ω = 0.73) and correlated with validation measures mostly in the weak to moderate range. Due to variable factor scores for reliability and validity, we only recommend using the total score. CONCLUSION The SRC-IPA is a novel measure of SRC derived from the IPA that captures social network data and has applications in research and clinical work. Secondary data analyses using the SRC-IPA in studies that collected the IPA can further demonstrate the interaction of SRC with a wide variety of clinical indicators and demographic characteristics, making it a valuable addition to other measures of SRC.
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Affiliation(s)
- Meredith W Francis
- Washington University in St. Louis, Brown School of Social Work, St. Louis, MO, USA
| | - Jessica L Bourdon
- Wellbridge Addiction Treatment and Research, Center for Addiction Science, Calverton, NY, USA
| | - Grace Chan
- University of Connecticut, Department of Psychiatry, Farmington, CT, USA
- University of Iowa, Department of Psychiatry, Iowa City, IA, USA
| | - Danielle M Dick
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | | | - Chella Kamarajan
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Sivan Kinreich
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - John Kramer
- University of Iowa, Department of Psychiatry, Iowa City, IA, USA
| | - Sally I-Chun Kuo
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Ashwini K Pandey
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Gayathri Pandey
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Rebecca L Smith
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Kathleen K Bucholz
- Washington University in St. Louis, Department of Psychiatry, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Washington University in St. Louis, Department of Psychiatry, St. Louis, MO, USA
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Sión A, Jurado-Barba R, Esteban-Rodríguez L, Arias F, Rubio G. Spanish Validation of the Assessment of Recovery Capital Scale in Clinical Population with Alcohol Use Disorder. THE SPANISH JOURNAL OF PSYCHOLOGY 2022; 25:e16. [PMID: 35503039 DOI: 10.1017/sjp.2022.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Recovery from alcohol use disorder involves achieving certain resources for positive lifestyle changes, well-being, and long-term abstinence. The present study aims to translate and validate the Assessment Capital Recovery (ARC) in a Spanish clinical sample of individuals with alcohol use disorder, in abstinence. The participants were 184 patients who attended outpatient treatments. They were evaluated with the adapted version of the ARC (Spanish abbreviation: "Valoración del Capital de Recuperación, VCR") and by WHOQOL-BREF (quality of life scale), in one session. Statistical analysis included the calculation of reliability, convergent validity (relationship with WHOQOL-BREF), specificity and sensitivity, as well as validity based on internal structure (confirmatory factor analysis). VCR scores show appropriate values for reliability (α = .90), and a low convergent validity with WHOQOL-BREF (Rho = .33-.53). The VCR appears to distinguish between patients with early and stable sobriety (χ2 = 20.55, p < .01). The ROC curve indicates significant discrimination values (p < .05) for stable recovery (5 years of abstinence) and sensitivity of 85.2% and specificity of 71.2%. Further, confirmatory factor analysis suggests the presence of a single factor, with relatively acceptable values of goodness of fit and factor loadings. We used ULS parameter estimation to study VCR properties, an appropriate tool for assessing recovery in clinical populations of individuals with alcohol use disorder in abstinence.
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Affiliation(s)
- Ana Sión
- Hospital Universitario 12 de Octubre (Spain)
- Universidad Complutense (Spain)
| | - Rosa Jurado-Barba
- Hospital Universitario 12 de Octubre (Spain)
- Universidad Camilo José Cela (Spain)
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Logan TK, McLouth CJ, Cole J. Examining Recovery Status Trends over 7-Years for Men and Women Clients of a Substance Use Disorder Recovery Housing Program. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221083654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adults who are homeless and/or involved in the criminal justice system have significantly higher risks of substance use disorders (SUD)s and they may have increased difficulty initiating and maintaining traditional SUD treatments. To address the needs of adults with SUDs who are homeless/criminal justice system involved the Recovery Kentucky programs were established. This study examined outcomes for this recovery housing program among an unduplicated statewide sample of men ( n=672) and women ( n = 732) clients who entered the Recovery Kentucky program and who were followed-up about 12 months after program entry across a 7-year period. Low, but similar rates of problem alcohol or illicit drug use at follow-up were found across the 7-year period. Men had higher rates of return to use than women. Further, about 40% of the clients had at least one recovery status vulnerability factor at follow-up each year of the study with no differences by gender.
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Affiliation(s)
- TK Logan
- University of Kentucky, Lexington, KY, USA
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Kaur A, Lal R, Sen MS, Sarkar S. Comparison of Recovery Capital in Patients with Alcohol and Opioid Dependence - An Exploratory Study. ADDICTION & HEALTH 2022; 14:105-114. [PMID: 36544508 PMCID: PMC9743817 DOI: 10.22122/ahj.2022.196722.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 12/24/2022]
Abstract
Background Recovery capital helps in the assessment of the personal strengths and challenges that exist in an individual with substance use which may have an impact on recovery process. This study aims at finding out the factors which help such individuals to sustain their recovery and how these factors differ across the two groups of people suffering from Alcohol Dependence Syndrome and Opioid Dependence Syndrome. Methods A cross-sectional observational was designed where sociodemographic and clinical variables, the recovery capital ARC (Assessment of Recovery Capital) Scale and Severity of substance use SDS (Severity of Dependence) Scale of patients diagnosed with Alcohol Dependence Syndrome (ADS group) and those with Opioid Dependence Syndrome (ODS group) were assessed among patients not reporting withdrawal symptoms. Findings A total of 49 subjects in the ODS group and 30 subjects in the ADS group were enrolled. The majority of the subjects in both groups were married, belonged to urban areas, practiced Hinduism, and were living in nuclear families. There was a significant difference between the educational status (p<0.001), religion practiced (p<0.001), age of onset of dependence (p<0.001), severity of dependence (p=0.11), and duration of abstinence (p<0.001) between the ADS and ODS groups. The mean scores on ARC Scale were 45.9 (S.D. =3.5) in the ODS group and 47.4 (S.D. =4.3) in the ADS group. ADS group had higher scores in Social Support Domain (p=0.034) and Housing and Safety domain (p=0.025). Other domains like global health, citizenship, meaningful activities, risk-taking, coping, and recovery experience did not significantly differ between the groups. Conclusion This study aims at comparing the recovery capital of ADS patients with ODS patients. It also suggests that tailored treatment plans for people with ADS and ODS especially in housing and social support and common treatment approach in other domains of recovery will help them sustain the state for a longer term.
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Affiliation(s)
- Apinderjit Kaur
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lal
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Mahadev Singh Sen
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India,Correspondence to: Mahadev Singh Sen; Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India;
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
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Keith D, Tegge A, Athamneh L, Freitas-Lemos R, Tomlinson D, Craft W, Bickel W. The phenotype of recovery: Association among delay discounting, recovery capital, and length of abstinence among individuals in recovery from substance use disorders. J Subst Abuse Treat 2022; 139:108783. [DOI: 10.1016/j.jsat.2022.108783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/10/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
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Kang M, Mackay L, Christie D, Callon C, Argento E. Can psychedelic-assisted psychotherapy play a role in enhancing motivation to change in addiction treatment settings? JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Despite growing availability of several evidence-based approaches in the treatment of substance use disorders, existing pharmacotherapy and psychosocial interventions continue to have significant limitations, such as low treatment retention rates and high rates of relapse. There is a need to develop new strategies and models to address these limitations and target underlying psychosocial drivers of addiction, such as motivation to change – a crucial factor in achieving positive addiction treatment outcomes. Re-emerging clinical evidence and literature signal the promise of psychedelic-assisted psychotherapies as being novel, adjunctive treatments for a range of mental health and substance use disorders, encouraging further research. However, there remains a lack of formally validated metrics to evaluate recovery capital and motivation, limiting interpretation of the growing psychedelic literature. This commentary describes the current state of this line of investigation and potential impact of psychedelic-assisted psychotherapy on enhancing motivation to change in addiction treatment, and the need for validated metrics to evaluate recovery motivation and capital to assess the potential for psychedelic-assisted psychotherapies to elicit positive, lasting changes in substance use behaviors among those seeking treatment.
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Affiliation(s)
- Mark Kang
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Lindsay Mackay
- Department of Medicine, University of British Columbia, Vancouver, Canada
- BC Centre on Substance Use, Vancouver, Canada
| | - Devon Christie
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Cody Callon
- BC Centre on Substance Use, Vancouver, Canada
| | - Elena Argento
- Department of Medicine, University of British Columbia, Vancouver, Canada
- BC Centre on Substance Use, Vancouver, Canada
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Burns J, Yates R. An examination of the reliability and validity of the recovery capital questionnaire (RCQ). Drug Alcohol Depend 2022; 232:109329. [PMID: 35101817 DOI: 10.1016/j.drugalcdep.2022.109329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/03/2022]
Abstract
AIMS AND BACKGROUND Recovery capital refers to the resources people can call upon to initiate and sustain alcohol and drug problem resolution. Measuring this phenomenon could help an individual better understand their strengths as well as gauge the impact of any interventions designed to improve recovery capital and / or reduce addiction severity. This study aimed to test the internal consistency, stability reliability, criterion-related concurrent validity and content validity of the Recovery Capital Questionnaire (RCQ). SETTING AND PARTICIPANTS Participants (n = 173) accessing community based addiction treatment (n = 108) and residential treatment (n = 65) in England and Scotland completed the RCQ at two time-points one week apart (n = 102) to test stability reliability, and also completed the RCQ alongside measures of quality of life and resilience (n = 152). Content validity was assessed by seven subject matter experts with content validity ratio and index calculated. FINDINGS Cronbach's Alpha values (internal consistency) included: social α = 0.52 (0.40-62); physical α = 0.73 (0.66-0.78); human α = 0.85 (0.82-0.88); community α = 0.85 (0.82-0.88); RCQ Total α = 0.88 (0.85-90). RCQ stability reliability (r = 0.89) and ICC (0.88) were calculated. Content Validity Index statistic of 0.91 was calculated. Correlations between relevant domains within the RCQ and WHOQOL Bref were found to include: r = 0.44, 0.59, 0.66 and 0.40. Correlations between RCQ and CD-RISC scores were calculated (r = 0.65). CONCLUSION The Recovery Capital Questionnaire was found to possess good overall internal consistency and stability reliability. Content validity was found to be strong and the RCQ demonstrated good concurrent validity with a measure of quality of life and a measure of resilience.
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Affiliation(s)
- John Burns
- Faculty of Social Sciences, University of Stirling, Stirling, Scotland FK94LA, UK.
| | - Rowdy Yates
- Faculty of Social Sciences, University of Stirling, Stirling, Scotland FK94LA, UK
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Eddie D, Bergman BG, Hoffman LA, Kelly JF. Abstinence versus moderation recovery pathways following resolution of a substance use problem: Prevalence, predictors, and relationship to psychosocial well-being in a U.S. national sample. Alcohol Clin Exp Res 2022; 46:312-325. [PMID: 34931320 PMCID: PMC8858850 DOI: 10.1111/acer.14765] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many people who report resolving an alcohol or other drug (AOD) problem continue some level of substance use. Little information exists, however, regarding the prevalence of this resolution pathway, or how continued substance use after resolving an AOD problem, relative to abstinence, relates to functioning, quality of life, and happiness (i.e., well-being). Greater knowledge of the prevalence and correlates of non-abstinent AOD problem resolution could inform public health messaging and clinical guidelines, while encouraging substance use goals likely to maximize well-being and reduce risks. METHODS We analyzed data from a nationally representative sample of individuals who endorsed having resolved an AOD problem (N = 2002). Analyses examined: (1) The prevalence of various substance use statuses coded from lowest to highest risk: (a) continuous abstinence from all AOD since problem resolution; (b) current abstinence from all AOD with some use since problem resolution; (c) current use of a substance reported as a secondary substance; (d) current use of the individual's primary substance only; or, (e) current use of a secondary and primary substance; (2) relationships between substance use status and demographic, clinical, and service use history measures; and (3) the relationship between substance use status and well-being. Weighted, controlled, regression analyses examined the influence of independent variables on substance use status. RESULTS (1) Prevalence: In this sample, 20.3% of patients endorsed continuous abstinence; 33.7% endorsed current abstinence; 21.0% endorsed current use of a secondary substance; 16.2% endorsed current use of a primary substance; and 8.8% endorsed current use of both a secondary and a primary substance. (2) Correlates: Lower-risk substance use status was associated with the initiation of regular substance use at an older age, more years since problem resolution, and fewer lifetime psychiatric diagnoses. (3) Well-Being: Controlling for pertinent confounds, lower-risk substance use status was independently associated with greater self-esteem, happiness, quality of life and functioning, and recovery capital, as well as less psychological distress. CONCLUSIONS About half of Americans who self-identify as having resolved an AOD problem continue to use AOD in some form. It appears that, although for many abstinence is not necessary to overcome an AOD problem, it is likely to lead to better functioning and greater well-being. Further, people appear to gravitate toward abstinence/lower risk substance use with greater time since problem resolution.
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Affiliation(s)
- David Eddie
- Recovery Research Institute Center for Addiction Medicine Massachusetts General HospitalHarvard Medical School Boston Massachusetts USA
| | - Brandon G. Bergman
- Recovery Research Institute Center for Addiction Medicine Massachusetts General HospitalHarvard Medical School Boston Massachusetts USA
| | - Lauren A. Hoffman
- Recovery Research Institute Center for Addiction Medicine Massachusetts General HospitalHarvard Medical School Boston Massachusetts USA
| | - John F. Kelly
- Recovery Research Institute Center for Addiction Medicine Massachusetts General HospitalHarvard Medical School Boston Massachusetts USA
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Eysenbach G, Chiodo L, Wilson A, Brezing C, Martinez S, Xiong X, Gerwien R, Imbert B, Deeg M, Maricich Y, Campbell A. Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial. JMIR Res Protoc 2022; 11:e32759. [PMID: 35080499 PMCID: PMC8829697 DOI: 10.2196/32759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prescription digital therapeutics are software-based disease treatments that are regulated by the US Food and Drug Administration; the reSET-O prescription digital therapeutic was authorized in 2018 and delivers behavioral treatment for individuals receiving buprenorphine for opioid use disorder. Although reSET-O improves outcomes for individuals with opioid use disorder, most of the therapeutic content is delivered as narrative text. PEAR-008 is an investigational device based on reSET-O that uses an interactive, game-based platform to deliver similar therapeutic content designed to enhance patient engagement, which may further improve treatment outcomes. OBJECTIVE We aim to investigate how participants interact with the prescription digital therapeutic's new content delivery format. Secondary objectives include evaluating treatment success, symptoms of co-occurring mental health disorders, recovery capital, and skill development. METHODS Due to the COVID-19 pandemic, this study was redesigned using a decentralized model because it was not possible to conduct medication initiation and study visits in person, as initially intended. A decentralized, randomized controlled trial design will be utilized to compare patient engagement with PEAR-008 and that with reSET-O using both subjective and objective assessments. The study population will consist of approximately 130 individuals with opioid use disorder (based on Diagnostic and Statistical Manual of Mental Disorders 5 criteria) who have recently started buprenorphine treatment for opioid use disorder. Participants will be virtually recruited and randomly assigned to receive either PEAR-008 or reSET-O. All study sessions will be virtual, and the duration of the study is 12 weeks. The primary outcome measure of engagement is operationalized as the number of active sessions per week with either PEAR-008 or reSET-O. (An active session is any session that contains some active participation in the app, such as navigating to a different screen, engaging with a learning module, or responding to a notification.) Subjective dimensions of engagement will be assessed with participant surveys. The hypothesis is that PEAR-008 will have significantly greater participant engagement than reSET-O. RESULTS As of February 2021, participant enrollment is ongoing. CONCLUSIONS This randomized controlled trial will investigate if changing the delivery format and enhancing the content of a prescription digital therapeutic for opioid use disorder will affect how participants use and interact with the prescription digital therapeutic. The study design may serve as a useful model for conducting decentralized studies in this patient population. TRIAL REGISTRATION ClinicalTrials.gov NCT04542642; https://clinicaltrials.gov/ct2/show/NCT04542642. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/32759.
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Affiliation(s)
| | - Lisa Chiodo
- Addiction Research and Education Foundation/Clean Slate, Florence, MA, United States
| | - Amanda Wilson
- Addiction Research and Education Foundation/Clean Slate, Florence, MA, United States
| | | | | | | | | | - Bruce Imbert
- Pear Therapeutics, Inc, Boston, MA, United States
| | - Mark Deeg
- Pear Therapeutics, Inc, Boston, MA, United States
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Baginski BN, Byrne KA, Demosthenes L, Roth PJ. Examining Internalizing Mental Health Correlates of Addiction Severity in Patients Hospitalized With Medical Complications From Substance Use Disorder. Subst Abuse 2022; 16:11782218221115583. [PMID: 35990751 PMCID: PMC9382059 DOI: 10.1177/11782218221115583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022]
Abstract
Background: Comorbidities between Substance Use Disorder (SUD) and mental health
disorders are highly prevalent, yet there remains a lack of information
regarding how mental health conditions may affect addiction severity.
Consequently, this study sought to investigate the relationship between
internalizing disorders (anxiety and mood disorders) and addiction severity
in patients hospitalized for SUD-related medical complications. Individual
difference predictors and history of prior treatment for SUD were also
examined. Methods: Participants (N = 200) were hospitalized patients who consented to receive
peer-based recovery support services for their SUD. To be eligible for the
study, participants needed to have a SUD diagnosis due to alcohol, opioids,
methamphetamine, cocaine, or a combination of these substances
(polysubstance use). Participants completed self-report questionnaires
regarding demographics, mental health history, prior SUD treatment, and
addiction severity (Drug and Alcohol Screening Test; DAST-10) during their
hospitalization. Results: Results showed that patients with Generalized Anxiety Disorder (GAD)
(M = 6.68, SD = 2.97) had greater addiction severity
compared to those without GAD (M = 5.41, SD = 3.34),
P = .016. Addiction severity results stratified by SUD
type showed that the relationship was significant among patients with
Alcohol Use Disorder (P = .014), but not among those with
other SUD types (Ps > .27). Major Depressive Disorder
(MDD) and Post-Traumatic Stress Disorder (PTSD) were not linked to addiction
severity. Among those with GAD, 81.4% had previously been to treatment
compared to only 53.1% of those without GAD, P = .010. The
only participant characteristic linked with addiction severity was insurance
status. Conclusions: GAD may represent a risk factor for advanced alcohol addiction trajectories,
including greater addiction severity and severe health complications
requiring inpatient hospitalization.
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Affiliation(s)
- Bryana N Baginski
- University of South Carolina School of Medicine Greenville, Greenville, SC, USA
| | | | - Lauren Demosthenes
- Department of Obstetrics and Gynecology, Prisma Health-Upstate, Greenville, SC, USA
| | - Prerana J Roth
- Department of Internal Medicine, Prisma Health-Upstate, Greenville, SC, USA
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Logan TK, Cole J, Schroeder M. Examining Recovery Status and Supports before and after Substance Abuse Disorder Treatment Among Clients Who Experienced Lifetime and Recent Firearm-Related Threats. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211056601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Firearm-related risks have often been overlooked in the sequela of substance use and substance use disorders. This study compares adult substance abuse disorder treatment (SADT) clients who experienced recent ( n = 274) and lifetime ( n = 889) firearm threats to adults who were not threatened with a firearm ( n = 2029) before and 12 months after program entry. More men experienced firearm threats (38.8%) than women (34.2%). However, among those with any firearm threats, more women (27.2%) experienced firearm threats in the year before program entry than men (20.2%). Being threatened with a firearm was associated with increased economic vulnerability, criminal justice system involvement, mental health problems, and victimization both before and after SADT program entry. A higher number of adverse childhood experiences were associated with firearm threats and particularly recent firearm threats. Results of this study underscore the importance of screening for firearm-related risks in substance abuse disorder treatment programs.
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Affiliation(s)
- TK Logan
- University of Kentucky, Lexington, KY, USA
| | | | - Maggie Schroeder
- Kentucky Department of Behavioral Health, Developmental and Intellectual Disabilities, Frankfort, KY, USA
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Recovery Capital among Migrants and Ethnic Minorities in Recovery from Problem Substance Use: An Analysis of Lived Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413025. [PMID: 34948635 PMCID: PMC8700971 DOI: 10.3390/ijerph182413025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/27/2021] [Accepted: 12/08/2021] [Indexed: 01/09/2023]
Abstract
Migrants and ethnic minorities (MEM) are known to be disadvantaged concerning risk factors for problem substance use and resources to initiate and sustain recovery (i.e., recovery capital). Yet, the voices of MEM are largely overlooked in recovery literature. This study explores recovery capital through 34 semi-structured interviews with a diverse sample of MEM in recovery in two ethnically diverse cities in Belgium. A Qualitative Content Analysis using recovery capital theory allowed us to identify various recovery resources on a personal, social, and community level. While physical and human recovery resources play a central role in participants' narratives, personal recovery capital is closely intertwined with meaningful social networks (i.e., social recovery capital) and recovery-supportive environments that maximize opportunities for building culturally sensitive recovery capital (i.e., community recovery capital). Though MEM-specific elements such as culture, migration background, stigma, and structural inequalities play a significant role in the recovery resources of MEM, the largely "universal" nature of recovery capital became clear. The narratives disclose a distinction between "essential" and "acquired" recovery capital, as well as the duality of some recovery resources. The need for developing recovery-oriented systems of care that are culturally responsive, diminish structural inequalities, and facilitate building recovery capital that is sensitive to the needs of MEM is emphasized.
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Substitute Behaviors following Residential Substance Use Treatment in the Western Cape, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312815. [PMID: 34886541 PMCID: PMC8657596 DOI: 10.3390/ijerph182312815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/27/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022]
Abstract
The dynamics of substitute behaviors and associated factors remain poorly understood globally, and particularly in low- and middle-income contexts. This prospective study describes the prevalence and types of substitute behaviors as well as predictors, correlates, and motivations associated with substitution in persons (n = 137) admitted to residential substance use treatment in the Western Cape province of South Africa. The brief assessment of recovery capital, overall life satisfaction scale, and an adapted version of the addiction matrix self-report measure were completed during and post-treatment. Results indicate that substitutes were employed consciously for anticipated appetitive effects, for time-spending, (re)connecting with others, and enjoyment. At follow-up, 36% of service users had substituted their primary substance(s) with another substance or behavior; 23% had relapsed and 40% had maintained abstinence. While some service users may be especially vulnerable to developing substitute behaviors, targeted prevention and intervention efforts can reduce this risk.
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Devlin AM, Wight D. Mechanisms and context in the San Patrignano drug recovery community, Italy: a qualitative study to inform transfer to Scotland. DRUGS (ABINGDON, ENGLAND) 2021; 28:85-96. [PMID: 34824492 PMCID: PMC7612027 DOI: 10.1080/09687637.2020.1747397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The San Patrignano drug recovery community, Italy, is regarded as one of the most successful in the world. However, if this model is to be transferred to other countries, it is necessary to clarify its underlying mechanisms and how far their success is context dependent. This qualitative study investigated these features of the San Patrignano model. Data collection included semi-structured interviews with six key stakeholders and 10 days’ observational field notes. Data were synthesised using frameworks and analysis was informed by realist principles. Individual level mechanisms include: commitment to change, removal from former social environment, communal living, peer mentor with lived experience and meaningful work. These operate in the context of a free of charge, long term (3–4 year) residential community. Organisational level mechanisms are: visionary leadership, staff dedication, social enterprise and adaptable learning. Organisational contextual factors include: a gap in suitable provision for drug recovery and the region’s high level of social capital. Articulating the programme theory of the recovery model and its contextual dependency helps clarify which elements should be transferred and how far they need to be adapted for different socio-cultural settings. The recognition of context is crucial when considering transfer of effective complex interventions across countries.
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Affiliation(s)
- Alison M Devlin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
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Swan JE, Aldridge A, Joseph V, Tucker JA, Witkiewitz K. Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment. J Psychoactive Drugs 2021; 53:394-403. [PMID: 34727839 DOI: 10.1080/02791072.2021.1986243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants' study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants' alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.
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Affiliation(s)
- Julia E Swan
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, RTI International, Research Triangle Park, NC, USA
| | - Verlin Joseph
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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Abstract
This paper offers a review and recommendations for clinicians working with patients interested in discontinuing opioid agonist treatment. As buprenorphine/naloxone has gained widespread acceptance for opioid addiction, many treatment providers and patients have a range of hopes and expectations about its optimal use. A surprising number assume buprenorphine/naloxone is primarily useful as a medication to transition off illicit opioid use, and success is partially defined by discontinuing the medication. Despite accumulating evidence that a majority of patients will need to remain on medication to preserve their gains, clinicians often have to address a patient's fervent desire to taper. Using the concept of "recovery capital," our review addresses (1) the appropriate duration of opioid agonist treatment, (2) risks associated with discontinuing, (3) a checklist that guides the patient through self-assessment of the wisdom of discontinuing opioid agonist treatment, and (4) shared decision making about how to proceed.
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