1
|
van den Berk-Clark C, Duncan E, Galbreath I, Marino A, Baker EA. Linking social capital and the political economy of substance treatment delivery: The case of recovery-oriented systems of care in Illinois. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 132:104561. [PMID: 39241533 DOI: 10.1016/j.drugpo.2024.104561] [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: 03/05/2024] [Revised: 05/13/2024] [Accepted: 08/11/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Recovery-oriented systems of care have been a widely supported approach to transforming existing substance treatment programs across different states through developing recovery programs and interagency networks. However, little is known about the facilitators and barriers influencing their development and implementation. METHODS Qualitative study of 5 different recovery-oriented systems of care in Illinois. Nineteen respondents completed individual interviews. RESULTS A total of 124 codes and 2 themes were identified, reflecting constraints and opportunities. Theme 1 focused on how ROSC programs developed bonding, bridging, and linking social capital. Theme 2 focused on the ROSC coordinator and lead agency's power and accountability. CONCLUSIONS The roles of lead agencies and ROSC coordinators were highlighted in the development and implementation of ROSCs. ROSC membership structures allow for bonding, bridging, and linking social capital. Still, additional technical support is needed to improve accountability, reduce power differentials and turf battles, and ensure greater participation among more diverse stakeholders.
Collapse
Affiliation(s)
| | - Emily Duncan
- Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA
| | - Ian Galbreath
- Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA
| | - Andrew Marino
- Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA
| | - Elizabeth A Baker
- School of Public Health and Social Justice, Saint Louis University, St. Louis, USA
| |
Collapse
|
2
|
Best D, Critchlow T, Higham D, Higham K, Thompson R, Shields D, Barton P. Delivering Peer-Based Support in Prisons During the COVID Pandemic and Lockdown: Innovative Activities Delivered by People Who Care. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:1161-1174. [PMID: 35950490 DOI: 10.1177/0306624x221110809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
During COVID and lockdown, many prisoners have not only been affected by infection transmission in crowded and ill-equipped institutions, they have also been separated from a range of supports, including loss of family and professional supports and support for prisoners with addiction and/or mental health problems has been disrupted. This paper reports on evidence of how peer-based recovery organizations have attempted to mitigate these adverse effects, based on a case study of one prison in the North-West of England, using a range of routine reporting data and original research data. The paper shows how prison-based peer recovery support has not only continued through lockdown but grown both in the prison and in continuing care on release. The key conclusion is that Lived Experience Recovery Organizations (LEROs) have a vital role to play in offering continuing care to prison populations both to support early recovery and to sustain change around release back into the community, in COVID but also more generally.
Collapse
|
3
|
Sinclair DL, Chantry M, De Ruysscher C, Magerman J, Nicaise P, Vanderplasschen W. Recovery-supportive interventions for people with substance use disorders: a scoping review. Front Psychiatry 2024; 15:1352818. [PMID: 38577404 PMCID: PMC10991812 DOI: 10.3389/fpsyt.2024.1352818] [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: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Background Recovery-supportive interventions and strategies for people with substance use disorders are a cornerstone of the emergent recovery paradigm. As compared to other services, such approaches have been shown to be holistically focused and improve outcomes (e.g. substance use, supportive relationships, social functioning, and well-being). Even so, a comprehensive overview of the nature, extent, and range of research on the topic is lacking. Methods A scoping review of the literature was conducted to characterize the main topics on recovery-supportive interventions. A systematic search was conducted in three databases: Scopus, Web of Science, and PubMed from January 2000 to July 2023 using the PRISMA-ScR. Twenty-five studies published between 2005-2022 met the inclusion criteria. Results Most studies emanated from the United States, and we found a peak in publication frequency between 2018-2022 (n = 13) relative to other years. The most prominent lines of inquiry appear to concern recovery-oriented policies; principles of recovery-oriented services (challenges encountered when implementing recovery-oriented practices, relationships with service providers characterized by trust, and service user-service provider collaboration), and recovery capital (particularly recovery-supportive networks, employment, and housing). Seventeen studies addressed co-occurring disorders, and eight addressed substance use recovery. Conclusion To advance the field, more context-specific studies are required on supporting peer professionals, (including enabling cooperation with service users, and hiring experts by experience as staff), and training of professionals (e.g., nurses, psychologists, social workers, physicians) in the principles of recovery.
Collapse
Affiliation(s)
| | - Mégane Chantry
- Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium
| | | | - Jürgen Magerman
- EQUALITY//ResearchCollective, HOGENT University of Applied Sciences and Arts, Ghent, Belgium
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium
| | | |
Collapse
|
4
|
Sampietro HM, Barrios M, Guilera G, Rojo JE, Gómez-Benito J. Effectiveness of a recovery workshop implemented in community mental health services in Catalonia (Spain): study protocol for a non-randomized controlled trial. BMC Psychiatry 2022; 22:827. [PMID: 36575419 PMCID: PMC9793523 DOI: 10.1186/s12888-022-04350-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/29/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). METHODS/DESIGN This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users' measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. DISCUSSION The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. TRIAL REGISTRATION ISRCTN11695542 (Registration date: 5 July 2022).
Collapse
Affiliation(s)
- Hernán María Sampietro
- ActivaMent Catalunya Associació, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - J. Emilio Rojo
- Department of Medicine, International University of Catalonia, Barcelona, Spain
- Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
5
|
Individual Paths to Recovery from Substance Use Disorder (SUD): What Are the Implications of the Emerging Recovery Evidence Base for Addiction Psychiatry and Practice? Psychiatr Clin North Am 2022; 45:547-556. [PMID: 36055738 DOI: 10.1016/j.psc.2022.04.006] [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: 11/20/2022]
Abstract
Although the research base around 12-step effectiveness has been grown markedly in recent years, there has also been growth in the broader evidence base around recovery models, and this article reviews three key components: the transition to a social model of recovery; the emergence of a metric of recovery progress, recovery capital focused on building strengths; and multiple pathways to recovery, involving mutual aid groups, recovery community organizations, and access to jobs, friends, and housing. We conclude with an overview of the practical implications for addiction treatment and sustaining the gains made in specialist treatment services.
Collapse
|
6
|
Härd S, Best D, Sondhi A, Lehman J, Riccardi R. The growth of recovery capital in clients of recovery residences in Florida, USA: a quantitative pilot study of changes in REC-CAP profile scores. Subst Abuse Treat Prev Policy 2022; 17:58. [PMID: 35933398 PMCID: PMC9356455 DOI: 10.1186/s13011-022-00488-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is a growing evidence base around predictors of retention and completion in a range of recovery residence models, particularly Oxford Houses and Sober Living Houses, and recovery housing is recognized as a clearly evidenced area of recovery intervention. The aim of the study was to quantitatively assess recovery capital in a sample of recovery residence clients. Method The study used a repeated measures self-completion of a standardized recovery capital instrument (REC-CAP) for clients retained across various houses within one Level 2 recovery residence provider whose program was based on a 12-step approach. While 823 clients participated in the baseline assessment, a sample of 267 clients was achieved for six-month follow-up interview, based on those retained in the residence. A logistic regression model examined factors associated with retention and a repeated measures marginal mixed model evaluated the factors associated with changes in recovery capital between the baseline and the follow-up assessment. Results Members of the group that remained in recovery residences were more likely to be older with a record of high participation in recovery groups, with greater drop-out among younger residents, female residents and those with an identified housing need. For those retained to follow-up, greater recovery capital growth was associated with employment, higher levels of social support and more recovery group involvement, as well as age and a higher quality of life. The need for family support was shown to reduce levels of recovery capital. However, those younger people who were retained reported better recovery capital growth during the initial six months of residence. Conclusion The key conclusion is that while recovery capital generally increases during a stay in a recovery residence, it does not do so consistently across the sample population. This has implications for how pathways to recovery group engagement are supported for women and young people and how social support (encompassing housing, employment and family issues) is provided to those populations during periods of residence. This suggests the potential need for training and guidance for house managers working with these groups.
Collapse
|
7
|
Support for COVID-19-Related Substance Use Services Policy Changes: a New York State-Wide Survey. J Behav Health Serv Res 2022; 49:262-281. [PMID: 35112221 PMCID: PMC8810146 DOI: 10.1007/s11414-021-09784-y] [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] [Accepted: 12/16/2021] [Indexed: 12/05/2022]
Abstract
This study aims to describe which substance use service (SUS) organizations and who within these organizations support the maintenance of policies targeted at improving substance use treatment services. An online survey assessing respondent, organizational and program demographics, and knowledge and support regarding policy changes was distributed to all certified SUS and harm reduction programs in NYS. Bivariate and latent class analyses were used to identify patterns and associations to policy choices. Across the 227 respondents, there was a support for maintaining expansion of insurance coverage, virtual behavioral health/counseling and medication initiation/maintenance visits, reductions in prior authorizations, and access to prevention/harm reduction services. Three classes of support for policies were derived: (1) high-supporters (n = 49; 21%), (2) low-supporters (n = 66; 29%), and (3) selective-supporters. Having knowledge of policy changes was associated with membership in the high-supporters class. Implications regarding the role of knowledge in behavioral health policies dissemination structures, decision-making, and long-term expansion of SUS are discussed.
Collapse
|
8
|
The line of vulnerability in a recovery assemblage. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103740. [DOI: 10.1016/j.drugpo.2022.103740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/22/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
|
9
|
Addiction and Recovery in Dutch Governmental and Practice-Level Drug Policy: What’s the Problem Represented to be? JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221087590] [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
Around 2009, ‘recovery’ was introduced in the Netherlands as a new approach to drug addiction and addiction services. Recovery is now featured in practice-level policy but is absent in governmental drug policy. To investigate whether the Dutch recovery vision is coherent with governmental drug policy, we apply Bacchi’s What’s the problem represented to be? approach to analyse problematizations of ‘drug addiction’. We analysed two influential practice-level policy documents and one governmental drug policy document. We found that governmental policy addresses the harms and public nuisance of drug addiction, whilst practice-level policy addresses the wellbeing of persons with addiction. Despite these different starting points, the Dutch recovery vision seems coherent with both problematizations. Its adoption in the Netherlands was less subject to political debate compared to other countries. This may be a result of recovery being driven by bottom-up efforts without government intervention, leading to constructive ambiguity between government- and practice-level policies.
Collapse
|
10
|
Johannessen DA, Nordfjærn T, Geirdal AØ. Work-Related Satisfaction among Clinicians Working at Inpatient Treatment Facilities for Substance Use Disorder: The Role of Recovery Orientation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147423. [PMID: 34299874 PMCID: PMC8303105 DOI: 10.3390/ijerph18147423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/30/2022]
Abstract
Several psychosocial factors have been suggested as facilitators of change among inpatients treated for substance use disorder (SUD). Research suggests that staff members are also influenced by the practice in which they are involved, and by contextual psychosocial factors at their treatment facilities. This cross-sectional questionnaire survey study was conducted to investigate the role of recovery-orientated interventions in describing work-related satisfaction among clinicians at inpatient SUD treatment facilities. The respondents (n = 407) rated items indicating work-related satisfaction and the degree of recovery orientation at their treatment facilities. The main findings of two block regression analyses indicated that clinicians’ work-related satisfaction was positively influenced by inpatients’ opportunities to pursue their goals and choices, and negatively influenced by inpatient involvement. The change in clinicians’ work-related satisfaction could not be described by the degree of individually tailored and varied interventions at the treatment facility. Clinicians should be supported and involved in the process of implementing measures to increase inpatient involvement in the treatment programmes, and treatment measures that enable inpatients to pursue their goals and choices should be enhanced. The findings of this and previous studies indicate that a recovery-oriented framework promotes clinicians’ work-related satisfaction and has an enabling influence on both inpatients and clinicians.
Collapse
Affiliation(s)
- Dagny Adriaenssen Johannessen
- Blue Cross East, 0182 Oslo, Norway
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
- Correspondence:
| | - Trond Nordfjærn
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway;
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, 7006 Trondheim, Norway
| | - Amy Østertun Geirdal
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, 0130 Oslo, Norway;
| |
Collapse
|
11
|
Shouan A, Ghosh A, Singh SM, Basu D, Mattoo SK. Predictors of retention in the treatment for opioid dependence: A prospective, observational study from India. Indian J Psychiatry 2021; 63:355-365. [PMID: 34456348 PMCID: PMC8363890 DOI: 10.4103/psychiatry.indianjpsychiatry_448_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 04/14/2021] [Accepted: 06/17/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Literature on a longitudinal study of the determinants of treatment retention for patients with opioid dependence is limited. AIM To find out patient- and treatment-related (buprenorphine-naloxone-assisted treatment [BNX treatment] versus naltrexone treatment) predictors for retention in maintenance treatment. MATERIALS AND METHODS A total of 100 participants with opioid dependence were recruited by convenience sampling. The primary outcome was treatment retention - 3 months and 6 months postentry into maintenance treatment. Multiple assessments were done for the severity of opioid dependence and withdrawal, high-risk behavior, quality of life, and recovery capital - baseline and 3 and 6 months. The secondary outcome was to assess the change observed in the above-listed variables. RESULTS AND CONCLUSIONS Bivariate analysis across retained and the dropout groups brought out significant differences for some (type of opioids and route of administration) but not for other (age, employment, and education) patient-related factors. Multivariate analysis, adjusting for the type of maintenance treatment, rendered these associations statistically insignificant. BNX-based treatment (compared to naltrexone maintenance) was the most significant predictor of treatment retention both at the end of 3 months and 6 months. Even after controlling for the severity of opioid dependence and withdrawal, type and route of opioid use, and high-risk behavior, patients on BNX were eleven times (14 times at the end of 6 months) more likely to be retained in the treatment. BNX group had significant improvements in the domains of recovery capital, quality of life, addiction severity, and severity of opioid dependence. There is a need to scale up the BNX-assisted treatment program in India and elsewhere.
Collapse
Affiliation(s)
- Anish Shouan
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhishek Ghosh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shubh Mohan Singh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debasish Basu
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surendra Kumar Mattoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
12
|
Abstract
Alcohol use disorder (AUD) and family functioning are inextricably bound, and families are impacted negatively by AUD, but families show substantial improvements with AUD recovery. Family members can successfully motivate a person with AUD to initiate changes in drinking or to seek AUD treatment. During recovery, family members can provide active support for recovery. Several couple- or family-involved treatments for AUD have been developed and tested in rigorous efficacy trials. Efficacious treatments based in family systems theory or cognitive behavioral approaches focus on the concerned family member alone, or they engage the couple or family as a unit in the treatment. However, most treatments have been studied in fairly homogeneous, heterosexual, White, non-Hispanic populations, limiting the potential generalizability of these treatments. Substantial gaps remain in our understanding of family processes associated with the initiation and maintenance of AUD recovery among adults. This review outlines the existing literature and describes opportunities for future research to address knowledge gaps in understanding the mechanisms by which these treatments are efficacious, use of family-based treatments with diverse populations, integration of pharmacotherapies with family-involved treatment, role of families in recovery-oriented systems of care, and how to improve treatment development and dissemination.
Collapse
Affiliation(s)
- Barbara S. McCrady
- Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico
| | - Julianne C. Flanagan
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, South Carolina,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| |
Collapse
|
13
|
Bellaert L, Martinelli TF, Vanderplasschen W, Best D, van de Mheen D, Vander Laenen F. Chasing a pot of gold: an analysis of emerging recovery-oriented addiction policies in Flanders (Belgium) and The Netherlands. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1915250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Lore Bellaert
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Thomas F. Martinelli
- IVO Research Institute, The Hague, The Netherlands
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | - David Best
- Department of Criminology, University of Derby, Derby, UK
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Freya Vander Laenen
- Department of Criminology, Penal Law, and Social Law, Ghent University, Ghent, Belgium
| |
Collapse
|
14
|
Best D, Sondhi A, Brown L, Nisic M, Nagelhout GE, Martinelli T, van de Mheen D, Vanderplasschen W. The Strengths and Barriers Recovery Scale (SABRS): Relationships Matter in Building Strengths and Overcoming Barriers. Front Psychol 2021; 12:663447. [PMID: 33841289 PMCID: PMC8033166 DOI: 10.3389/fpsyg.2021.663447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
There is a well-established relationship between isolation and both morbidity and mortality in the context of addiction recovery, yet the protective effects of intimate and familial relationships have not been adequately assessed. The current paper uses the European Life In Recovery database to assess the association between relationship status and living with dependent children on recovery capital of people in recovery from drug addiction, operationalised by the Strengths And Barriers Recovery Scale (SABRS). The study participants were drawn from the REC-PATH study and supplemented by a second sample recruited by the Recovered Users Network (RUN) across various European countries, resulting in a combined sample of 1,313 individuals completing the survey, primarily online. The results show that, in recovery, those who are married or co-habiting reported significantly greater recovery strengths and fewer barriers to recovery, and reported greater gains in recovery capital across their recovery journeys. Similar associations are found for participants who have dependent children living with them. There is also some indication that this association is stronger for female than for male participants. Finally, having more people that one can rely on and a greater proportion of people in recovery in the social network are both linked to greater recovery capital and greater self-reported growth in recovery capital. We conclude that this study provides further evidence in favour of a "social cure" in recovery, in which close familial ties are associated with stronger recovery resources.
Collapse
Affiliation(s)
- David Best
- Department of Criminology, College of Business, Law and Social Sciences, University of Derby, Derby, United Kingdom
| | - Arun Sondhi
- Therapeutic Solutions (Addictions), London, United Kingdom
| | - Lorna Brown
- Department of Criminology, College of Business, Law and Social Sciences, University of Derby, Derby, United Kingdom
| | - Mulka Nisic
- Recovered Users Network (RUN), Brussels, Belgium
| | - Gera E. Nagelhout
- IVO Research Institute, The Hague, Netherlands
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands
| | | | | | - Wouter Vanderplasschen
- Recovery and Addiction Cluster, Department of Special Needs Education, Ghent University, Ghent, Belgium
| |
Collapse
|
15
|
Andersson C, Wincup E, Best D, Irving J. Gender and recovery pathways in the UK. DRUGS: EDUCATION, PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1852180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Catrin Andersson
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, UK
| | | | - David Best
- College of Business, Law and Social Science, University of Derby, One Friar Gate Square, Derby, UK
| | - Jamie Irving
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
16
|
Webb L, Clayson A, Duda-Mikulin E, Cox N. ' I' m getting the balls to say no': Trajectories in long-term recovery from problem substance use. J Health Psychol 2020; 27:69-80. [PMID: 32693631 PMCID: PMC8739601 DOI: 10.1177/1359105320941248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study uses individualisation theory to explore identity transition in substance misuse recovery. Identity narratives gained over 4 years from co-produced video/audio interview and video diary accounts were co-productively collected and analysed using framework analysis. Results indicate a trend towards individualistic and agentic identity as recovery trajectories progress over time. Within-case analysis demonstrates agentic growth for most participants, from early-stage gratitude and reliance on support groups to self-determination and independent decision-making. This early work exploring longer-term recovery adds to the current recovery and social identity discussion and provides evidence of identity growth in longer-term stages of recovery.
Collapse
Affiliation(s)
- Lucy Webb
- Manchester Metropolitan University, UK
| | | | | | - Nigel Cox
- Manchester Metropolitan University, UK
| |
Collapse
|
17
|
Harrison R, Van Hout MC, Cochrane M, Eckley L, Noonan R, Timpson H, Sumnall H. Experiences of Sustainable Abstinence-Based Recovery: an Exploratory Study of Three Recovery Communities (RC) in England. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-018-9967-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
18
|
Abstract
Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.
Collapse
|
19
|
Thomas N, Bull M, Dioso-Villa R, Smith K. The movement and translation of drug policy ideas: The case of ‘new recovery’. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:72-80. [DOI: 10.1016/j.drugpo.2019.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/22/2019] [Accepted: 07/02/2019] [Indexed: 01/09/2023]
|
20
|
Pelullo CP, Curcio F, Auriemma F, Cefalo G, Fabozzi A, Rossiello R, Spagnoli L, Attena F. The Discrimination Against, Health Status and Wellness of People Who Use Drugs in Italian Services: A Survey. MEDICINA-LITHUANIA 2019; 55:medicina55100662. [PMID: 31575011 PMCID: PMC6843327 DOI: 10.3390/medicina55100662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022]
Abstract
Background and Objectives: The aims of this study are to: describe the sociodemographic characteristics and typology of drug addiction among people who use drugs that attend the Servizio per le Dipendenze (SerD), and evaluate the competence and ability of these rehabilitation services to improve their health status and wellness. Materials and Methods: A cross-sectional study was conducted from January to July 2017. Patients attending two selected SerD facilities in the city of Naples, Italy were interviewed with a questionnaire gathering information on sociodemographic data, characteristics of drug addiction, characteristics of enrolment at the SerD, self-reported health status and wellness, and reports of the discrimination suffered. Results: Among the 451 people interviewed, 72.3% had started taking drugs by the age of 20, and half of them have used drugs within the last year. 54.5% of responders attended SerD for more than 10 years, and the two main reasons for attendance were to get help and to get methadone. 79.4% were declared to have a good/very good/excellent health status at the time of interviewing. 53.7% reported suffering from discrimination. Conclusions: Based on our study, discrimination is higher in participants who attended SerD for more than one year, who were formerly in prison, or who were current drug users.
Collapse
Affiliation(s)
- Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138 Naples, Italy.
| | - Fabio Curcio
- Servizio per le Dipendenze, DS 25, ASLNA1, Uscita sottopasso G.B. Marino, 80125 Naples, Itlay.
| | - Francesco Auriemma
- Servizio per le Dipendenze, DS 25, ASLNA1, Uscita sottopasso G.B. Marino, 80125 Naples, Itlay.
| | - Giuseppe Cefalo
- Servizio per le Dipendenze, DS 29, ASLNA1, via Fontanelle 66, 80136 Naples, Italy.
| | - Antonio Fabozzi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138 Naples, Italy.
| | - Riccardo Rossiello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138 Naples, Italy.
| | - Laura Spagnoli
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138 Naples, Italy.
| | - Francesco Attena
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Luciano Armanni 5, 80138 Naples, Italy.
| |
Collapse
|
21
|
Collins A, McCamley A. Quality of life and better than well: a mixed method study of long-term (post five years) recovery and recovery capital. DRUGS AND ALCOHOL TODAY 2018. [DOI: 10.1108/dat-11-2017-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to compare quality of life scores in a long-term recovery population group (post five years) with a general population group and to explore how any differences might be explained by recovering individuals themselves in a small number of follow up qualitative interviews.
Design/methodology/approach
A sequential explanatory mixed method design combining quantitative quality of life measure (WHOQOL-BREF, 1996) and six subsequent semi-structured individual interviews. The quality of life measure compared long-term recovery scores (post five years) with the general population group. The subsequent qualitative semi-structured interviews explored what the participants themselves said about their recovery.
Findings
The quantitative data provide evidence of a significant difference in quality of life (WHOQoL-BREF) in two domains. The long-term recovery group (five or more years into recovery) scored higher in both the environment and psychological domains than the general population group. Of the long-term recovery group, 17 people who still accessed mutual aid scored higher in all four domains than those 23 people who did not. The interviews provide evidence of the this difference as result of growth in psychological elements of recovery, such as developing perspective, improvement in self-esteem, spirituality, as well as contributing as part of wider social involvement.
Research limitations/implications
This study provides support for the quality of life measure as useful in recovery research. The empirical data support the concept of recovery involving improvements in many areas of life and potentially beyond the norm, termed “better than well” (Best and Lubman, 2012; Valentine, 2011; Hibbert and Best, 2011). Limitations: snowballing method of recruitment, and undertaken by public health practitioner. Some suggestions of women and those who attend mutual aid having higher quality of life but sample too small.
Practical implications
Use QoL measure more in recovery research. Public health practitioners and policy makers need to work with partners and agencies to ensure that there is much more work, not just treatment focused, addressing the wider social and environmental context to support individuals recovering from alcohol and drugs over the longer term.
Originality/value
One of small number of studies using with participants who have experienced long-term (post five years) recovery, also use of quality of life measure (WHOQOL-BREF, 1996) with this population.
Collapse
|
22
|
Edwards M, Best D, Irving J, Andersson C. Life in Recovery: A Families’ Perspective. ALCOHOLISM TREATMENT QUARTERLY 2018. [DOI: 10.1080/07347324.2018.1488553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Michael Edwards
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| | - David Best
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| | - James Irving
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| | - Catrin Andersson
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| |
Collapse
|
23
|
Best D, Edwards M. Editorial: International Experiences of Life in Recovery. ALCOHOLISM TREATMENT QUARTERLY 2018. [DOI: 10.1080/07347324.2018.1488551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- David Best
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| | - Michael Edwards
- Department of Law & Criminology, Sheffield Hallam University, Sheffield, United Kingdom
| |
Collapse
|
24
|
Frank D. "I Was Not Sick and I Didn't Need to Recover": Methadone Maintenance Treatment (MMT) as a Refuge from Criminalization. Subst Use Misuse 2018; 53:311-322. [PMID: 28704148 PMCID: PMC6088379 DOI: 10.1080/10826084.2017.1310247] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences, or meet the needs of people who use drugs (PWUD), many of whom who use the program as a pragmatic means of reducing harms associated with criminalization. OBJECTIVES To examine alternative constructions of MMT in order to produce a richer, more contextualized picture of the program and the reasons PWUD employ its services. METHODS This paper uses semi-structured interviews with 23 people on MMT (either currently or within the previous two years). RESULTS Most participants linked their use of MMT to the structural-legal context of prohibition/criminalization rather than through the narrative of the recovery model. Responses suggested the recovery model functions in part to obscure the role of criminalization in the harms PWUD experience in favor of a model based on individual pathology. Conclusions/Importance: In contrast to the recovery model, MMT cannot be understood outside of the structural context of criminalization and the War on Drugs which shape illegal drug use as a difficult and dangerous activity, and consequently position MMT as a way to moderate or escape from those harms.
Collapse
Affiliation(s)
- David Frank
- a City University of New York Graduate School and University Center , New York , USA
| |
Collapse
|
25
|
Miller E, Stanhope V, Restrepo-Toro M, Tondora J. Person-centered planning in mental health: A transatlantic collaboration to tackle implementation barriers. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2017; 20:251-267. [PMID: 31632212 PMCID: PMC6800658 DOI: 10.1080/15487768.2017.1338045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Collaborative, person-centered approaches to care planning are increasingly recognized as instrumental in supporting attainment of personal recovery outcomes. Yet, though much is known about factors that support person-centered planning, successful implementation often remains an elusive goal. This article reviews international efforts to promote person-centered care planning (PCCP) in the context of a randomized clinical trial in the United States and in the Meaningful and Measurable initiative, a collaborative action research project involving diverse provider organizations in Scotland. The authors review the history of international efforts to implement PCCP and offer preliminary evidence regarding its positive impact on both process outcomes (e.g., the nature of the primary therapeutic relationship and the service-user's experience) and personal recovery outcomes (e.g., quality of life, community belonging, and valued roles). PCCP will be defined through descriptions of key principles and practices as they relate to both relational aspects (e.g., shifts in stakeholder roles and conversations) and documentation/recording aspects (e.g., how person-centered relationships are captured in written or electronic records). Similarities and differences between the United States and Scottish experiences of PCCP are highlighted and a series of recommendations offered to further implementation of this essential recovery-oriented practice.
Collapse
Affiliation(s)
- Emma Miller
- School of Social Work and Social Policy, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Victoria Stanhope
- Silver School of Social Work, New York University, New York, New York, USA
| | - Maria Restrepo-Toro
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Janis Tondora
- Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
26
|
Best D, de Alwis S. Community Recovery as a Public Health Intervention: The Contagion of Hope. ALCOHOLISM TREATMENT QUARTERLY 2017. [DOI: 10.1080/07347324.2017.1318647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- David Best
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, England
| | - Stephanie de Alwis
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, England
| |
Collapse
|
27
|
Best D, De Alwis SJ, Burdett D. The recovery movement and its implications for policy, commissioning and practice. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017; 34:107-111. [PMID: 32934473 PMCID: PMC7450866 DOI: 10.1177/1455072517691058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 12/08/2016] [Indexed: 11/15/2022] Open
|
28
|
Cox N, Clayson A, Webb L. A safe place to reflect on the meaning of recovery: a recovery community co-productive approach using multimedia interviewing technology. DRUGS AND ALCOHOL TODAY 2016. [DOI: 10.1108/dat-08-2015-0044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to develop further the understanding of co-productive methodological practice for substance use research by demonstrating the use of a mobile, multimedia interviewing aid by members of a UK recovery community.
Design/methodology/approach
– A co-productive approach to data collection was piloted using a bespoke, audio-visual booth located in a range of recovery and community-focused social events. Audio-visual data were collaboratively selected, curated and analysed by recovery community partners and researchers.
Findings
– Findings illustrate how a mobile audio-visual booth can be used successfully within co-productive research. This approach facilitated a better understanding of the experiences and practices of self-reflection within the recovery community as they worked together to create a meaningful recovery largely independent of conventional recovery services.
Research limitations/implications
– This research was performed with one cohort of co-production members. However, the co-productive nature of the enquiry and the rich data this provided invites the making of cautious but firmer claims with regard to the transferability of this approach to similar recovery contexts.
Social implications
– Co-productive approaches confer a meaningful impact upon members of the recovery community, and wider understanding of this approach will promote an impact upon others engaging in recovery, supporting growth of a practice-based and theoretically underpinned evidence base.
Originality/value
– This study highlights use of digital technologies within co-productive community-based methodologies, reducing reliance upon academic expertise, and facilitating participant leadership in research. The analysis also signposts new areas for scholarly discussion in the area of co-productive, community-driven research.
Collapse
|
29
|
ALBERTSON KATHERINE, IRVING JAMIE, BEST DAVID. A Social Capital Approach to Assisting Veterans Through Recovery and Desistance Transitions in Civilian Life. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/hojo.12138] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - JAMIE IRVING
- Criminology; Department of Law and Criminology, Sheffield Hallam University
| | - DAVID BEST
- Criminology; Department of Law and Criminology, Sheffield Hallam University
| |
Collapse
|
30
|
Abstract
Society has had an interest in controlling the production, distribution, and use of alcohol for millennia. The use of alcohol has always had consequences, be they positive or negative, and the role of government in the regulation of alcohol is now universal. This is accomplished at several levels, first through controls on production, importation, distribution, and use of alcoholic beverages, and second, through criminal laws, the aim of which is to address the behavior of users themselves. A number of interventions and policies reduce alcohol-related consequences to society by regulating alcohol pricing, targeting alcohol-impaired driving, and limiting alcohol availability. The legal system defines criminal responsibility in the context of alcohol use, as an enormous percentage of violent crime and motor death is associated with alcohol intoxication. In recent years, recovery-oriented policies have aimed to expand social supports for recovery and to improve access to treatment for substance use disorders within the criminal justice system. The Affordable Care Act, also know as "ObamaCare," made substantial changes to access to substance abuse treatment by mandating that health insurance include services for substance use disorders comparable to coverage for medical and surgical treatments. Rather than a simplified "war on drugs" approach, there appears to be an increasing emphasis on evidence-based policy development that approaches alcohol use disorders with hope for treatment and prevention. This chapter focuses on alcohol and the law in the United States.
Collapse
Affiliation(s)
- Ariela O Karasov
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michael J Ostacher
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Psychiatry, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
| |
Collapse
|