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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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Patton R, Chou J, Kestner T, Feeney E. Exploring social connectedness, isolation, support, and recovery factors among women seeking substance use treatment. Women Health 2024; 64:202-215. [PMID: 38282278 DOI: 10.1080/03630242.2024.2308518] [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: 04/27/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
This cross-sectional study examined the relationship between social variables, recovery orientation, and recovery capital among a sample of n = 30 women actively seeking substance use disorder treatment at a community-based facility in the Midwest United States. Results indicated a positive association between social connectedness, abstinence recovery orientation (p = .048) and social isolation (p = .010). Social isolation was positively associated with abstinence recovery orientation (p = .004) and negatively related to recovery capital (p = .003). Social support was positively correlated with positive expectancy (p = .030) and recovery capital (p = .033). Further, moderate/high alcohol use was related to lower normal living scores (t(28) = 3.10, p = .004), lower recovery capital scores (t(28) = 4.15, p < .000), and higher social isolation scores (t(28) = -2.53, p = .017). Screening at moderate/high risk for cannabis use was related to lower normal living scores (t(28) = 3.01, p = .005), and lower positive expectancy scores (t(28) = 3.03, p = .005). Finally, screening for moderate/high risk for polysubstance use was related to lower normal living orientation (t(28) = 2.52, p = .018) and recovery capital scores (t(28) = 2.79, p = .009). Current findings may inform strategies for examining social connectedness and social isolation variables in future clinical practice, policy, and scholarship.
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Affiliation(s)
- Rikki Patton
- Department of Counseling and Family Therapy, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jessica Chou
- Department of Counseling and Family Therapy, Drexel University, Philadelphia, Pennsylvania, USA
| | - Tiffanie Kestner
- The Counseling Center of Wayne & Holmes County, Wooster, Ohio, USA
| | - Erika Feeney
- Department of Counseling and Family Therapy, Drexel University, Philadelphia, Pennsylvania, USA
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Bosak J, Messersmith L, Bryer C, Drainoni M, Goodman D, Adams M, Barry T, Flanagan C, Flanagan V, Wolff K, Declercq E. "They just looked at me like I was human": The experiences of parenting women and providers with substance use disorder treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209240. [PMID: 38061633 DOI: 10.1016/j.josat.2023.209240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/11/2023] [Accepted: 11/30/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND The current US addiction treatment system does not effectively meet the needs of pregnant and parenting women with substance use disorder (SUD). The aim of this research was to identify barriers and facilitators to engagement and retention in SUD residential treatment for pregnant and parenting women. This research was part of a co-design process to collaboratively create a more patient-centered long-term residential program. DESIGN AND METHODS The study conducted semi-structured individual interviews with both parenting women with lived experience (WWLE) in residential SUD treatment and SUD treatment providers. Interviews aimed to elicit participants' experiences either receiving or providing care. The study team analyzed data in NVivo-12 using a deductive codebook based on the six principles of trauma informed care (TIC). RESULTS We conducted a total of 32 interviews (WWLE =13, SUD providers =19). The study identified four major themes: 1) peer relationships provide inspiration and diminish shame; 2) providing individuals safe space to stumble in recovery creates opportunities for growth and builds self-efficacy; 3) reasonable, clear boundaries create a structured, protective environment for early recovery; 4) nonjudgmental connections facilitate engagement and build trust. We identified small pivotal moments along the continuum of care that showed how the elements in the four themes enhanced engagement and retention in treatment. These interactions, along the care continuum, are either structural (workflow process) or relational (interpersonal). CONCLUSION This research increases understanding of the interplay of the structural and relational barriers and facilitators to engagement and retention in treatment. These seemingly minor positive or negative interactions along the care continuum are pivotal to fully operationalizing TIC and optimizing women's engagement in treatment. Improvement strategies that integrate the voices of WWLE and collaboratively co-design a more patient-centered system are critical steps to improving engagement in SUD treatment and more equitable SUD treatment services.
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Affiliation(s)
- J Bosak
- Community Health Services, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA 02118, United States; Dartmouth Hitchcock Medical Center, 1 Medical Drive, Lebanon, NH 03766, United States; Dartmouth Geisel School of Medicine, 1 Medical Drive, Lebanon, NH 03766, United States.
| | - L Messersmith
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA 02118, United States
| | - C Bryer
- Dartmouth Hitchcock Medical Center, 1 Medical Drive, Lebanon, NH 03766, United States
| | - M Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA 02118, United States; Department of Health Law Policy & Management, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, United States
| | - D Goodman
- Dartmouth Hitchcock Medical Center, 1 Medical Drive, Lebanon, NH 03766, United States; Dartmouth Geisel School of Medicine, 1 Medical Drive, Lebanon, NH 03766, United States
| | - M Adams
- Families Flourish Northeast, P.O Box 20, Enfield Center, NH 03749, United States
| | - T Barry
- Dartmouth Hitchcock Medical Center, 1 Medical Drive, Lebanon, NH 03766, United States
| | - C Flanagan
- Families Flourish Northeast, P.O Box 20, Enfield Center, NH 03749, United States
| | - V Flanagan
- Dartmouth Hitchcock Medical Center, 1 Medical Drive, Lebanon, NH 03766, United States
| | - K Wolff
- Independent Researcher, 566 Hanover Center Rd, Hanover, NH 03755, United States
| | - E Declercq
- Community Health Services, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA 02118, 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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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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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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