Recovery Research

nssatsA wealth of information is at your fingertips on substance use disorder prevalence, by age, drug… almost any demographic characteristics you might seek. But do you know how many Americans are in recovery? Do you know how they initiated recovery, or how they maintain it? If we are to gain the support we need to help more people find and sustain recovery, we need more research on what recovery looks like, how people get there, and how they stay there. Research on recovery is relatively new, however a promising body of evidence supports what we are doing at Roads to Recovery – read on…

laudetOur nation’s most distinguished recovery scientist is Alexandre B. Laudet, PhD. Here are excerpts from a blog post by Dr. Laudet on the Wired in to Recovery website. The links in the post will take you to some of Dr. Laudet’s publications.

Hi, I’m Alexandre. I’m an addiction recovery scientist. I’m not in recovery…

…I didn’t know anything about addiction or drugs except that my father had told me when I was young that if I did drugs, he’d kill me. Living in a strict European household several decades ago, I believed him. It saved my life. I am pretty certain that had I fallen into drugs, I would not have gotten up, not in one piece anyway…

…Back to 1994. I liked the work [at NIH]. I could see this as a career. But I couldn’t fathom how people focused on pathology (addiction) and what was viewed as ‘failure’ (i.e. research centering on whether or not people relapse). It seemed a bit of a bummer to be frank.

When I plan something I haven’t done before – visit a new country or buy a car – I turn for advice to people who did it successfully. Of course, I also read negative reviews of products and hotels to be alerted to shortcomings, but we know the shortcoming of addiction: it destroys lives and it’s hard to kick.

What we don’t know is how people do well? And why?  So I set out to read quantitative research on people doing well. There wasn’t much.

…The term ‘recovery’ wasn’t really on the radar at the time anyway, not among academics and scientists. ‘Recovery’ was a 12-step term and many in polite society hadn’t made up their mind about whether 12-step is a cult or an association of losers.

I’m an explorer more than anything else, so I liked the idea of branching into an area that no one had truly developed before. Funding went well early on (about ten years ago); congress had recently doubled the NIH’s budget and funding was somewhat less competitive than it is now…I got funded. A few times.

…With all the evidence pointing to substance use disorders being a chronic condition, it goes without saying that recovery is a process and documenting this process requires long-term studies …

As it stands, the bulk of what we know about recovery comes from people recruited in treatment programs and it bears almost exclusively on the first six months to a year after treatment. What exactly happens after that isn’t clear, yet we need to find out to inform policy and the development and evaluation of recovery support services …

Though our work hasn’t exactly changed the world (yet!), I sincerely believe some of our studies will come to be regarded as significant to the broad ongoing shift to a chronic care, wellness based (i.e. recovery) paradigm in the addiction field.

…Our field has much to learn from the views and experiences of the people in our research studies – and society has much to learn from the recovery experience. Therefore, I am a firm believer in the importance of combining quantitative and qualitative methods, which boils down to incorporating people’s experiences in their own words with more ‘rigorous’ methods such as established research questionnaires.

Using this combined approach, we identified the critical importance of quality of life (QOL) to recovery and documented its role in predicting substance use/abstinence over time.

Put simply, it goes like this: quality of life is very poor in active addiction, it gradually starts improving when people enter recovery and these gains – a place of one’s own, a clear mind, a healing relationship with family – are greatly valued. The fear of going back to how life was in active addiction sustains the motivation to stay away from drugs and alcohol, i.e. it helps people stay in recovery. Life keeps getting better as recovery progress, as we recently documented in the Faces & Voices of Recovery ‘Life in Recovery’ survey discussed later, and people do not want to lose that. Quality of life was a key dimension incorporated in the provisional definition of recovery issued by the Betty Ford Institute panel to which I was honored to contribute. Previously, most research focused only on studying improvements in quality of life as a result of recovery; our work showed that the relationship between the two goes both ways.

We also documented people’s priorities in recovery, areas where they are experiencing difficulties and how that changes over time. We – society as a whole, but also loved ones of people in recovery and people in recovery themselves – tend to assume (or hope) that once someone stops drinking and/or taking drugs, everything falls into place (‘just say no’).‘Things not happening fast enough’ in recovery is actually a challenge for many, as we documented among people in addiction recovery who have a mental health disorder.

…The Life in Recovery survey I conducted with Faces & Voices or Recovery, the largest recovery grassroots organization in the U.S., was the first large-scale nationwide study of people at various stages of recovery. Our key goal was to begin documenting the changes that happen in all the areas of life typically affected by active addiction (health, work, finances, family and involvement with the criminal justice system) as a result of being in recovery.

As summarized in the survey report, we found that relative to when they were actively addicted, people experience dramatic improvements in all areas of life. Equally noteworthy, these improvements continue as recovery is sustained. In other words, life gets better in recovery and it keeps getting better.

 LIFE IN RECOVERY SURVEY

Read about the Life in Recovery survey and download the full report here: http://www.facesandvoicesofrecovery.org/resources/life-recovery-survey

WILLIAM WHITE PAPERS

Perhaps the largest collection of recovery research and other publications may be found here: http://www.williamwhitepapers.com/

William L. (Bill) White is our hero of the recovery movement. He is an Emeritus Senior Research Consultant at Chestnut Health Systems / Lighthouse Institute and past-chair of the board of Recovery Communities United.  Bill has a Master’s degree in Addiction Studies and has worked full time in the addictions field since 1969 as a street worker, counselor, clinical director, researcher and well-traveled trainer and consultant.  He has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 17 books.  His book, Slaying the Dragon – The History of Addiction Treatment and Recovery in Americareceived the McGovern Family Foundation Award for the best book on addiction recovery.  Bill was featured in the Bill Moyers’ PBS special “Close To Home: Addiction in America” and Showtime’s documentary “Smoking, Drinking and Drugging in the 20th Century.”  Bill’s sustained contributions to the field have been acknowledged by awards from the National Association of Addiction Treatment Providers, the National Council on Alcoholism and Drug Dependence, NAADAC:  The Association of Addiction Professionals, the American Society of Addiction Medicine, and the Native American Wellbriety Movement.  Bill’s widely read papers on recovery advocacy have been published in a book entitled Let’s Go Make Some History:  Chronicles of the New Addiction Recovery Advocacy Movement. (http://www.williamwhitepapers.com/bio/)