The Road to Recovery: Where Are We Going and How Do We Get There? Empirically Driven Conclusions and Future Directions for Service Development and Research

Abstract

The term “recovery” is often used in the addiction field. However, we have thus far failed to define the term, to delineate its dimensions, or to elucidate the prerequisite conditions to this outcome. This has hindered service development and evaluation as well as changes in policy. This paper:

1.	Reviews empirical findings about how “recovery” is defined and experienced by individuals engaged in the process;
2.	Examines factors associated with recovery initiation, maintenance, and sustained lifestyle, and review obstacles to recovery; and
3.	Discusses implications for services and research; implications include the need to adopt a long-term, wellness-centered approach to addressing substance use related problems, the importance for society to address the stigma of former addiction and to offer attractive viable opportunities to promote making significant life changes toward recovery from substance use.

Keywords:

• recovery
• remission
• substance use
• substance user treatment
• 12-step fellowships
• quality of life

Acknowledgments

This work was supported by NIDA Grants R01 DA14409, R01 DA015133 and by a grant from the Peter McManus Charitable Trust.

Notes

¹ Participants were recruited through media advertisement in New York City over 1 year starting in March 2003. They were interviewed four times at yearly intervals.

² The reader is referred to an extensive “natural recovery” literature, which documents that notwithstanding the diagnosed, diseased, and chronicity of substance use, a range of “users” have ceased their substance use without being in formal or informal ‘treatment.’ [H.K. Klingemann and L.C. Sobell (eds.) 2001, Natural Recovery Research Across Substance Use, Substance Use and Misuse 36(11); Shorkey, C.T. (2004). Spontaneous Recovery and Chemical Dependence: Indexed bibliography of articles published in Professional Chemical Dependency Journals, University of Texas at Austin http://128.83.80.200/tattc/spontaneousrecovery.html]. Editor's note.

³Data initially presented in Laudet (2007).

⁴Answers add up to over 100% because up to three answers were coded for each participant.

³ Clients were recruited between September 2003 and December 2004 (96% of those asked).

^{4 6}The study's prospective cohort consisted of 278 clients; of those, 249 were interviewed after services ended (whether they completed or felt the program prior to completion); 40.2% (N = 100) completed services and 59.8 (N = 149) left before competing the planned duration of services.

^{5 7}Answers add up to over 100% because up to three answers were coded for each participant.

⁶ Traditionally BMI is offered to and used with IP's (identified patients/persons) who need to change and/or want to change. In an era in which harm reduction and quality-of-life ideologies are now part of the substance use disorder treatment armamentarium, it may be useful to consider offering this service and opportunity to active substance user, for example in the context of peer-driven intervention whose agents function and adapt within their social and risk networks and communities. Editor's note.