Research Snapshot: How to measure addiction recovery? Incorporating perspectives of people with lived experience

What you need to know:

To understand how people who’ve experienced alcohol or other substance use problems define recovery, Ontario researchers held focus groups with people who had completed inpatient addiction treatment and were currently enrolled in an aftercare program. The researchers also aimed to identify ways to best assess recovery. From participants’ responses, the researchers identified four main themes: recovery is an ongoing process; abstinence is important but not the only measure of recovery; recovery has many dimensions; recovery requires ongoing commitment.

 

This Research Snapshot looks at the article, “How to measure addiction recovery? Incorporating perspectives of individuals with lived experience,” by Mary Jean Costello and colleagues, published in the International Journal of Mental Health and Addiction in 2018.

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What is this research about?

Recovery from addiction is considered an ongoing process; it requires the person to continuously manage their addiction to prevent problems from returning. This view is similar to how recovery is defined in the mental health field, as well as in other chronic disease areas, such as hypertension and diabetes. However, there is no clear consensus on what recovery means in the field of addictions.

Ontario researchers conducted a study to understand how people with lived experience of addiction to alcohol or other substances define recovery. They also sought to identify ways to best assess recovery that can be used as part of a recovery-monitoring system in an addictions treatment setting.

What did the researchers do?

The researchers brought together five focus groups to explore how people who use alcohol or other substances make sense of their own lived experience. The researchers used semi-structured interviews, with three main open-ended questions. The questions focused on how those in the groups define “successful” recovery and what they believe to be particularly harmful or helpful to their recovery. They used an inductive approach to analyze the data to identify commonalities among responses.

In total, 26 people participated in the study. On average, they were three months into an aftercare program, ranging from one week to eight months. Eighty percent reported not using alcohol or drugs during that period. Most participants were white (92%), more than 40 years old (57%), had stable housing (rented or owned) (96%), were employed (64%), and had at least some postsecondary education (76%). Half the sample had used both alcohol and other substances while 42% had used alcohol only and 8% had used other substances only.

What did the researchers find?

The researchers identified four main themes related to participants’ definitions of recovery:

1. Recovery is a lifelong or ongoing process or journey. It involves continuous and productive—although nonlinear—change that involves personal growth and learning. This was the dominant theme.

  • Some saw relapse as a setback but others felt it a learning opportunity that could spur movement forward.
  • Some described recovery as being an individual process, but others felt some aspects of the process can be shared with others who are also in recovery for mutual learning and support.

2. Abstinence or sobriety is important to recovery, but is not the only measure.

  • Some saw this as key to recovery and especially important in the early days of recovery. They felt sustained abstinence is a marker of recovery success.
  • Many felt it’s important to remain abstinent while also focusing on other aspects of life.

3. Recovery has many dimensions, including psychological, spiritual, social, physical health, occupational functioning, daily life functioning, and life satisfaction.

  • Some felt that improvement in one of these areas was enough to achieve recovery, while others thought improvement needed to happen in more than one area.

4. Recovery requires ongoing commitment to the pursuit of abstinence.

  • They identified activities that helped them work on abstinence (e.g., 12-step programs and formal outpatient services) or simply actively manage their recovery over the long term.

According to the authors, these findings illustrate the breadth of recovery-oriented outcomes that it may be important to measure when evaluating addiction treatment programs and services. They also point to the need to measure recovery outcomes at multiple time points to accurately reflect the recovery process.

How can you use this research

This research can be useful to agency leadership aiming to provide recovery-promoting services and supports. It also provides valuable information for system planners considering the development of recovery monitoring systems.

Limitations and next steps

Since the research involved a homogeneous participant group, there was limited discussion on the role of social determinants of health (e.g., housing, food security, and social inclusion) and culture in recovery.

About the researchers

Mary Jean Costello,1 Sarah Sousa,1 Courtney Ropp,1 Brian Rush1,2 

  1. Homewood Research Institute, Guelph, Ontario
  2. Centre for Addiction and Mental Health, Toronto, Ontario

Keywords

Addiction, substance use, alcohol, health outcomes, recovery

This Research Snapshot was written by Rossana Coriandoli based on the article, “How to measure addiction recovery? Incorporating perspectives of individuals with lived experience” which was published in International Journal of Mental Health and Addiction in 2018. https://doi.org/10.1007/s11469-018-9956-y