Advertisement

How to Measure Addiction Recovery? Incorporating Perspectives of Individuals with Lived Experience

  • Mary Jean CostelloEmail author
  • Sarah Sousa
  • Courtney Ropp
  • Brian Rush
Original Article

Abstract

Recovery from addiction is a complex phenomenon. Without a clear and measureable definition, its ambiguity risks hindering the advancement of recovery-oriented practice and research. The purpose of this study was twofold: (1) understand the meaning of recovery from the perspective of individuals with lived experience and (2) identify measurement domains to inform the development of a recovery monitoring system. We conducted five semi-structured focus groups and two interviews with individuals 18 years and older who completed an addiction treatment program and were enrolled in aftercare. Participants were asked questions about how they personally defined “successful” recovery. Data were analyzed using a general inductive approach through independent parallel coding. We explored emergent themes including the following: Recovery is a process; abstinence is an important aspect of recovery, but not sufficient; recovery is multidimensional; and, recovery requires ongoing commitment. This study identified measurable recovery-oriented outcomes and methodological considerations to inform future recovery monitoring systems.

Keywords

Addiction Substance use Alcohol Health outcomes Recovery 

Notes

Acknowledgements

We thank Kayla Deroux and Kathryn Junkin for their assistance with recruitment, data collection, transcription, and preliminary data coding. Special thanks to program staff for their support and effort facilitating recruitment, and to participants for sharing their insights on and experiences in recovery.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Regional Centre for Excellence in Ethics, Guelph, Ontario, Canada) and with the Helsinki Declaration of 1975, as revised in 2000 (5).

Conflict of Interest

The authors declare the following potential conflict of interest: Homewood Research Institute is an independent charitable organization funded through a variety of sources including community stakeholders, corporations, private foundations, and philanthropic support from the Schlegel family. The Schlegel family owns Homewood Health.

Informed Consent

Informed consent was obtained from all patients prior to being included in the study.

References

  1. American Society of Addiction Medicine. (2013). Terminology related to addiction, treatment and recovery. Retrieved from http://www.asam.org/docs/default-source/public-policy-statements/1-terminology-atr-7-135f81099472bc604ca5b7ff000030b21a.pdf?sfvrsn=0
  2. Best, D., & Laudet, A. (2010). The potential of recovery capital. Accessed Dec.15, 2017 at http://farronline.org/wp-content/uploads/2014/06/potential-of-recovery-capital.pdf
  3. Best, D., Beckwith, M., Haslam, C., & Haslam, A. (2016). Overcoming alcohol and other drug addiction as a process of social identify transition: the social identity model of recovery (SIMOR). Addiction Research & Theory., 24, 111–123.CrossRefGoogle Scholar
  4. Betty Ford Institute (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment, 33, 221–228.Google Scholar
  5. Borkman, T. J., Stunz, A., & Kaskutas, L. A. (2016). Developing an experiential definition of recovery: participatory research with recovering substance abusers from multiple pathways. Substance Use & Misuse, 51(9), 1116–1129.CrossRefGoogle Scholar
  6. Braun, V., & Clark, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.CrossRefGoogle Scholar
  7. Canadian Centre on Substance Use and Addiction (2017). Moving toward a recovery-oriented system of care: A resource for service providers and decision makers. Ottawa, Ontario.Google Scholar
  8. Cloud, W., & Granfield, R. (2009). Conceptualizing recovery capital: expansion of a theoretical construct. (2008). Substance Use and Misuse, 12-13, 1971–1986.Google Scholar
  9. Cornwall, A., & Jewkes, R. (1995). What is participatory research? Social Science and Medicine, 41(12), 1667–1676.CrossRefPubMedGoogle Scholar
  10. Costello, M. J., Ropp, C., Sousa, S., Woo, W., Vedelago, H., & Rush, B. (2016). The development and implementation of an outcome monitoring system for addiction treatment. Canadian Journal of Addiction, 7(3), 15–24.Google Scholar
  11. Dennis, M., & Scott, C. K. (2007). Managing addiction as a chronic condition. Addiction Science & Clinical Practice, 4(1), 45–55.CrossRefGoogle Scholar
  12. Dodge, K., Krantz, B., & Kenny, P. J. (2010). How can we begin to measure recovery? Substance Abuse Treatment, Prevention, and Policy, 5, 31 Retrieved from http://www.substanceabusepolicy.com/content/5/1/31.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Duffy, P. & Baldwin, H. (2013). Recovery post treatment: plans, barriers and motivators. Substance Abuse Treatment, Prevention, and Policy, 8, 6. Retrieved from http://www.substanceabusepolicy.com/content/8/1/6.
  14. Groshkova, T., Best, D., & White, W. (2013). The assessment of recovery capital: properties of a measure of addiction recovery strengths. Drug and Alcohol Review, 32(2), 187–194.CrossRefPubMedGoogle Scholar
  15. Hibbert, L. J., & Best, D. W. (2011). Assessing recovery and functioning in former problem drinkers at different stages of their recovery journeys. Drug and Alcohol Review., 30(1), 12–20.CrossRefPubMedGoogle Scholar
  16. Jarusiewisz, B. (2008). Spirituality and addiction. Alcoholism Treatment Quarterly, 18(4), 99–109.CrossRefGoogle Scholar
  17. Kaskutas, L. A., Borkman, T. J., Laudet, A., Ritter, L. A., Witbrodt, J., Subbaraman, M. S., Stunz, A., & Bond, J. (2014). Elements that define recovery: The experiential perspective. Journal of Studies on Alcohol and Drugs, 75, 999–1010.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Kaskutas, L. A., Witbrodt, J., & Grella, C. E. (2015). Recovery definitions: do they change? Drug and Alcohol Dependence, 154, 85–92.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Laudet, A. B. (2007). What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment, 33, 243–256.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Mackintosh, V., & Knight, T. (2012). The notion of self in the journey back from addiction. Qualitative Health Research, 22(8), 1094–1101.CrossRefPubMedGoogle Scholar
  21. Marcellus, L., MacKinnon, K., Benoit, C., Phillips, R., & Stengel, C. (2015). Reenvisioning success for programs supporting pregnant women with problematic substance use. Qualitative Health Research, 25(4), 500–512.Google Scholar
  22. McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment, insurance and outcomes evaluation. Journal of the American Medical Association, 284(13), 1689–1695.CrossRefPubMedGoogle Scholar
  23. McLellan, A. T., McKay, J. R., Forman, R., Cacciola, J., & Kemp, J. (2005). Reconsidering the evaluation of addiction treatment: from retrospective follow-up to concurrent recovery monitoring. Addiction, 100, 447–458.CrossRefPubMedGoogle Scholar
  24. McLellan, A. T., Chalk, M., & Bartlett, J. (2007). Outcomes, performance, and quality—what’s the difference? Journal of Substance Abuse Treatment, 32, 331–340.CrossRefPubMedGoogle Scholar
  25. McQuaid, R., Malik, A., Moussouni, K., Baydack, N., Stargardter, M., & Morrisey, M. (2017). Life in recovery from addiction in Canada. Ottawa: Canadian Centre on Substance Use and Addiction Retrieved from http://www.ccsa.ca/Resource%20Library/CCSA-Life-in-Recovery-from-Addiction-Report-2017-en.pdf.Google Scholar
  26. Neale, J., Finch, E., Marsden, J., Luke, M., Rose, D., Strang, J., Tompkins, C., Wheeler, C., & Wykes, T. (2014). How should we measure addiction recovery? Analysis of service provider perspectives using online Delphi groups. Drugs: Education, Prevention and Policy, 21(4), 310–323.Google Scholar
  27. Norlyk, A., & Harder, I. (2010). What makes a phenomenological study phenomenological? An analysis of peer-reviewed empirical nursing studies. Qualitative Health Research, 20(3), 420–431.CrossRefPubMedGoogle Scholar
  28. Rush, B. R., Martin, G., & Corea, L. M. (2009). Monitoring alcohol and drug treatment: What would an optimal system look like? Contemporary Drug Problems, 36, 545–574.Google Scholar
  29. Rush, B. R., Rotondi, N. K., Chau, N., Furlong, A., Godinho, A., Schell, C., Kwong, C., Ehtesham, S. (2013). Drug treatment funding program client recovery monitoring project. Toronto: Centre for Addiction and Mental Health. Retrieved from http://eenet.ca/dtfp/client-outcome-monitoring-project/.
  30. Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s Working definition of recovery: 10 guiding principles of recovery. Retrieved from https://blog.samhsa.gov/2012/03/23/defintion-of-recovery-updated/#.WOvJwPnyupo
  31. Thomas, D. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237–246.CrossRefGoogle Scholar
  32. Van Manen, M. (1990). Researching lived experience: Human science for an action sensitive pedagogy. New York: State University of New York.Google Scholar
  33. Watson, D. P., & Rollins, A. L. (2015). The meaning of recovery from co-occurring disorders: Views from consumers and staff members living and working in housing first programming. International Journal of Mental Health and Addiction, 13, 635–649.CrossRefPubMedPubMedCentralGoogle Scholar
  34. White, W. L. (2007). Addiction recovery: its definition and conceptual boundaries. Journal of Substance Abuse Treatment, 33, 229–241.CrossRefPubMedGoogle Scholar
  35. White, W., Boyle, M., & Loveland, D. (2005). Recovery from addiction and from mental illness: shared and contrasting lessons. In R. O. Ralph & P. W. Corrigan (Eds.), Recovery in mental illness: Broadening our understanding of wellness (pp. 233–258). Washington: American Psychological Association.CrossRefGoogle Scholar
  36. Witbroadt, J., Kaskuta, L. A., & Grella, C. E. (2015). How do recovery definitions distinguish recovering individuals? Five typologies. Drug and Alcohol Dependence, 148, 109–117.CrossRefGoogle Scholar
  37. World Health Organization (2016). International standards for the treatment of drug use disorders. Vienna, Austria. Retrieved from https://www.unodc.org/documents/commissions/CND/CND_Sessions/CND_59/ECN72016_CRP4_V1601463.pdf

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Homewood Research InstituteGuelphCanada
  2. 2.Centre for Addiction and Mental HealthTorontoCanada

Personalised recommendations