Skip to main content
SpringerLink
Log in

Addiction Treatment and Recovery Careers

  • Chapter
  • First Online:
Addiction Recovery Management

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Recovery from addiction is a complex and dynamic process, with considerable variations across individuals. Despite historical and recent surge of interest in recovery among many stakeholders in the addiction field, empirical research on recovery has been limited. The varying definitions of recovery across different stakeholder groups best illustrate the wide-ranging thinking on recovery, yet how recovery is conceptualized, promoted, and achieved has important implications for how treatment systems should be structured, delivered, and evaluated. The concept of addiction as a chronic illness is redefining the fundamental way we view drug abuse and its treatment. Currently, many efforts are directed toward determining how to provide a continuity of treatment and how to measure if treatment systems are successfully addressing addiction as a chronic disease. In this chapter, we describe empirical patterns of drug use trajectories over the life course, discuss the diverse ways of conceptualizing recovery, and identify key aspects of addiction that require attention as we investigate and treat addiction to promote long-term, stable recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Anglin MD, Hser Y. Treatment of drug abuse. In: Tonry M, Wilson JQ, editors. Drugs and crime, vol. 13. Chicago, IL: University of Chicago Press; 1990. p. 393–460.

    Google Scholar 

  2. Compton WM, Glantz M, Delany P. Addiction as a chronic illness: putting the concept into action. Eval Program Plan. 2003;26:353–4.

    Article  Google Scholar 

  3. Hser Y, Anglin MD, Grella CE, Longshore D, Prendergast ML. Drug treatment careers: a conceptual framework and existing research findings. J Subst Abuse Treat. 1997;14:543–58.

    Article  PubMed  CAS  Google Scholar 

  4. Hser Y, Hoffman V, Grella CE, Anglin MD. A 33-year follow-up of narcotics addicts. Arch Gen Psychiatry. 2001;58:503–8.

    Article  PubMed  CAS  Google Scholar 

  5. Hser Y, Huang D, Chou C, Anglin MD. Trajectories of heroin addiction: growth mixture modeling results based on a 33-year follow-up study. Eval Rev. 2007;31:548–63.

    Article  PubMed  Google Scholar 

  6. McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA. 2000;284:1689–95.

    Article  PubMed  CAS  Google Scholar 

  7. Dennis M, Scott C. Managing addiction as a chronic condition. Addict Sci Clin Pract. 2007;4(1):45–55.

    Article  PubMed  Google Scholar 

  8. Scott CK, Dennis ML. Recovery Management Checkup (RMC) protocol for people with chronic substance use disorders. Bloomington, IL: Chestnut Health Systems; 2002.

    Google Scholar 

  9. Hser Y, Longshore D, Anglin MD. The life course perspective on drug use: a conceptual framework for understanding drug use trajectories. Eval Rev. 2007;31:515–47.

    Article  PubMed  Google Scholar 

  10. Laudet AB. What does recovery mean to you? lessons from the recovery experience for research and practice. J Subst Abuse Treat. 2007;33:243–56.

    Article  PubMed  Google Scholar 

  11. White WL. Addiction recovery: its definition and conceptual boundaries. J Subst Abuse Treat. 2007;33:229–41.

    Article  PubMed  Google Scholar 

  12. Center for Substance Abuse Treatment. National Summit on Recovery: 2005 Conference Report. DHHS Publication No. (SMA) 07-4276. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2007.

    Google Scholar 

  13. Teruya C, Hser YI. Turning points in the life course: current findings and future directions in drug use research. Curr Drug Abuse Rev. 2010; [Epub ahead of print]

    Google Scholar 

  14. Elder Jr GH. Perspectives in the life course. In: Elder GH, editor. Life course dynamics. Ithaca, NY: Cornell University Press; 1985. p. 23–49.

    Google Scholar 

  15. Sampson RJ, Laub JH. Socioeconomic achievements in the life course of disadvantaged men: military service as a turning point, 1940–1965. Am Sociol Rev. 1996;61:347–67.

    Article  Google Scholar 

  16. Laub JH, Sampson RJ. Turning points in the life course: why change matters to the study of crime. Criminology. 1993;31:301–25.

    Article  Google Scholar 

  17. Cloud W, Granfield R. The social process of exiting addiction: a life course perspective. In: Blomqvist J, Koski-Jannes A, Ojesjo L, editors. Addiction and life course. Helsinki, Finland: Nordic Council on Alcohol and Drug Research; 2004. p. 185–202.

    Google Scholar 

  18. Granfield R, Cloud W. Social context and “natural recovery”: the role of social capital in the resolution of drug-associated problems. Subst Use Misuse. 2001;36:1543–70.

    Article  PubMed  CAS  Google Scholar 

  19. Wheaton B, Gotlib IH. Trajectories and turning points over the life course: concepts and themes. In: Gotlib IH, Wheaton B, editors. Stress and adversity over the life course: trajectories and turning points. New York, NY: Cambridge University Press; 1997. p. 1–25.

    Chapter  Google Scholar 

  20. Hser Y, Huang D, Brecht M, Li L, Evans E. Contrasting trajectories of heroin, cocaine, and methamphetamine use. J Addict Dis. 2008;27:13–21.

    Article  PubMed  Google Scholar 

  21. Substance Abuse and Mental Health Services Administration. Overview of findings from the 2002 National Survey on Drug Use and Health (Office of Applied Studies, NHSDA Series H-21, DHHS Publication No. SMA 03-3774). Rockville, MD: SAMHSA; 2003.

    Google Scholar 

  22. Center for Human Resource Research. NLSY97 Codebook Supplement Main File Round 8, Prepared for the U.S. Department of Labor, by Center for Human Resource Research. Columbus, OH: The Ohio State University; 2006.

    Google Scholar 

  23. Hser Y, Evans E, Huang D, Brecht M, Li L. Comparing the dynamic course of heroin, cocaine, and methamphetamine use over 10 years. Addict Behav. 2008;33:1581–9.

    Article  PubMed  Google Scholar 

  24. Nagin DS. Analyzing developmental trajectories: semi-parametric group-based approach. Psychol Methods. 1999;4:39–177.

    Article  Google Scholar 

  25. Nagin DS. Group-based modeling of development. Cambridge, MA: Harvard University Press; 2005.

    Google Scholar 

  26. Muthen B. Latent variable analysis: growth mixture modeling and related techniques for longitudinal data. In: Kaplan D, editor. Handbook of quantitative methodology for the social sciences. Newbury Park, CA: Sage Publications; 2004. p. 345–68.

    Google Scholar 

  27. Muthen B, Asparouhov T. Growth mixture analysis: models with non-Gaussian random effects. In: Fitzmaurice G, Davidian M, Verbeke G, Molenberghs G, editors. Advances in longitudinal data analysis. Boca Raton, FL: Chapman & Hall/CRC Press; 2006.

    Google Scholar 

  28. Chassin L, Presson CC, Pitts SC, Sherman SJ. The natural history of cigarette smoking from adolescence to adulthood in a midwestern community sample: multiple trajectories and their psychosocial correlates. Health Psychol. 2000;19:223–31.

    Article  PubMed  CAS  Google Scholar 

  29. Orlando M, Tucker JS, Ellickson PL, Klein DJ. Developmental trajectories of cigarette smoking and their correlates from early adolescence to young adulthood. J Consult Clin Psychol. 2004;72(3):400–10.

    Article  PubMed  Google Scholar 

  30. Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. J Consult Clin Psychol. 2002;70:67–78.

    Article  PubMed  Google Scholar 

  31. Hix-Small H, Duncan TE, Duncan SC, Okut H. A multivariate associative finite growth mixture modeling approach examining adolescent alcohol and marijuana use. J Psychopathol Behav Assess. 2004;26:255–70.

    Article  Google Scholar 

  32. Ellickson PL, Martino SC, Collins RL. Marijuana use from adolescence to young adulthood: multiple developmental trajectories and their associated outcomes. Health Psychol. 2004;23:299–307.

    Article  PubMed  Google Scholar 

  33. Anthony JC, Petronis KR. Early-onset drug use and risk of later drug problems. Drug Alcohol Depend. 1995;40:9–15.

    Article  PubMed  CAS  Google Scholar 

  34. Yu J, Williford WR. The age of alcohol onset and alcohol, cigarette, and marijuana use patterns: an analysis of drug use progression of young adults in New York State. Int J Addict. 1992;27:1313–23.

    PubMed  CAS  Google Scholar 

  35. Hser Y. Predicting long-term stable recovery from heroin addiction: findings from a 33-year follow-up study. J Addict Dis. 2007;26:51–60.

    Article  PubMed  Google Scholar 

  36. The Betty Ford Institute Consensus Panel. What is recovery? A working definition from the Betty Ford Institute. J Subst Abuse Treat. 2007;33:221–8.

    Article  Google Scholar 

  37. World Health Organization (WHO). Basic documents. 35th ed. Geneva, Switzerland: WHO; 1985.

    Google Scholar 

  38. Dennis ML, Foss MA, Scott CK. An eight-year perspective on the relationship between the duration of abstinence and other aspects of recovery. Eval Rev. 2007;31:585–612.

    Article  PubMed  Google Scholar 

  39. Sobell L, Cunningham JA, Sobell MB. Recovery from alcohol problems with and without treatment: prevalence in two population surveys. Am J Public Health. 1996;7:966–72.

    Article  Google Scholar 

  40. Cross G, Morgan C, Moonye A, Martin C, Rafter J. Alcoholism treatment: a ten-year follow-up study. Alcohol Clin Exp Res. 1990;14:169–73.

    Article  PubMed  CAS  Google Scholar 

  41. Hser Y, Stark ME, Paredes A, Huang D, Anglin MD, Rawson R. A 12-year follow-up of a treated cocaine-dependent sample. J Subst Abuse Treat. 2006;30:219–26.

    Article  PubMed  Google Scholar 

  42. Scott CK, Foss MA, Dennis ML. Pathways in the relapse–treatment–recovery cycle over 3 years. J Subst Abuse Treat. 2005;28:S63–72.

    Article  PubMed  Google Scholar 

  43. Weisner C, Ray GT, Mertens JR, Satre DD, Moore C. Short-term alcohol and drug treatment outcomes predict long-term outcome. Drug Alcohol Depend. 2003;1071(3):281–94.

    Article  Google Scholar 

  44. Salome HJ, French MT, Scott C, et al. Investigating the economic costs and benefits of addiction treatment: econometric analysis of the Chicago Target Cities project. Eval Program Plann. 2003;26(3):325–38.

    Article  Google Scholar 

  45. Scott CK, Foss MA, Dennis ML. Factors influencing initial and longer-term responses to substance abuse treatment: a path analysis. Eval Program Plann. 2003;26:287–96.

    Article  Google Scholar 

  46. Laudet A, Savage R, Mahmood D. Pathways to long-term recovery: a preliminary investigation. J Psychoactive Drugs. 2002;34:305–11.

    Article  PubMed  Google Scholar 

  47. Moos RH, Moos BS. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction. 2006;101:212–22.

    Article  PubMed  Google Scholar 

  48. Moos RH. Theory-based processes that promote the remission of substance use disorders. Clin Psychol Rev. 2007;27:537–51.

    Article  PubMed  Google Scholar 

  49. Vaillant GE. A long-term follow-up of male alcohol abuse. Arch Gen Psychiatry. 1996;53:243–9.

    Article  PubMed  CAS  Google Scholar 

  50. Vaillant G. A 60-year follow-up of alcoholic men. Addiction. 2003;98:1043–51.

    Article  PubMed  Google Scholar 

  51. Sampson RJ, Laub JH. Life-course desisters? Trajectories of crime among delinquent boys followed to age 70. Criminology. 2003;41:555.

    Article  Google Scholar 

  52. Simpson DD, Sells SB. Opioid addiction and treatment: a 12-year follow-up. Malabar, FL: Krieger; 1990.

    Google Scholar 

  53. Termorshuizen F, Krol A, Prins M, van Ameijden EJ. Long-term outcome of chronic drug use: The Amsterdam Cohort Study among Drug Users. Am J Epidemiol. 2005;161:271–9.

    Article  PubMed  Google Scholar 

  54. Winick C. Maturing out of narcotic addiction. Bull Narc. 1962;14:1–8.

    Google Scholar 

  55. Anglin MD, Hser Y. Legal coercion and drug abuse treatment: research findings and social policy implications. In: Inciardi J, editor. Handbook of drug control in the United States. Westport, CT: Greenwood Press; 1990. p. 151–76.

    Google Scholar 

  56. Simpson DD, Joe GW, Fletcher BW, Hubbard RL, Anglin MD. A national evaluation of treatment outcomes for cocaine dependence. Arch Gen Psychiatry. 1999;56:507–14.

    Article  PubMed  CAS  Google Scholar 

  57. Simpson DD, Joe GW, Broome KM. A national 5-year follow-up of treatment outcomes for cocaine dependence. Arch Gen Psychiatry. 2002;59:538–44.

    Article  PubMed  Google Scholar 

  58. Institute of Medicine (IOM). Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academy Press; 2006.

    Google Scholar 

  59. Rawson, R. Building a treatment system: elements and challenges. Presentation at the Hawaii Addiction Conference/AAPI Workgroup Scientific Conference; May 2009; Honolulu, Hawaii.

    Google Scholar 

  60. McLellan AT, Carise D, Kleber HD. Can the national addiction treatment infrastructure support the public’s demand for quality care? J Subst Abuse Treat. 2003;25:117–21.

    Article  PubMed  Google Scholar 

  61. Gerstein DR, Harwood HJ. National Academy of Sciences, Institute of Medicine, Division of Health Care Services, Committee for the Substance Abuse Coverage Study, Washington, DC. Treating drug problems, vol. 1: a study of the evolution, effectiveness, and financing of public and private drug treatment systems. Washington, DC: National Academy Press; 1990.

    Google Scholar 

  62. Anglin MD, Hser Y, Grella CE. Drug addiction and treatment careers among clients in the Drug Abuse Treatment Outcome Study (DATOS). Psychol Addict Behav. 1997;11:30823.

    Article  Google Scholar 

  63. Robins JM. Causal inference from complex longitudinal data. In: Berkane M, editor. Latent variable modeling and applications to causality. Lecture notes in statistics, vol. 120. New York, NY: Springer; 1997. p. 69–117.

    Chapter  Google Scholar 

  64. Robins JM. Marginal structural models versus structural nested models as tools for causal inference. In: Halloran E, editor. Statistical models in epidemiology. New York, NY: Springer; 1999. p. 95–134.

    Google Scholar 

  65. Robins JM, Hernán MA, Brumback B. Marginal structural models and causal inference in epidemiology. Epidemiology. 2000;11:550–60.

    Article  PubMed  CAS  Google Scholar 

  66. Li L, Evans E, Hser Y. A marginal structural modeling approach to assess the cumulative effect of drug treatment on later drug use abstinence. J Drug Issues. 2010;40(1):221–40.

    Google Scholar 

  67. Hser Y, Huang D, Teruya C, Anglin MD. Diversity of drug abuse treatment utilization patterns and outcomes. Eval Program Plann. 2004;27:309–19.

    Article  Google Scholar 

  68. Khalsa ME, Paredes A, Anglin MD, Potepan P, Potter C. Combinations of treatment modalities and therapeutic outcome for cocaine dependence. In: Tims FM, Leukefeld CG, editors. Cocaine treatment: research and clinical perspectives. Rockville, MD: National Institute on Drug Abuse; 1993. p. 237–59. NIDA Research Monograph 135.

    Google Scholar 

  69. McKay JR. Is there a case for extended interventions for alcohol and drug use disorders? Addiction. 2005;100:1594–610.

    Article  PubMed  Google Scholar 

  70. McKay JR, Merikle E, Mulvaney FD, Weiss RV, Koppenhaver JM. Factors accounting for cocaine use two years following initiation of continuing care. Addiction. 2001;96:213–25.

    Article  PubMed  CAS  Google Scholar 

  71. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74:511–44.

    Article  PubMed  CAS  Google Scholar 

  72. Rush AJ, Koran LM, Keller MB, et al. The treatment of chronic depression, part I. Study design and rationale for evaluating the comparative efficacy of sertraline and imipramine as acute, crossover, continuation and maintenance phase therapies. J Clin Psychiatry. 1993;59:589–97.

    Article  Google Scholar 

Download references

Acknowledgment

This work was supported in part by the UCLA Center for Advancing Longitudinal Drug Abuse Research (CALDAR) under grant P30DA016383 (PI: Hser) from the National Institute on Drug Abuse (NIDA). Dr. Hser is also supported by a NIDA Senior Scientist Award (K05DA017648).

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, UCLA Integrated Substance Abuse Programs, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA, 90025, USA

    Yih-Ing Hser

Authors
  1. Yih-Ing Hser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Douglas Anglin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yih-Ing Hser .

Editor information

Editors and Affiliations

  1. Harvard Center for Addiction, Massachusetts General Hospital, Staniford St. 60, Boston, 02114, Massachusetts, USA

    John F. Kelly

  2. Chestnut Health Systems, Lighthouse Institute, 720 W. Chestnut St., Bloomington, 61701, USA

    William L. White

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Hser, YI., Anglin, M.D. (2010). Addiction Treatment and Recovery Careers. In: Kelly, J., White, W. (eds) Addiction Recovery Management. Current Clinical Psychiatry. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-960-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-960-4_2

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-959-8

  • Online ISBN: 978-1-60327-960-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation