Difference between revisions of "The Recovery Ecosystem"

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=Introductory Paragraph =
=Introductory Paragraph =


Recovery support can look like many different things for individuals on their pathway to recovery. This is a crucial component of viewing SUD as a chronic disorder requiring long-term care. Individuals entering recovery through treatment, the criminal justice system, or on there own often face many challenges in early recovery. It is important that communities identify needs, examine what supports are available, and ensure those with the greatest need have access to these supports. Individuals who do not have these needs met are more likely to relapse. Communities that fund these supports help those in early recovery re-engage with the community, increase self-esteem, and become highly productive members of their communities. Providing effective recovery supports prevents relapse, the need to engage additional treatment and other services, and reduces the numbers of overdose. Communities that have invested in recovery supports have seen a substantial return on their investment both in financial and human terms.
This article is the first in a series of articles designed to address the science of recovery. It covers the definitions and dimension of recovery, as outlined by SAMHSA. It also introduces the concept of recovery capital. The various scales at which recovery capital can be built matches the socio-ecological model detailed in the prevention science article titled "Address Risk & Protective Factors for Individuals, Families, and Communities." <ref>https://www.yoursafesolutions.us/wiki/Address_Risk_%26_Protective_Factors_for_Individuals,_Families,_and_Communities</ref> The recovery ecosystem is complex and requires intention to be applied at each scale (individual, family, social, and community). Aligning prevention science and recovery science in comparable multi-scale approaches will be a significant element in bridging prevention and recovery efforts and in advancing work that is coordinated across the full continuum of care.


SAMHSA defines recovery as "a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential." <ref>https://www.samhsa.gov/find-help/recovery</ref> SAMHSA also identifies four major dimensions that support recovery:
= Key Information =
 
'''Definition and Dimensions of Recovery'''
 
SAMHSA defines recovery as "a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential." <ref>https://www.samhsa.gov/find-help/recovery</ref> The four major dimensions that SAMHSA has identified which support recovery include:


*Health — overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.  
*Health — overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.  
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*Community — having relationships and social networks that provide support, friendship, love, and hope.
*Community — having relationships and social networks that provide support, friendship, love, and hope.


= Key Information =
It is noteworthy that these four dimension span the socio-ecological model -- individual, family, social, and community.


The recovery journey does not start in one place. Recovery is a critical asset that communities need to invest in, including removing barriers so recovery can be sustained. Recovery-oriented approaches involve a multi-system, person-centered continuum of care where a comprehensive menu of coordinated services and supports is tailored to individuals' recovery stage, needs, and chosen recovery pathway; the goal is to promote abstinence and a better quality of life (Clark, 2007, 2008).<ref>http://addictionrecoverytraining.org/wp-content/uploads/2016/08/PeerRecoveryEffectiveness.pdf</ref>
'''Recovery Capital'''


Below are a summary of different recovery supports communities can provide:
Recovery Capital is a crucial component for sustained recovery. It has been defined as the quantity and quality of internal and external resources that one can bring to bear on the initiation and maintenance of recovery. <ref>Granfield, R., & Cloud, W. (1999). Coming clean: Overcoming Addiction without treatment. New York: New York University Press.</ref>
Sober Living-Helps individuals transfer from treatment to independent living. For some individuals, returning to their previous living environment can be unsafe or not conducive to their recovery. Sober living offers individuals a safe, peer-to-peer recovery-oriented home with structure, accountability, and support. Typically, there are household duties in sober living that need to be fulfilled including rent, chores, curfew, etc.  For more information about strategies for improving recovery housing, please see the Your Safe Solutions Recovery Housing page as well.<ref>https://www.yoursafesolutions.us/wiki/Improve_Recovery_Housing</ref>
For too long, most of the aspects of recovery capital were either random or only reserved for individuals who had these resources readily available. Recovery capital is not dependent on socioeconomic status, and socioeconomic status is not
an accurate indicator of either high or low recovery capital. Since change in one's home or work environment may not be possible for everyone, many individuals return to family or community environments that are unsafe or recovery-hostile. Returning to a problematic home life or to a community which has a culture of alcohol and other drug use, can place stress on recovery capital. Faces & Voices of Recovery provides a breakdown of the scales of recovery capital and their role in sustaining recovery: <ref>https://facesandvoicesofrecovery.org/blog/2019/10/08/recovery-capital-its-role-in-sustaining-recovery/</ref>


Vocational Training- Substance use disorders could result in loss of job, job abandonment, or legal issues that may add additional barriers to obtaining employment. Vocational training can provide on-the-job training, remedial training, college training, and resume building. For more information about improving education, job training, and employment for people in recovery, please visit Your Safe Solutions Improve Education, Job Training, and Employment for people in Recovery.<ref>https://www.yoursafesolutions.us/wiki/Improve_Education,_Job_Training,_and_Employment_for_People_in_Recovery</ref>
*'''Personal.''' This includes an individual’s physical and human capital. Physical capital is the available resources to fulfill a person’s basic needs, like their health, healthcare, financial resources, clothing, food, transportation, and safe and habitable shelter. Human capital relates to a person’s abilities, skills, and knowledge, like problem-solving, education and credentials, self-esteem, the ability to navigate challenging situations and achieve goals, interpersonal skills, and a sense of meaning and purpose in life. See the SAFE Solutions article titled "Increase Support for Individuals in Recovery” for more information on building personal recovery capital. <ref>https://www.yoursafesolutions.us/wiki/Improve_Tracking_of_Recovery_Progress</ref>


Collegiate Recovery Programs-Helps students balance recovery and higher education. Provides support to students such as therapy, sober housing, and substance-free events. For more information on strategies to expand recovery schools and collegiate recovery programs, please see Your Safe Solutions Expand Recovery Schools. <ref>https://www.yoursafesolutions.us/wiki/Expand_Recovery_Schools_and_Collegiate_Recovery_Programs</ref>
*'''Family/social. '''These resources relate to intimate relationships with friends and family, relationships with people in recovery, and supportive partners. It also includes the availability of recovery-related social events. SAFE Solutions has two articles related to family/social recovery capital. The first, titled "Expand Community Support for Impacted Families"  <ref>https://www.yoursafesolutions.us/wiki/Expand_Community_Support_for_Impacted_Families</ref> focuses on the family, and the second article titled "Strengthen Peer Recovery Support Services and Programs" addresses the role of peers in the broader social dimensions. <ref>https://www.yoursafesolutions.us/wiki/Strengthen_Peer_Recovery_Support_Services_and_Programs</ref>


Peer-Based Recovery Support- Giving and receiving nonprofessional, nonclinical, peer-to-peer assistance to achieve long-term recovery from substance use disorders.
*'''Community.''' This includes attitudes, policies, and resources specifically related to helping individuals resolve substance use disorders. Community resources can include recovery support institutions, such as recovery high schools, college recovery programs, recovery housing, and recovery ministries. Likewise, agencies and employers can bring resources to sustain recovery and early intervention programs, such as drug courts and employee assistance programs. See the SAFE Solutions article titled "Create Recovery-Ready Communities," for more detailed information on building recovery capital at the community scale. <ref>https://www.yoursafesolutions.us/wiki/Create_Recovery-Ready_Communities#Key_Information</ref>
• AA-Most common support group. Based on the 12 steps.
• All Recovery-Bringing people together from multiple pathways of recovery
• SMART Recovery-Self Management and Recovery Training, clients find and develop the power within themselves to change and lead fulfilling lives. Guided by the 4-point program.
For more information about how to strengthen peer recovery support services and programs, please see Your Safe Solutions Peer Recovery Support Services & Programs. <ref>https://www.yoursafesolutions.us/wiki/Strengthen_Peer_Recovery_Support_Services_and_Programs</ref>
 
Harm Reduction- Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in and respect for, the rights of people who use drugs. (National Harm Reduction Coalition, 2022)<ref>https://harmreduction.org/about-us/principles-of-harm-reduction/</ref>. For more information about strategies to expand harm reduction practices, please also see Your Safe Solutions Expand Harm Reduction Practices.<ref>https://www.yoursafesolutions.us/wiki/Expand_Harm_Reduction_Practices</ref>
 
Medicated Assisted Treatment/Therapy (MAT)-Use of medication and counseling to provide a whole-patient approach to recovery. Medications are FDA approved. MAT can help sustain recovery and prevent or reduce opioid overdose. Primary, MAT is used for addiction to opioids such as heroin and prescription pain killers. For information on expanding access to Medication-Assisted Treatment (MAT), please see Your Safe Solutions Expand Access to Medication-Assisted Treatment. <ref>https://www.yoursafesolutions.us/wiki/Expand_Access_to_Medication-Assisted_Treatment_(MAT)</ref>
 
Recovery Coach- People who have lived experience of substance use disorder and/or mental health conditions who provide non-clinical recovery support to their peers. They are not sponsors or alcohol and drug counselors. Recovery coaches can also be called Peer Recovery Specialists. There is a certification process that solidifies the Recovery Coach/Peer Recovery Specialist workforce.
 
Criminal Justice-Substance use disorder and the justice system have a complex history. It is estimated that about one-half of state and federal prisoners misuse drugs or are addicted to drugs, but few typically receive treatment while incarcerated (NIDA, 2018).<ref>https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/what-role-can-criminal-justice-system-play-in-addressing</ref>
 
For more information about strategies to support people who are criminal justice involved, please visit Your Safe Solutions Recovery Supports for People in the Criminal Justice System.<ref>https://www.yoursafesolutions.us/wiki/Improve_Recovery_Support_for_People_in_the_Criminal_Justice_System</ref>
 
 
 
 
The resources pages that follow address the key of support. These include:
 
=== Recovery Housing ===
 
Perhaps the most basic support needed is housing and food. Without this there can be no security or the ability for focus on health and recovery. In many cases going home is not a safe option for those new to recovery. A stable housing situation is foundational and allows growth and progress in other areas to take place. Resources included focus on how to find safe, affordable, and supportive recovery housing options in communities across the country.
 
=== Education and Job Training ===
 
Finding meaning and purpose in one's life is important to all, but is especially critical to a person who has not found, or has lost, that purpose. The ability to get and hold a job, get a promotion, improve one's education, and become independent are all important needs for many in early recovery. Safe Solutions includes resources and information designed to help people in recovery develop the tools they need to find that purpose and achieve their goals.
 
=== Collegiate and High School Recovery Support ===
 
Many in early recovery find recovery while still in high school or college. Many others enter high school or college after beginning their recovery journey. Building an infrastructure of recovery support withing these specific communities is another area of focus, where it is possible to learn both where programs currently exist and the tools used by others to create these supports at colleges and high schools.
 
=== Improving Connections. ===
 
Many of the strategies come under the broad umbrella of improving connections. Isolation is the enemy of recovery. Connections include those to others in recovery across a number of peer-led support organizations and others that can help support the recovery of an individuals - including peer recovery specialists and recovery coaches. Family connections are also addressed and resources focus on helping the family recover and be able to support members in recovery
 
Other connections include those made in the wider community and even regional/national organizations that can help foster connection to others who provide support for individuals in recovery.


=Relevant Research=
=Relevant Research=


* '''Nora's Blog''' on the Director's page of NIDA highlights recent advances in the science of drug use and addiction. For example, in evaluating the relationship between abstinence and relapse, it is noted that setbacks are regarded as a failure, leading to the perception that the client is starting all over, when in fact, a return to use may strengthen someone’s resolve to recover. <ref>https://nida.nih.gov/about-nida/noras-blog/2022/01/making-addiction-treatment-more-realistic-pragmatic-perfect-should-not-be-enemy-good</ref>
'''Nora's Blog''' on the Director's page of NIDA highlights recent advances in the science of drug use and addiction. For example, in evaluating the relationship between abstinence and relapse, it is noted that setbacks are regarded as a failure, leading to the perception that the client is starting all over, when in fact, a return to use may strengthen someone’s resolve to recover. <ref>https://nida.nih.gov/about-nida/noras-blog/2022/01/making-addiction-treatment-more-realistic-pragmatic-perfect-should-not-be-enemy-good</ref>
 
* This article provides a systematic review of nine different studies that examined peer-delivered recovery support services. <ref>https://addictionrecoverytraining.org/wp-content/uploads/2016/08/PeerRecoveryEffectiveness.pdf</ref>


= Impactful Federal, State, and Local Policies =
= Impactful Federal, State, and Local Policies =


* The Mainstreaming Addiction Treatment Act of 2021 removes the requirement that a health care practitioner apply for a separate waiver through the Drug Enforcement Administration (DEA) to dispense certain narcotic drugs (e.g., buprenorphine) for maintenance or detoxification treatment (i.e., substance use disorder treatment).<ref>https://www.congress.gov/bill/117th-congress/senate-bill/445</ref>
'''Partners for Recovery''' published a report that provides information regarding the funding sources that support recovery support services throughout the continuum of care. The report includes an overview of federal, state, and private funding and highlights practices for obtaining funding. <ref>https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/Financing-Recovery-Support-Services.pdf</ref>
   
   
* Oregon passed a Drug and Addiction Treatment Act whose purpose is to make screening health assessment, treatment and recovery services for drug addiction available to all those who need and want access to those services; and to adopt a health approach to drug addiction by removing criminal penalties for low-level drug possession.<ref>https://www.oregon.gov/oha/hsd/amh/pages/measure110.aspx</ref>
'''Oregon''' passed a Drug and Addiction Treatment Act whose purpose is to make screening health assessment, treatment and recovery services for drug addiction available to all those who need and want access to those services; and to adopt a health approach to drug addiction by removing criminal penalties for low-level drug possession.<ref>https://www.oregon.gov/oha/hsd/amh/pages/measure110.aspx</ref>


=Available Tools and Resources=
=Available Tools and Resources=
<ref>https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf</ref>Faces & Voices of Recovery (Faces & Voices) conducted the first nationwide survey of persons in recovery from alcohol and other drug problems. The purpose of this survey was to document the benefits of recovery.


<ref>https://www.safeproject.us/bridging-prevention-recovery/</ref>SAFE Project’s Bridging Prevention and Recovery Program is a new evidence-based program model designed to provide substance use disorder professionals with a step-by-step process to facilitate sustainable integration of traditional siloed approaches in communities.
* '''SAMHSA''' published "Recovery from Substance Use and Mental Health Problems Among Adults in the United States." This brief report presents self-reports of recovery among adults aged 18 and older in the United States who thought they had a problem with their use of drugs or alcohol and/or mental health. These findings provide a clearer characterization of the factors associated with recovery among adults and how future efforts can foster a whole-health approach to sustain recovery from mental health and substance use conditions. <ref>https://store.samhsa.gov/product/recovery-substance-use-and-mental-health-problems-among-adults-united-states/pep23-10-00?utm_source=SAMHSA&utm_campaign=3315782ffc-EMAIL_CAMPAIGN_2023_09_20_06_25&utm_medium=email&utm_term=0_-3315782ffc-%5BLIST_EMAIL_ID%5D</ref> SAMHSA also provides video trainings which promote recovery-oriented services and supports by highlighting new knowledge areas, hot topics, and cutting-edge programs, <ref>https://www.samhsa.gov/brss-tacs/video-trainings</ref> and it has a website titled "Recovery Resources for American Indian and Alaska Natives" with resources addressing recovery support within AIAN communities. <ref>https://www.samhsa.gov/tribal-affairs/recovery-resources-american-indian-alaska-natives?utm_source=SAMHSA&utm_campaign=24c288fca9-EMAIL_CAMPAIGN_2024_03_13_03_56&utm_medium=email&utm_term=0_-24c288fca9-%5BLIST_EMAIL_ID%5D</ref>


<ref>https://www.safeproject.us/ifprs-training/</ref> SAFE Project’s I-FPRS Training of Trainers equips participants to train Certified Peer Recovery Specialists and Supervisors to navigate the complexities associated with providing support to individuals who are justice-involved.
* '''Faces & Voices of Recovery (Faces & Voices)''' conducted the first nationwide survey of persons in recovery from alcohol and other drug problems. The purpose of this survey was to document the benefits of recovery. <ref>https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf</ref>


<ref>https://safelocator.org/en/search</ref> SAFE Project and the Partnership to End Addiction’s Treatment and Family Support Locator can assist individuals and their loved ones in finding the best treatment for their needs, as well as programs, supports, and other services for friends and family of people caring for individuals with substance use disorder and/or mental health challenges.  
* '''SAFE Project''' offers a suite of resources across the recovery ecosystem:
**'''Bridging Prevention and Recovery''' is a new evidence-based program designed to provide substance use disorder professionals with a step-by-step process to facilitate sustainable integration of these two approaches in communities that have traditionally been siloed. <ref>https://www.safeproject.us/bridging-prevention-recovery/</ref>
**'''Integrated-Forensic Peer Recovery Specialist (I-FPRS)''' uses a Training of Trainers model to equip participants to train Certified Peer Recovery Specialists and Supervisors to navigate the complexities associated with providing support to individuals who are justice-involved. <ref>https://www.safeproject.us/ifprs-training/</ref>
**"Recovery Supports for People in the Criminal Justice System" is a Safe Solutions article that provides information about strategies to support people in this population -- who have unique recovery needs.  <ref>https://www.yoursafesolutions.us/wiki/Improve_Recovery_Support_for_People_in_the_Criminal_Justice_System</ref> Substance use disorder and the justice system have a complex history. It is estimated that about one-half of state and federal prisoners misuse drugs or are addicted to drugs, but few typically receive treatment while incarcerated. <ref>https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-opioid-use-disorder-treated-in-criminal-justice-system</ref>
** "Improve Recovery Housing" is a Safe Solutions article which addresses the transfer from treatment to independent living. For some individuals, returning to their previous living environment can be unsafe or not conducive to their recovery. Sober living offers individuals a safe, peer-to-peer recovery-oriented home with structure, accountability, and support. Typically, there are household duties in sober living that need to be fulfilled including rent, chores, curfew, etc. <ref>https://www.yoursafesolutions.us/wiki/Improve_Recovery_Housing</ref>
** "Improve Education, Job Training, and Employment for People in Recovery" focuses on vocational training. Substance use disorders could result in loss of job, job abandonment, or legal issues that may add additional barriers to obtaining employment. Vocational training can provide on-the-job training, remedial training, college training, and resume building. <ref>https://www.yoursafesolutions.us/wiki/Improve_Education,_Job_Training,_and_Employment_for_People_in_Recovery</ref>
**"Expand Collegiate Recovery Programs" provides information on how to help students balance recovery and higher education. <ref>https://www.yoursafesolutions.us/wiki/Expand_Recovery_Schools_and_Collegiate_Recovery_Programs</ref> This includes therapy, sober housing, and substance-free events. There is a related aSAFE Solutions article on recovery high schools. <ref>https://www.yoursafesolutions.us/wiki/Expand_Recovery_High_Schools</ref> 
**"Expand Harm Reduction Practices" is a SAFE Solutions article focused on a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. <ref>https://www.yoursafesolutions.us/wiki/Expand_Harm_Reduction_Practices</ref> Harm Reduction is also a movement for social justice built on a belief in and respect for, the rights of people who use drugs. <ref>https://harmreduction.org/about-us/principles-of-harm-reduction/</ref>
**"Expand Access to Medication-Assisted Treatment" is an article focused on the role of MAT to provide a whole-patient approach to recovery. MAT is primarily used for addiction to opioids, such as prescription pain killers and heroin. MAT utilizes FDA-approved medications to help sustain recovery and prevent or reduce opioid overdose. <ref>https://www.yoursafesolutions.us/wiki/Expand_Access_to_Medication-Assisted_Treatment_(MAT)</ref>


<ref>https://findtreatment.gov/</ref> SAMHSA’s treatment finder connects you with licensed treatment providers who specialize in substance use, addiction, and mental health.
=Promising Practices=
<ref>https://americanaddictioncenters.org/therapy-treatment/12-step-alternatives</ref>  Although AA is the most well-known peer recovery support program, there are other pathways that provide support. This article gives alternatives to the 12-steps.


<ref>https://www.samhsa.gov/brss-tacs/video-trainings</ref> Video trainings that promote recovery-oriented services and supports by highlighting new knowledge areas, hot topics, and cutting-edge programs.
* '''Connecticut Community for Addiction Recovery (CCAR)''' supports all things recovery -- no matter what stage of recovery. The CCAR website helps people navigate the recovery community by providing support services and connections to people in recovery. They offer telephone recovery support, virtual support meetings on different recovery topics, peer recovery training, and a coffee lounge. They also have five recovery community centers throughout the state. <ref>https://ccar.us/</ref>


=Promising Practices=
* '''The Hazelden Betty Ford Foundation''' has a series of virtual services. On-line outpatient addiction programs encompass addiction treatment, family services, community solutions, prevention and early intervention, recovery support, and mental health services. <ref>https://www.hazeldenbettyford.org/locations/online-care-support-services</ref>
Hazelden Betty Fords RecoveryGo-Virtual outpatient addiction program that encompasses, addiction treatment, family services, community solutions, prevention and early intervention, recovery support, and mental health services.<ref>https://www.hazeldenbettyford.org/locations/online-care-support-services</ref>


Recovery Texas-State movement that provides recovery support specialists, screenings for substance use and mental health, and digital recovery support such as meetings, meditation, yoga, and other local resources. <ref>https://recoverytexas.org/</ref>
*'''Oregon''' This case study highlights steps which advanced a "recovery-ready ecosystem" in the city of Eugene. <ref>https://www.opioidlibrary.org/wp-content/uploads/2019/08/Building-a-Recovery-Ready-Ecosystem-in-Oregon-Robert-Ashford1000.pdf</ref>


Connecticut Community for Addiction Recovery (CCAR)-Resources in Connecticut for all things recovery. No matter what stage of recovery you’re in, the website helps you navigate the recovery community by providing support services and connecting you to people in recovery. They offer telephone recovery support, virtual support meetings on different recovery topics, peer recovery training, and a coffee lounge. They also have five recovery community centers throughout the state.<ref>https://ccar.us/</ref>
*'''Texas.''' Recovery Texas is a state-wide movement provides recovery support specialists, screenings for substance use and mental health, and digital recovery support such as meetings, meditation, and yoga. <ref>https://recoverytexas.org/</ref>


=Sources=
=Sources=

Latest revision as of 09:55, 25 September 2024

Introductory Paragraph

This article is the first in a series of articles designed to address the science of recovery. It covers the definitions and dimension of recovery, as outlined by SAMHSA. It also introduces the concept of recovery capital. The various scales at which recovery capital can be built matches the socio-ecological model detailed in the prevention science article titled "Address Risk & Protective Factors for Individuals, Families, and Communities." [1] The recovery ecosystem is complex and requires intention to be applied at each scale (individual, family, social, and community). Aligning prevention science and recovery science in comparable multi-scale approaches will be a significant element in bridging prevention and recovery efforts and in advancing work that is coordinated across the full continuum of care.

Key Information

Definition and Dimensions of Recovery

SAMHSA defines recovery as "a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential." [2] The four major dimensions that SAMHSA has identified which support recovery include:

  • Health — overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.
  • Home — having a stable and safe place to live.
  • Purpose — conducting meaningful daily activities and having the independence, income, and resources to participate in society.
  • Community — having relationships and social networks that provide support, friendship, love, and hope.

It is noteworthy that these four dimension span the socio-ecological model -- individual, family, social, and community.

Recovery Capital

Recovery Capital is a crucial component for sustained recovery. It has been defined as the quantity and quality of internal and external resources that one can bring to bear on the initiation and maintenance of recovery. [3] For too long, most of the aspects of recovery capital were either random or only reserved for individuals who had these resources readily available. Recovery capital is not dependent on socioeconomic status, and socioeconomic status is not an accurate indicator of either high or low recovery capital. Since change in one's home or work environment may not be possible for everyone, many individuals return to family or community environments that are unsafe or recovery-hostile. Returning to a problematic home life or to a community which has a culture of alcohol and other drug use, can place stress on recovery capital. Faces & Voices of Recovery provides a breakdown of the scales of recovery capital and their role in sustaining recovery: [4]

  • Personal. This includes an individual’s physical and human capital. Physical capital is the available resources to fulfill a person’s basic needs, like their health, healthcare, financial resources, clothing, food, transportation, and safe and habitable shelter. Human capital relates to a person’s abilities, skills, and knowledge, like problem-solving, education and credentials, self-esteem, the ability to navigate challenging situations and achieve goals, interpersonal skills, and a sense of meaning and purpose in life. See the SAFE Solutions article titled "Increase Support for Individuals in Recovery” for more information on building personal recovery capital. [5]
  • Family/social. These resources relate to intimate relationships with friends and family, relationships with people in recovery, and supportive partners. It also includes the availability of recovery-related social events. SAFE Solutions has two articles related to family/social recovery capital. The first, titled "Expand Community Support for Impacted Families" [6] focuses on the family, and the second article titled "Strengthen Peer Recovery Support Services and Programs" addresses the role of peers in the broader social dimensions. [7]
  • Community. This includes attitudes, policies, and resources specifically related to helping individuals resolve substance use disorders. Community resources can include recovery support institutions, such as recovery high schools, college recovery programs, recovery housing, and recovery ministries. Likewise, agencies and employers can bring resources to sustain recovery and early intervention programs, such as drug courts and employee assistance programs. See the SAFE Solutions article titled "Create Recovery-Ready Communities," for more detailed information on building recovery capital at the community scale. [8]

Relevant Research

Nora's Blog on the Director's page of NIDA highlights recent advances in the science of drug use and addiction. For example, in evaluating the relationship between abstinence and relapse, it is noted that setbacks are regarded as a failure, leading to the perception that the client is starting all over, when in fact, a return to use may strengthen someone’s resolve to recover. [9]

Impactful Federal, State, and Local Policies

Partners for Recovery published a report that provides information regarding the funding sources that support recovery support services throughout the continuum of care. The report includes an overview of federal, state, and private funding and highlights practices for obtaining funding. [10]

Oregon passed a Drug and Addiction Treatment Act whose purpose is to make screening health assessment, treatment and recovery services for drug addiction available to all those who need and want access to those services; and to adopt a health approach to drug addiction by removing criminal penalties for low-level drug possession.[11]

Available Tools and Resources

  • SAMHSA published "Recovery from Substance Use and Mental Health Problems Among Adults in the United States." This brief report presents self-reports of recovery among adults aged 18 and older in the United States who thought they had a problem with their use of drugs or alcohol and/or mental health. These findings provide a clearer characterization of the factors associated with recovery among adults and how future efforts can foster a whole-health approach to sustain recovery from mental health and substance use conditions. [12] SAMHSA also provides video trainings which promote recovery-oriented services and supports by highlighting new knowledge areas, hot topics, and cutting-edge programs, [13] and it has a website titled "Recovery Resources for American Indian and Alaska Natives" with resources addressing recovery support within AIAN communities. [14]
  • Faces & Voices of Recovery (Faces & Voices) conducted the first nationwide survey of persons in recovery from alcohol and other drug problems. The purpose of this survey was to document the benefits of recovery. [15]
  • SAFE Project offers a suite of resources across the recovery ecosystem:
    • Bridging Prevention and Recovery is a new evidence-based program designed to provide substance use disorder professionals with a step-by-step process to facilitate sustainable integration of these two approaches in communities that have traditionally been siloed. [16]
    • Integrated-Forensic Peer Recovery Specialist (I-FPRS) uses a Training of Trainers model to equip participants to train Certified Peer Recovery Specialists and Supervisors to navigate the complexities associated with providing support to individuals who are justice-involved. [17]
    • "Recovery Supports for People in the Criminal Justice System" is a Safe Solutions article that provides information about strategies to support people in this population -- who have unique recovery needs. [18] Substance use disorder and the justice system have a complex history. It is estimated that about one-half of state and federal prisoners misuse drugs or are addicted to drugs, but few typically receive treatment while incarcerated. [19]
    • "Improve Recovery Housing" is a Safe Solutions article which addresses the transfer from treatment to independent living. For some individuals, returning to their previous living environment can be unsafe or not conducive to their recovery. Sober living offers individuals a safe, peer-to-peer recovery-oriented home with structure, accountability, and support. Typically, there are household duties in sober living that need to be fulfilled including rent, chores, curfew, etc. [20]
    • "Improve Education, Job Training, and Employment for People in Recovery" focuses on vocational training. Substance use disorders could result in loss of job, job abandonment, or legal issues that may add additional barriers to obtaining employment. Vocational training can provide on-the-job training, remedial training, college training, and resume building. [21]
    • "Expand Collegiate Recovery Programs" provides information on how to help students balance recovery and higher education. [22] This includes therapy, sober housing, and substance-free events. There is a related aSAFE Solutions article on recovery high schools. [23]
    • "Expand Harm Reduction Practices" is a SAFE Solutions article focused on a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. [24] Harm Reduction is also a movement for social justice built on a belief in and respect for, the rights of people who use drugs. [25]
    • "Expand Access to Medication-Assisted Treatment" is an article focused on the role of MAT to provide a whole-patient approach to recovery. MAT is primarily used for addiction to opioids, such as prescription pain killers and heroin. MAT utilizes FDA-approved medications to help sustain recovery and prevent or reduce opioid overdose. [26]

Promising Practices

  • Connecticut Community for Addiction Recovery (CCAR) supports all things recovery -- no matter what stage of recovery. The CCAR website helps people navigate the recovery community by providing support services and connections to people in recovery. They offer telephone recovery support, virtual support meetings on different recovery topics, peer recovery training, and a coffee lounge. They also have five recovery community centers throughout the state. [27]
  • The Hazelden Betty Ford Foundation has a series of virtual services. On-line outpatient addiction programs encompass addiction treatment, family services, community solutions, prevention and early intervention, recovery support, and mental health services. [28]
  • Oregon This case study highlights steps which advanced a "recovery-ready ecosystem" in the city of Eugene. [29]
  • Texas. Recovery Texas is a state-wide movement provides recovery support specialists, screenings for substance use and mental health, and digital recovery support such as meetings, meditation, and yoga. [30]

Sources

  1. https://www.yoursafesolutions.us/wiki/Address_Risk_%26_Protective_Factors_for_Individuals,_Families,_and_Communities
  2. https://www.samhsa.gov/find-help/recovery
  3. Granfield, R., & Cloud, W. (1999). Coming clean: Overcoming Addiction without treatment. New York: New York University Press.
  4. https://facesandvoicesofrecovery.org/blog/2019/10/08/recovery-capital-its-role-in-sustaining-recovery/
  5. https://www.yoursafesolutions.us/wiki/Improve_Tracking_of_Recovery_Progress
  6. https://www.yoursafesolutions.us/wiki/Expand_Community_Support_for_Impacted_Families
  7. https://www.yoursafesolutions.us/wiki/Strengthen_Peer_Recovery_Support_Services_and_Programs
  8. https://www.yoursafesolutions.us/wiki/Create_Recovery-Ready_Communities#Key_Information
  9. https://nida.nih.gov/about-nida/noras-blog/2022/01/making-addiction-treatment-more-realistic-pragmatic-perfect-should-not-be-enemy-good
  10. https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/Financing-Recovery-Support-Services.pdf
  11. https://www.oregon.gov/oha/hsd/amh/pages/measure110.aspx
  12. https://store.samhsa.gov/product/recovery-substance-use-and-mental-health-problems-among-adults-united-states/pep23-10-00?utm_source=SAMHSA&utm_campaign=3315782ffc-EMAIL_CAMPAIGN_2023_09_20_06_25&utm_medium=email&utm_term=0_-3315782ffc-%5BLIST_EMAIL_ID%5D
  13. https://www.samhsa.gov/brss-tacs/video-trainings
  14. https://www.samhsa.gov/tribal-affairs/recovery-resources-american-indian-alaska-natives?utm_source=SAMHSA&utm_campaign=24c288fca9-EMAIL_CAMPAIGN_2024_03_13_03_56&utm_medium=email&utm_term=0_-24c288fca9-%5BLIST_EMAIL_ID%5D
  15. https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf
  16. https://www.safeproject.us/bridging-prevention-recovery/
  17. https://www.safeproject.us/ifprs-training/
  18. https://www.yoursafesolutions.us/wiki/Improve_Recovery_Support_for_People_in_the_Criminal_Justice_System
  19. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-opioid-use-disorder-treated-in-criminal-justice-system
  20. https://www.yoursafesolutions.us/wiki/Improve_Recovery_Housing
  21. https://www.yoursafesolutions.us/wiki/Improve_Education,_Job_Training,_and_Employment_for_People_in_Recovery
  22. https://www.yoursafesolutions.us/wiki/Expand_Recovery_Schools_and_Collegiate_Recovery_Programs
  23. https://www.yoursafesolutions.us/wiki/Expand_Recovery_High_Schools
  24. https://www.yoursafesolutions.us/wiki/Expand_Harm_Reduction_Practices
  25. https://harmreduction.org/about-us/principles-of-harm-reduction/
  26. https://www.yoursafesolutions.us/wiki/Expand_Access_to_Medication-Assisted_Treatment_(MAT)
  27. https://ccar.us/
  28. https://www.hazeldenbettyford.org/locations/online-care-support-services
  29. https://www.opioidlibrary.org/wp-content/uploads/2019/08/Building-a-Recovery-Ready-Ecosystem-in-Oregon-Robert-Ashford1000.pdf
  30. https://recoverytexas.org/