Background: Mutual aid organizations, such as Narcotics Anonymous (NA), can provide support in substance use disorder (SUD) recovery processes. However, research on NA and its recovery-supportive elements is scarce and perspectives of NA-members remain understudied, in particular outside the US. Therefore, this study aims to gain insight into recovery-supportive elements of NA, as experienced by its members. Methods: To explore the perspectives on and experiences with recovery-supportive elements in NA, 11 in-depth interviews with NA-members were conducted in Flanders (Belgium). Interviews were audio-taped, transcribed verbatim and analyzed by using CHIMED , a personal recovery framework (Connectedness, Hope, Identity, Meaning in life, Empowerment, Difficulties) developed by Leamy and colleagues in 2011. Results: Various recovery-supportive elements of NA were highlighted, with Connectedness as a key component including opportunities for building up a social network and for providing a safety net or sounding board. Elements that enabled Connectedness were 1) a non-judgemental approach, and 2) mutual understanding through sharing in NA. Other elements of the CHIMED framework were less frequently mentioned, although these were inextricably linked to Connectedness. Conclusions: Connectedness appeared to be the crucial recovery-supportive element in NA, emphasizing the relational character of SUD recovery. Although other elements of the CHIMED framework were identified, these were closely related to and intertwined with the concept of connectedness.

Introduction. Earlier reviews regarding the effectiveness of Drug Treatment Courts (DTCs) reported a reduction in reoffending and substance use. Although substance users suffer from other difficulties than drug use and judicial issues, none of these reviews focused on outcomes or effects of DTCs on drug-related life domains, such as social relationships, employment, or health. Therefor, the present paper aims to review the impact of adult DTCs on substance use and drug-related life domains. Method. Primary studies were systematically searched in Web of Knowledge. Observational and controlled evaluation studies of adult DTCs were considered eligible if substance use and/or drug-related life domains were measured. Results. Moderately positive results were found with respect to within-program substance use. Few studies used drug-related life domains as an outcome measure and most of them yielded no effects. Employment and family relations ameliorated when specific interventions were used. Discussion. DTCs yield beneficial outcomes and effects regarding within-program substance use. However, evidence regarding the impact of DTCs on post-program drug and alcohol use and on other drug-related life domains is scarce. These life domains and thus QoL possibly can be improved by DTCs if specifically targeted. Future research is warranted.

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Even though various pathways to addiction recovery have been identified, knowledge on overarching essential components of addiction recovery processes remains limited. To explore these essential components, in-depth interviews were conducted with a heterogeneous group of individuals across pathways to addiction recovery (i.e. a low-threshold activation center, Narcotics Anonymous, a CRA þ vouchers out-patient program, residential treatment programs, and 'natural' recovery). The interviews (n ¼ 25) were audio-taped, transcribed verbatim, and thematically analyzed. In-depth analysis of the data resulted in a model that includes essential components of addiction recovery processes and their dynamic relationship. 'Time' and 'supportive environments' were identified as the foundations and facilitators for the transformative changes required in addiction recovery processes, which in turn contributed to 'developing a sense of self' and 'developing a sense of future'. These components, interrelated and in a continuous interplay with each other, facilitated recovery processes. As a result, recovery-oriented support should be strengthened and specifically focus on supporting these essential components, by providing tailor-made and continuously available support. Given the relational character of addiction recovery processes, social networks and society at large should evolve towards the development of responsive and inclusive spaces to support persons in addiction recovery.