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Purpose The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals’ perceptions of their contribution to improvement. Design/methodology/approach In all, 15 experienced professionals were interviewed. The interviews were analysed using thematic analysis. Findings Recovery processes were dependent of the persons’ access to different forms of recovery capital (RC). Lack of RC was often associated with lack of trust in one’s self and others (identity and personal capital). Professionals had to be accepted as trustful agents through co-creating changes in the person’s life. Trusting a professional might be a basis for trusting one’s self as an agent in one’s recovery process and develop a social network (identity and relationship capital). Other aspects stressed by the professionals were to manage their own fragmentized organisations and societal shortcomings (economic capital). Practical implications Recovery has been described as a profoundly individual journey. However, it is also deeply social, involving other persons and contextual factors. Focusing on just one level might counteract the complex work behind double recovery. Originality/value Improvement was described as dependent on the presence of personal, inter-personal, organisational and societal factors. The findings give a deep and concrete understanding of the process constituting the development of a working alliance and its dependence on factors outside the direct relation between the staff member and the person.

Alcohol misuse among substance abusers might have a negative impact on mortality rates. Methodological changes in how drug related deaths is registered affects the interpretation of the statistics of cause of death. Further analysis on the relation between drug related cause of death and drug misuse related death is needed.

In social work practice, the role of substance use is often encountered in the context of other social problems such as child abuse and domestic violence. This article compares descriptions of important factors for initiating and maintaining positive changes among male and female clients treated for alcohol and/or drug problems. The results have a bearing both on substance use treatment and on other areas in social work practice where these problems are encountered. Studies highlighting gender perspective indicate differences regarding experience of alcohol and drug problems and treatment. An advantage of the study is the qualitative analysis of a rather comprehensive material (n ¼ 90) enabling more general conclusions than in previous research with a limited number of clients.Findings: Women more often than men stress poor mental health and their children as important for initiating change. When referring to partners, women report abusive rather than supportive partners while the opposite applies to men. For maintaining change, male clients more often stress changes in ways of thinking and feeling as important. Men also report becoming more sensitive while women get more active. This can be understood as transcending of gender with possibilities of a broader repertoire of how to act.Applications: A challenge for practical treatment work is to create possibilities for clients to broaden their repertoire of ways of living and thinking about themselves, expressed by women as the importance of taking space and speaking up and by the men of showing emotion and listening more.

Recovery is an established term used to describe positive processes of change concerning problems related to alcohol and other drugs (AOD). The present article investigates first-person experiences of recovery self-identification over time in clients who have completed 12-step programs with a positive outcome (sobriety). The data comprises qualitative interviews with 47 individuals five years after the first post-treatment interview, analyzed in a process inspired by reflexive thematic analysis. Although all the individuals had continued their recovery, their recovery paths and how they identified themselves in relation to their AOD problems had taken different directions. Thus, many of the individuals described their recovery in a broader sense which ranges from abstinence to moderation. Some individuals perceived themselves as no longer in recovery. The multitude of recovery processes described in the study underlines the need for acceptance and respect for individual identity processes. Furthermore, the importance is stressed of supporting an individual's perceptions of how their recovery process should best be outlined. The results should not be interpreted as a critique of the 12-step approach. Instead, there is a need for variety over time in the support and treatment options available for people in need of treatment for AOD problems.