On being “in recovery”: A national study of prevalence and correlates of adopting or not adopting a recovery identity among individuals resolving drug and alcohol problems.

Abstract

The concept of recovery has become an organizing paradigm in the addiction field globally. Although a convenient label to describe the broad phenomena of change when individuals resolve significant alcohol or other drug (AOD) problems, little is known regarding the prevalence and correlates of adopting such an identity. Greater knowledge would inform clinical, public health, and policy communication efforts. We conducted a cross-sectional nationally representative survey (N = 39,809) of individuals resolving a significant AOD problem (n = 1,995). Weighted analyses estimated prevalence and tested correlates of label adoption. Qualitative analyses summarized reasons for prior recovery identity adoption/nonadoption. The proportion of individuals currently identifying as being in recovery was 45.1%, never in recovery 39.5%, and no longer in recovery 15.4%. Predictors of identifying as being in recovery included formal treatment and mutual-help participation, and history of being diagnosed with AOD or other psychiatric disorders. Qualitative analyses regarding reasons for no/prior recovery identity found themes related to low AOD problem severity, viewing the problem as resolved, or having little difficulty of stopping. Despite increasing use of the recovery label and concept, many resolving AOD problems do not identify in this manner. These appear to be individuals who have not engaged with the formal or informal treatment systems. To attract, engage, and accommodate this large number of individuals who add considerably to the AOD-related global burden of disease, AOD public health communication efforts may need to consider additional concepts and terminology beyond recovery (e.g., "problem resolution") to meet a broader range of preferences, perspectives and experiences. (PsycINFO Database Record

How Many Recovery Attempts Does it Take to Successfully Resolve an Alcohol or Drug Problem? Estimates and Correlates From a National Study of Recovering U.S. Adults

“…In this scenario, it is also possible that they may have misinterpreted the question to mean not including the current recovery attempt or that use of such services still did not surpass their own subjective threshold of what constitutes a “serious” attempt. From our prior research with this sample (Kelly et al., ), however, it is quite possible that at least some people found it very straightforward to resolve their AOD problem as it was reported as not severe and not resulting in substantial impairment. Regardless, even when assuming everyone in this zero group did indeed have at least 1 serious recovery attempt, it did not make a large absolute difference in increasing the average number of recovery attempts as our sensitivity analyses revealed the absolute median number of recovery attempts needed prior to AOD problem resolution remained low, moving from 2 to 3, and with the mean moving from 5.35 to 6.14.…”

“…It is possible that they misinterpreted the question or perhaps did not consider any of their attempts “serious.” Regarding the first possibility of question misinterpretation, it is possible that because the question asked about serious recovery attempts “prior to overcoming” their AOD problem, they did not count the current attempt, even though it may have been regarded as a serious attempt. Regarding the second possibility, in subsidiary analyses (not shown) we found that about 34% of this group (of n = 260) who reported zero prior serious recovery attempts also reported use of some kind of treatment or mutual‐help recovery support service, indicative of perhaps a more “serious” concerted effort to resolve their problem (Kelly et al., ). In this scenario, it is also possible that they may have misinterpreted the question to mean not including the current recovery attempt or that use of such services still did not surpass their own subjective threshold of what constitutes a “serious” attempt.…”

“…Canadians ( N = 855) who self‐identified as being in recovery reported the pattern of recovery attempts as follows: no recurrence of AOD use following initial recovery initiation (51.2%), 1 recurrence (14.3%), 2 to 5 recurrences (19.4%), and 6 or more AOD recurrence episodes (15%) prior to recovery stability. These clinical and Life in Recovery surveys may not be applicable to broader general population samples containing significant numbers of people who have resolved an AOD problem but have not necessarily embraced a recovery identity (Kelly et al., ).…”

Defining a recovery-oriented cascade of care for opioid use disorder: A community-driven, statewide cross-sectional assessment

“…For stage 0, we also recognize that there are limitations inherent in using selfreported measures of heroin use and prescription opioid misuse, including social desirability bias, where individuals who use heroin or misuse prescription opioids may report not doing so to avoid perceived judgment. Furthermore, recovery (stage 4) is often a self-identified status that is difficult to measure through administrative claims data due to potential overlap with other stages (i.e., those with long-term engagement with MOUD in stage 3) [67]. Future analyses will focus on improved linkages across datasets that account for movement between the outlying stages (stages 0 and 4) and the system of care transition stages (stages 1, 2, and 3), and the time-varying nature of the transition of individual patients from one stage to the next [67].…”

“…Furthermore, recovery (stage 4) is often a self-identified status that is difficult to measure through administrative claims data due to potential overlap with other stages (i.e., those with long-term engagement with MOUD in stage 3) [67]. Future analyses will focus on improved linkages across datasets that account for movement between the outlying stages (stages 0 and 4) and the system of care transition stages (stages 1, 2, and 3), and the time-varying nature of the transition of individual patients from one stage to the next [67]. Given the challenges with unrelated, cross-sectional data sources, we ask that the descriptive data and results be interpreted with caution.…”