Overcoming the pains of recovery: the management of negative recovery capital during addiction recovery pathways

‘This is hardcore’: a qualitative study exploring service users’ experiences of Heroin-Assisted Treatment (HAT) in Middlesbrough, England

“…Another participant, Georgie, expressed concerns about relinquishing control and autonomy over their own heroin consumption, transforming what they deemed as optional heroin use into a regulated ‘habit’ under state control. Participants’ pessimism and mistrust were likely rooted in their repeated experiences of ‘failed recovery’, which diminished trust and confidence in treatment efficacy [ 43 , 52 , 53 ]. Service users also expressed apprehension regarding treatment longevity due to concerns around funding.…”

“…Such ‘turning points’, or experiences of hitting ‘rock bottom’, have been suggested as strong motivators for change, pushing individuals towards drug use cessation as the pains of continued drug-use come to outweigh the potential pains of leaving this lifestyle behind [ 43 , 57 ]. Participants’ anxieties over physical health and mortality were acutely linked to the unpredictability of street heroin quality.…”

“…Thus, participants experienced positive, de-stigmatising effects of regular clinic attendance, while simultaneously experiencing constraints and limitations on freedom. In balancing this tension, participants reported engaging in intuitive cost/benefit analyses, where the difficulties of the high-intensity treatment, or the ‘pains of recovery’ [ 43 ] were compared to the predicted pains of recommencing street heroin use. As such, participants justified the sacrifices and difficulties involved in twice-daily community-based treatment as ultimately preferable to the dangerous and stigmatised activities involved in street heroin acquisition.…”

“…Such highly regulated and intensive drug treatment models have been criticised for restricting service users’ daily movements, constricting freedom, and compromising service users’ autonomy [ 40 – 42 ]. Furthermore, moving away from illicit drug use can comprise multiple challenges, with reports of social isolation, separating from entrenched social networks, and stigmatisation described as ‘pains’ impacting recovery outcomes [ 43 , 44 ]. It is vital, therefore, to understand how HAT is experienced in a UK context, from the perspective of service users and in relation to these challenges, to inform recommendations for service modifications at scale.…”

Substance use disorders, physical health and recovery capital: Examining the experiences of clients and the alcohol and other drug workforce

“…Although Cloud and Granfield highlight the significant challenges posed by poor physical health in the process of recovering from substance use disorders [12], updated conceptualisations of recovery capital have largely overlooked the potential of physical health as a recovery resource [27][28][29][30][31]. Instead, there has been an increasing emphasis on recovery from substance use as a social and community phenomenon [27,[32][33][34]. This has been highlighted previously in a study of early recovery experiences among people seeking treatment for heroin use [31] and in a systematic review of recovery capital [35].…”