Tens of millions successfully in long‐term recovery—let us find out how they did it

Kelly, John F.

doi:10.1111/add.13696

Cited by 15 publications

(13 citation statements)

References 8 publications

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“…Use of FDA-approved medications was rare; it is plausible that wider prescribing practices could increase long-term AOD problem resolution rates at a population level (Weiss and Rao, 2017). Improved understanding of this large population of individuals and how they have been successful (Kelly, 2017c; McKay, 2017) could inform and enhance our broad public health as well as clinical, research, and policy efforts in addressing endemic concerns related to AOD misuse. Results suggest that as a society struggling with the impact of substance-related problems, there may need to be a widening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

Kelly

Bergman

Hoeppner

et al. 2017

Drug and Alcohol Dependence

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176

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Background: Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision. Method: Probability-based survey of US adult population estimating: 1) AOD problem resolution prevalence; 2) lifetime use of “assisted” (i.e., treatment/medication, recovery services/mutual help) vs. “unassisted” resolution pathways; 3) correlates of assisted pathway use. Participants (response = 63.4% of 39,809) responding “yes” to, “Did you use to have a problem with alcohol or drugs but no longer do?” assessed on substance use, clinical histories, problem resolution. Results: Weighted prevalence of problem resolution was 9.1%, with 46% self-identifying as “in recovery”; 53.9% reported “assisted” pathway use. Most utilized support was mutual-help (45.1%,SE = 1.6), followed by treatment (27.6%,SE = 1.4), and emerging recovery support services (21.8%,SE = 1.4), including recovery community centers (6.2%,SE = 0.9). Strongest correlates of “assisted” pathway use were lifetime AOD diagnosis (AOR = 10.8[7.42–15.74], model R2 = 0.13), drug court involvement (AOR = 8.1[5.2–12.6], model R2 = 0.10), and, inversely, absence of lifetime psychiatric diagnosis (AOR = 0.3[0.2–0.3], model R2 = 0.10). Compared to those with primary alcohol problems, those with primary cannabis problems were less likely (AOR = 0.7[0.5–0.9]) and those with opioid problems were more likely (AOR = 2.2[1.4–3.4]) to use assisted pathways. Indices related to severity were related to assisted pathways (R2 < 0.03). Conclusions: Tens of millions of Americans have successfully resolved an AOD problem using a variety of traditional and non-traditional means. Findings suggest a need for a broadening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.

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Section: Discussionmentioning

confidence: 99%

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

Kelly

Bergman

Hoeppner

et al. 2017

Drug and Alcohol Dependence

Self Cite

210

176

View full text Add to dashboard Cite

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“…Kelly makes three excellent suggestions that would advance work on how to make recovery more attractive: asking people in recovery how they got better (which Lancaster also recommended), promoting recovery support services in the community that can provide an entree to rewarding activities and recognizing that there will be important individual differences in the kinds of experiences that will be most rewarding. The insights of those who have been successful in recovery might not always be relevant to those who continue to struggle.…”

mentioning

confidence: 99%

Making recovery more rewarding: difficult with possible unintended consequences, but successful examples are out there

McKay

2017

Addiction

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more accessible, attractive and rewarding. They are popular and growing, but need further evaluation [11]. 'Personalized recovery'It is said that: 'One man's trash is another man's treasure', and we know that what different individuals with SUD may find attractive and rewarding could well depend upon many additional factors, such as their life-stage (e.g. adolescence, emerging adulthood, etc.), gender, ethnicity, type and severity of SUD, length of time in recovery and the degree of recovery capital already at their disposal. Like the current clinical emphasis on 'personalized medicine', uncovering models and pathways of 'personalized recovery' would help to identify which factors might have the most value for whom and at which point in the recovery journey. Understanding more from the millions already in recovery, as noted above, would provide valuable information about subgroups of individuals seeking recovery (e.g. African Americans; pregnant women) that communities could subsequently use to plan for and provide the types and quantities of resources that most are likely to find appealing.In sum, our professionally delivered treatments have been designed mainly to address the more acute and early recovery needs associated with alleviating pain and suffering and preventing short-term re-initiation of use. As in a burning-building scenario, the first job, to be sure, is to extinguish the fire and try to prevent it from immediately re-igniting. However, missing in our treatment scenario has been a focus on the subsequent architectural planning and rebuilding process once the fire is out. Declaration of interestsNone.

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“…In spite of some incredible work around 12-step interventions (e.g. Kaskutas, 2009;Kelly, 2017) and the beginnings of research reviews (Sheedy & Whitter, 2009;Humphreys & Lembke, 2013), there remains a concern that we know relatively little about who recovers, why or under what circumstances.…”

Section: Editorialmentioning

confidence: 99%

Editorial: International Experiences of Life in Recovery

Best

Edwards

2018

Alcoholism Treatment Quarterly

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Tens of millions successfully in long‐term recovery—let us find out how they did it

Cited by 15 publications

References 8 publications

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy

Making recovery more rewarding: difficult with possible unintended consequences, but successful examples are out there

Editorial: International Experiences of Life in Recovery

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