Beyond Abstinence: Changes in Indices of Quality of Life with Time in Recovery in a Nationally Representative Sample of U.S. Adults

Kelly, John F.; Greene, M. Claire; Bergman, Brandon G.

doi:10.1111/acer.13604

Cited by 118 publications

(96 citation statements)

References 39 publications

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“…This current study leveraged a geo-demographically representative sample of US adults who resolved a substance use problem (from the National Recovery Study, or NRS; Kelly, Bergman, Hoeppner, Vilsaint, & White, 2017; Kelly, Greene, & Bergman, 2017; Kelly, Greene, & Bergman, 2018) to conduct the first nationwide investigation of ROOT. This analysis of ROOT in the NRS had the following specific aims:…”

Section: Introductionmentioning

confidence: 99%

Expanding the reach of alcohol and other drug services: Prevalence and correlates of US adult engagement with online technology to address substance problems

Bergman

Greene

Hoeppner

et al. 2018

Addictive Behaviors

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Online technologies are well integrated into the day-to-day lives of individuals with alcohol and other drug (i.e., substance use) problems. Interventions that leverage online technologies have been shown to enhance outcomes for these individuals. To date, however, little is known about how those with substance use problems naturally engage with such platforms. In addition, the scientific literatures on health behavior change facilitated by technology and harms driven by technology engagement have developed largely independent of one another. In this secondary analysis of the National Recovery Study (NRS), which provides a geo-demographically representative sample of US adults who resolved a substance use problem, we examined a) the weighted prevalence estimate of individuals who engaged with online technologies to "cut down on substance use, abstain from substances, or strengthen one's recovery" (i.e., recovery-related use of online technology, or ROOT), b) clinical/recovery correlates of ROOT, controlling for demographic covariates, and c) the unique association between ROOT and self-reported history of internet addiction. Results showed one in ten (11%) NRS participants reported ROOT. Significant correlates included greater current psychological distress, younger age of first substance use, as well as history of anti-craving/anti-relapse medication, recovery support services, and drug court participation. Odds of lifetime internet addiction were 4 times greater for those with ROOT (vs. no ROOT). These data build on studies of technology-based interventions, highlighting the reach of ROOT, and therefore, the potential for a large, positive impact on substance-related harms in the US.

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Section: Introductionmentioning

confidence: 99%

Expanding the reach of alcohol and other drug services: Prevalence and correlates of US adult engagement with online technology to address substance problems

Bergman

Greene

Hoeppner

et al. 2018

Addictive Behaviors

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View full text Add to dashboard Cite

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“…Historical precedence notwithstanding, a growing body of conceptual and empirical work supports a broader conceptualization of AUD recovery that is not limited to alcohol‐related outcomes but also includes other domains of psychosocial functioning (Ashford et al, 2019; Best et al, 2016; Kaskutas et al, 2014; Kelly et al, 2018b; Neale et al, 2016; Witbrodt et al, 2015; Witkiewitz and Tucker, 2020). Recent definitions of recovery advanced by key stakeholder groups include this expanded set of criteria.…”

mentioning

confidence: 99%

Can Alcohol Use Disorder Recovery Include Some Heavy Drinking? A Replication and Extension up to 9 Years Following Treatment

Witkiewitz

Pearson

Wilson

et al. 2020

Alcoholism Clin & Exp Res

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Background Recent research indicates some individuals who engage in heavy drinking following treatment for alcohol use disorder fare as well as those who abstain with respect to psychosocial functioning, employment, life satisfaction, and mental health. The current study evaluated whether these findings replicated in an independent sample and examined associations between recovery profiles and functioning up to 6 years later. Methods Data were from the 3‐year and 7‐ to 9‐year follow‐ups of subsamples initially recruited for the COMBINE study (3‐year follow‐up: n = 694; 30.1% female, 21.0% non‐White; 7‐ to 9‐year follow‐up: n = 127; 38.9% female, 27.8% non‐White). Recovery at 3 years was defined by latent profile analyses including measures of health functioning, quality of life, employment, alcohol consumption, and cannabis and other drug use. Functioning at the 7‐ to 9‐year follow‐up was assessed using single items of self‐rated general health, hospitalizations, and alcohol consumption. Results We identified 4 profiles at the 3‐year follow‐up: (i) low‐functioning frequent heavy drinkers (13.9%), (ii) low‐functioning infrequent heavy drinkers (15.8%), (iii) high‐functioning heavy drinkers (19.4%), and (iv) high‐functioning infrequent drinkers (50.9%). At the 7‐ to 9‐year follow‐up, the 2 high‐functioning profiles had the best self‐rated health, and the high‐functioning heavy drinking profile had significantly fewer hospitalizations than the low‐functioning frequent heavy drinking profile. Conclusions Previous findings showing heterogeneity in recovery outcomes were replicated. Most treatment recipients functioned well for years after treatment, and a subset who achieved stable recovery engaged in heavy drinking and reported good health outcomes up to 9 years after treatment. Results question the long‐standing emphasis on drinking practices as a primary outcome, as well as abstinence as a recovery criterion in epidemiologic and treatment outcome research and among stakeholder groups and funding/regulatory agencies. Findings support an expanded recovery research agenda that considers drinking patterns, health, life satisfaction, and functioning.

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“…This is suggestive that there are subgroups of individuals within the sample who may be quite different. This is what we would expect given the nature of this sample of individuals who have resolved a significant AOD problem who exhibit a wide range of impairment and distress (Kelly et al., , ).…”

Section: Discussionmentioning

confidence: 67%

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

Kelly

Greene

Bergman

et al. 2019

Alcoholism Clin & Exp Res

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Background Alcohol and other drug (AOD) problems are commonly depicted as chronically relapsing, implying multiple recovery attempts are needed prior to remission. Yet, although a robust literature exists on quit attempts in the tobacco field, little is known regarding patterns of cessation attempts related to alcohol, opioid, stimulant, or cannabis problems. Greater knowledge of such estimates and the factors associated with needing fewer or greater attempts may have utility for health policy and clinical communication efforts and approaches. Methods Cross‐sectional, nationally representative survey of U.S. adults (N = 39,809) who reported resolving a significant AOD problem (n = 2,002) and assessed on number of prior serious recovery attempts, demographic variables, primary substance, clinical histories, and indices of psychological distress and well‐being. Results The statistical distribution of serious recovery attempts was highly skewed with a mean of 5.35 (SD = 13.41) and median of 2 (interquartile range [IQR] = 1 to 4). Black race, prior use of treatment and mutual‐help groups, and history of psychiatric comorbidity were associated with higher number of attempts, and more attempts were associated independently with greater current distress. Number of recovery attempts did not differ by primary substance (e.g., opioids vs. alcohol). Conclusions Estimates of recovery attempts differed substantially depending on whether the mean (5.35 recovery attempts) or median (2 recovery attempts) was used as the estimator. Implications of this are that the average may be substantially lower than anticipated because cultural expectations are often based on AOD problems being “chronically relapsing” disorders implicating seemingly endless tries. Depending on which one of these estimates is reported in policy documents or communicated in public health announcements or clinical settings, each may elicit varying degrees of help‐seeking, hope, motivation, and the use of more assertive clinical approaches. The more fitting, median estimate of attempts should be used in clinical and policy communications given the distribution.

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Beyond Abstinence: Changes in Indices of Quality of Life with Time in Recovery in a Nationally Representative Sample of U.S. Adults

Cited by 118 publications

References 39 publications

Expanding the reach of alcohol and other drug services: Prevalence and correlates of US adult engagement with online technology to address substance problems

Expanding the reach of alcohol and other drug services: Prevalence and correlates of US adult engagement with online technology to address substance problems

Can Alcohol Use Disorder Recovery Include Some Heavy Drinking? A Replication and Extension up to 9 Years Following Treatment

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

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