Exploring essential components of addiction recovery: a qualitative study across assisted and unassisted recovery pathways

Abstract

Even though various pathways to addiction recovery have been identified, knowledge on overarching essential components of addiction recovery processes remains limited. To explore these essential components, in-depth interviews were conducted with a heterogeneous group of individuals across pathways to addiction recovery (i.e. a low-threshold activation center, Narcotics Anonymous, a CRA þ vouchers out-patient program, residential treatment programs, and 'natural' recovery). The interviews (n ¼ 25) were audio-taped, transcribed verbatim, and thematically analyzed. In-depth analysis of the data resulted in a model that includes essential components of addiction recovery processes and their dynamic relationship. 'Time' and 'supportive environments' were identified as the foundations and facilitators for the transformative changes required in addiction recovery processes, which in turn contributed to 'developing a sense of self' and 'developing a sense of future'. These components, interrelated and in a continuous interplay with each other, facilitated recovery processes. As a result, recovery-oriented support should be strengthened and specifically focus on supporting these essential components, by providing tailor-made and continuously available support. Given the relational character of addiction recovery processes, social networks and society at large should evolve towards the development of responsive and inclusive spaces to support persons in addiction recovery.

“I Grew Up Amidst Alcohol and Drugs:” a Qualitative Study on the Lived Experiences of Parental Substance Use Among Adults Who Developed Substance Use Disorders Themselves

“…Although families have been identified as a primary context of care for young adults' substance use treatment processes (129), this study showed that the family context among adult children of parents with SUDs is often not facilitative for their treatment and recovery processes. In line with evidence on the importance of relationships and social resources needed for initiation and maintenance of addiction recovery (130)(131)(132)(133)(134)(135)(136)(137), this study confirms the importance of interpersonal relationships and social resources in readiness to change and early stages of recovery (131,(138)(139)(140)(141)(142)(143). Although the importance of social networks in improving early and more sustained recovery outcomes has been established (144), this study provides insight in how family, parent and peer support systems can both inhibit and encourage recovery in offspring of parents with SUDs.…”

“…Activating non-substance using family and friends has shown to provide potential pathways to help persons with SUDs access and benefit from community support (154,155). Moreover, given that early recovery stages are sensitive periods for experiencing loneliness and social isolation (138), which has been associated with SUDs (156)(157)(158), adult offspring with SUDs may benefit from strategies to build and sustain prosocial connections and recovery-supportive networks (159), that prepare them for "normal everyday living" (137) and "outside living" in a way that promotes positive relational enactment.…”

Mechanisms and mediators of addiction recovery

“…All other papers in this special issue (Anderson et al, 2021;Dekkers et al, 2021;Frings et al, 2021;Gueta et al, 2020;Jason et al, 2021) focus on diverse recovery mediators and mechanisms and their role in individuals' recovery trajectories, reflecting the primary objective of the REC-PATH study.…”

“…Developing 'the self' and a 'post-addiction' identity as well as social identification appear to be crucial elements in early recovery (Frings et al, 2021;Kougiali et al, 2021;Van Steenberghe et al, 2021). Second, time in recovery and recovery stage came to the fore as important predictors of stability of behaviour change (Dekkers et al, 2021;von Greiff & Skogens, 2021). Third, Cloud and Granfield's notion of recovery capital (Cloud and Granfield 2008) emerged in several papers, illustrating the importance of personal, social and community resources for promoting recovery and avoiding relapse.…”

“…Third, Cloud and Granfield's notion of recovery capital (Cloud and Granfield 2008) emerged in several papers, illustrating the importance of personal, social and community resources for promoting recovery and avoiding relapse. Frequently mentioned resources were supportive social and family environments (Anderson et al, 2021;Dekkers et al, 2021;, recovery-supportive housing facilities (Jason et al, 2021), and personalised and holistic support services (Bellaert et al, 2021;Jouet et al, 2021;Van Steenberghe et al, 2021). Finally, several papers show that women face different challenges compared with men in recovery, as they experience more mental health and family needs (Andersson et al, 2020) and are more often confronted with adverse childhood experiences and multiple stigma (Kougiali et al, 2021), indicating the need for gender-sensitive recovery services (Collinson & Hall, 2021).…”