Inkspots and ice cream cones: a model of recovery contagion and growth

Best, David; Ivers, Jo-Hanna

doi:10.1080/16066359.2021.1986699

Cited by 23 publications

(7 citation statements)

References 22 publications

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“…Employment, volunteering, education, and holidays are rendered effectively impossible while undergoing twice-daily supervised treatment. As active participation in and contribution to community and society are key components of recovery [ 44 , 69 , 70 ], twice-daily clinic attendance may constrain MHAT’s therapeutic potential by limiting service users’ opportunities for active citizenship [ 40 – 42 ]. Participants’ desire to regain freedom and autonomy may not only encourage disengagement, but inadvertently push participants through treatment towards the ‘end-goal’ of abstinence, potentially undermining the value of harm reduction and other broader recovery-related treatment outcomes [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Further, the destigmatising effects of medicalised injecting fostered a sense of acceptance for participants within the clinic environment, contributing to a collective sense of community and support within the small cohort of MHAT service users. Positive social connection is a catalyst for increased well-being, self-efficacy, and hope, which in turn promotes increased identification and engagement with positive social groups and strengthens the groups’ sense of pride in their collective identity [ 67 , 69 ]. Service users’ growing sense of belonging improved self-worth and increased self-efficacy were inter-connected with their identification as members of a ‘special’ group of service users within the Middlesbrough clinic, demonstrating how personal recovery is a relational, dynamic, and socially embedded process [ 70 , 71 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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Background Heroin-Assisted Treatment (HAT) is well evidenced internationally to improve health and social outcomes for people dependent on opioids who have not been helped by traditional treatment options. Despite this evidence base, England has been slow to implement HAT. The first service outside of a trial setting opened in 2019, providing twice-daily supervised injections of medical-grade heroin (diamorphine) to a select sample of high-risk heroin users in Middlesbrough. This paper explores their experiences, including the negotiation of the strict regularly controls required of a novel intervention in the UK context. Methods We conducted in-depth interviews with service providers and users of the Middlesbrough HAT service between September and November 2021. Data from each group were thematically analysed and reported separately. This paper details the experiences of the twelve heroin dependent men and women accessing HAT. Results Participants’ accounts of HAT treatment evidenced a tension between the regulatory constraints and uncertainty of treatment provision, and the positive outcomes experienced through supportive service provision and an injectable treatment option. Limited confidence was held in treatment efficacy, longevity of funding, and personal capacity for treatment success. This was counteracted by a strong motivation to cease engagement with the illicit drug market. While attendance requirements placed restrictions on daily activities, participants also experienced benefits from strong, supportive bonds built with the service providers through their continued engagement. Conclusions The Middlesbrough HAT programme provided benefits to a high-risk population of opioid dependent people who were unable or disinclined to participate in conventional opioid substitution treatments. The findings in this paper highlight the potential for service modifications to further enhance engagement. The closure of this programme in 2022 prohibits this opportunity for the Middlesbrough community, but holds potential to inform advocacy and innovation for future HAT interventions in England.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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“…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].…”

Section: Introductionmentioning

confidence: 99%

“…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 [27–31]. Instead, there has been an increasing emphasis on recovery from substance use as a social and community phenomenon [27, 32–34]. 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].…”

Section: Introductionmentioning

confidence: 99%

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

Osborne

Kelly

2023

Drug and Alcohol Review

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IntroductionChallenges associated with the integration of physical health within alcohol and other drug (AOD) treatment services persist. The construct of recovery capital has gained currency within the sector, however, its potential in understanding the integration of physical health within AOD treatment has not been examined. This study explores the role of physical health in the process of recovery, examining the potential of ‘recovery capital’ frameworks to enhance integrated care.MethodsInterviews were conducted with residential and outpatient AOD services across New South Wales, Australia. Qualitative data was collected from clients (n = 20) and staff (n = 13) and transcribed. Data were systematically coded and analysed using the iterative categorisation method.ResultsUnmanaged physical health issues compromised recovery, particularly when associated with hopelessness and pain. Improved physical health ameliorated sources of negative recovery capital such as boredom, social isolation and mental health symptoms. When addressed during treatment, physical health facilitated recovery capital resources through knowledge and skill acquisition, increased autonomy, enjoyment and immersive experience. Benefits extended to domains of ‘social capital’ (social connection) and ‘cultural capital’ (physical appearance).Discussion and ConclusionsPhysical health offers variegated pathways for building recovery capital. Findings support calls for a more assertive approach to addressing physical health when AOD treatment occurs outside of primary care settings. Future research should examine the potential of recovery capital as a heuristic for optimising care of physical health issues and health‐related behaviour within AOD treatment services.

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“…Recovery capital can be divided into three theoretical domains: Personal, social, and cultural. Recently, recovery capital has been redefined as the “resources and capacities that enable growth and human flourishing”, a definition which reflects a strengths‐based health equity approach and a conceptualization of recovery that is well‐aligned with SAMHSA's definition of recovery as “a process of change through which individuals improve their health and wellness, live a self‐directed life, and strive to reach their full potential” (Best & Ivers, 2022). Importantly, SAMHSA frames recovery in terms of flourishing health and autonomy rather than abstinence.…”

Section: Introductionmentioning

confidence: 99%

Partnering with recovery community centers to build recovery capital by improving access to reproductive health

Feld

Elswick

Goodin

et al. 2022

J of Nursing Scholarship

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Background: People with substance use disorders (SUD), especially opioid use disorder (OUD) have the highest rates of unintended pregnancies (80-95%) and report unmet reproductive health needs. Women of childbearing age have some of the highest death rates from opioids and are notably rising the most rapidly, and when pregnancy does occur overdose is one of the leading causes of maternal mortality.There are numerous gender-based health disparities and social determinants of health shaped by the distribution of power and privilege that influence the risk trajectories of people who can get pregnant or are pregnant with a substance use disorder (SUD).

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Inkspots and ice cream cones: a model of recovery contagion and growth

Cited by 23 publications

References 22 publications

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

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

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

Partnering with recovery community centers to build recovery capital by improving access to reproductive health

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