Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions

Abstract

Based on this review, future natural recovery studies should: (a) report respondents' demographic characteristics at the time of their recovery; (b) describe respondents' pre-recovery problem severity; (c) explore in some depth what factors, events or processes are associated with the self-change process; (d) provide corroboration of respondents' self-reports; (e) examine factors related to the maintenance of recoveries; (f) conduct interviews with individuals who have naturally recovered from cocaine, marijuana and polydrug abuse; (g) include a second interview at a later time to examine stability of natural recoveries; and (h) require a minimum 5-year recovery time frame.

Awakening: 'Spontaneous recovery’ from substance abuse among Aboriginal peoples in Canada

“…The substance abuse literature also highlights the role of motivation in recovery (Klingemann, 1991;Miller, 1999;Sobell et al, 2000). Motivation was linked in this study to participants' consideration of their own well-being and that of others after experiencing a traumatic life event.…”

“…All participants in this study chose to seek social support, to varying degrees, as an alternative coping mechanism. The literature identifies the seeking of social support, such as with close family and friends, in a healthy environment as an effective coping strategy from substance abuse (Carey et al, 1989;Klingemann, 1991;Sobell et al, 2000;Tuchfeld, 1981;Waldorf et al, 1991). Interestingly, the participants' support networks included family and community members, which for some were unresolved sources of pain in their lives.…”

“…Mainstream scholars have suggested that SR involves a life-triggering event that leads to cognitive appraisal (Klingemann, 1991;Sobell et al, 2000). Cognitive appraisal is understood as how a person interprets a situation or event; in primary appraisal attention is given to how an event affects personal well-being, while in secondary appraisal a coping response is considered (Folkman et al, 1986).…”

“…In the context of SR, a major life event prompts an individual to consider the effects of their substance abuse and commit to change as their coping response. Some initial research (Hazel & Mohatt, 2001; and the recent People Awakening Study with Alaskan Natives (Mohatt et al, 2008) suggest that cognitive appraisal is critical to the self-change process in SR. Further, meta-analyses on survey studies suggest that cognitive appraisal is central to the change process for many people who recovered 'on their own' from problematic substance use (Klingemann & Sobell, 2007;Sobell et al, 2000).…”

“…In addition to cognitive appraisal ensuing from a major life event in SR, scholars have also suggested that an individual's initiation toward motivation to change is central (Klingemann, 1991;Sobell, et al, 2000). Self-change theories likewise propose that individual motivation to change can be prompted by a series of negative or positive life experiences (Connors et al, 2001;Klingemann, 1991), often resulting in an awareness of the personal and social impacts of substance abuse and their anticipated consequences (e.g., ill health, relationship problems).…”