Recovery and Straw Men: An Analysis of the Objections Raised to the Transition to a Recovery Model in UK Addiction Services

Abstract

In both Scotland and England, the current drug strategies (HM Government, 2008;Scottish Government, 2008) have demonstrated a clear commitment to an integrated recovery-oriented model of treatment for drug problems, which represents a significant change in focus toward a more person-centered and individualized philosophy for the delivery of drug treatment in the United Kingdom. This change has met with some resistance from a range of professionals in the United Kingdom, and the purpose of the article is to make explicit these concerns and objections, classify them, and examine their foundations. A group of UK academics, policymakers, and practitioners, who met under the auspices of the UK Recovery Academy, agreed to collate a list of objections to the viability of recovery approaches in the addiction field and to assess the merits of each concern. This process resulted in a total of 26 objections that are reviewed. The article concludes with an overview of the questions remaining unanswered in the United Kingdom and an assessment of the position of the "recovery movement" in the UK addictions field.

Recovery post treatment: plans, barriers and motivators

“…There are concerns that this recovery movement is ahead of the development of an evidence base for its implementation [7-9]. A lack of clarity and agreement about the meaning of recovery has prompted debate about the goals of treatment and created difficulties for drug treatment commissioners and practitioners [7,10].…”

“…A lack of clarity and agreement about the meaning of recovery has prompted debate about the goals of treatment and created difficulties for drug treatment commissioners and practitioners [7,10]. However, in general terms recovery is thought to be characterised by voluntarily sustained control over substance use, health and wellbeing, and participation in society [10,11].…”

An examination of the first Oxford House in the UK: A preliminary investigation

“…The focus on harm-reduction extended beyond reducing the transmission of infectious diseases to the treatment of substance use disorders; as indicated in the government’s 1998 ten-year drug strategy, and evidenced by clients’ reports of their encounters with treatment services and by analysis of available community resources for treatment (McKegeney, Morris, Neal & Robertson, 2004; Best et al, 2010). A debate between harm-reduction and abstinence-based strategies raged, and although those from the harm-reduction side might not deny the ultimate “desirability of abstinence,” they found it unrealistic that many with substance use disorders would be capable of achieving it.…”

“…Best et al (2010) described growing “recovery activity in local communities that is rich and diverse and that is progressing irrespective of funding support or research endorsement,” (p. 266). Grassroots recovery niches such as “Recovery Is Out There” (RIOT) in Burton, SMART Recovery UK, and a contingency of AA and NA support groups among others can be found throughout the UK (White, 2011).…”

“…The implementation of a self-run, communal-living setting within the UK is highly unique. In addition, experts in the UK have noted the prevailing lack of long-term recovery and abstinence-based treatment services, and called for evidence to substantiate the need and efficacy of abstinence-based treatments for substance use disorders (Best et al, 2010). Although research has been plentiful in the United States, where both Oxford House and 12-step models for achieving and maintaining abstinence and long-term recovery are central, there is a dearth of such research within the UK.…”