A biaxial formulation of the recovery construct

Abstract

The term “recovery” in the substance use disorder (SUD) field has been used generally and non-technically to describe global improvements in health and functioning typically following successful abstinence. More recently, however, in an attempt to reduce the stigma and negative public and clinical perceptions regarding remission potential for individuals suffering from SUD, “recovery” has been used more strategically to instil hope and to serve as an organizing paradigm that has inspired a growing recovery movement. In addition, with “recovery” gaining momentum internationally within governments' national health care agencies, there is increasing pressure to operationalise this construct as without it, it is difficult to develop, commission, and deliver the tailored packages of recovery support services needed to help individuals suffering from SUD. Initial attempts to define recovery and delineate its constituent parts have agreed on major elements, but differ on important subtleties; generally lacking has been a conceptual grounding of these definitions. The goal of this article is to promote further thought and debate by offering a conceptual basis for, and description of, the recovery construct that we hope enhances clarity and measurability. To accomplish this, we review existing definitions of recovery and offer a simplified bi-axial formulation and definition, reciprocal in nature, and grounded in stress and coping theory, which mirrors conceptually original formulations of the addiction syndrome.