Recovery Support Research Articles

Workforce outcomes among substance use peer supports and their contextual determinants: A scoping review protocol.

Peer recovery support services are a promising approach for improving harm reduction, treatment, and recovery-related outcomes for people who have substance use disorders. However, unique difficulties associated with the role may place peer recovery support staff [i.e., peers] at high risk for negative workforce outcomes, including burnout, vicarious trauma, and compassion fatigue. This scoping review protocol aims to describe a proposed effort to review the nature and extent of research evidence on peer workforce outcomes and how these outcomes might differ across service settings. Results of the review described in this protocol will help to answer the following research questions: 1) What is known about workforce-related outcomes for peers working in the substance use field?; 2) What is known about how the structure of work impacts these outcomes?; and 3) How do these outcomes differ by service setting type? A scoping review will be conducted with literature searches conducted in PsycINFO®, [EBSCO],Embase® [EBSCO], CINAHL® [EBSCO], Web of Science™ [Clarivate], and Google Scholar databases for relevant articles discussing US-based research and published in English from 1 January 1999 to 1 August 2023. The proposed review will include peer-reviewed and grey-literature published materials describing the experiences of peers participating in recovery support services and harm reduction efforts across a variety of service settings. Two evaluators will independently review the abstracts and full-text articles. We will perform a narrative synthesis, summarizing and comparing the results across service settings. Publishing this protocol will help accelerate the identification of critical workforce issues, and bolster the transparency and reporting of the final review. The proposed review will assess the state of the literature on peer workforce-related outcomes and how outcomes might vary by service setting context. Results of the proposed review will be disseminated in peer-reviewed publications and conference presentations. Findings will inform the field regarding future directions to support the emerging peer workforce. Systematic review registration Submitted to Open Science Framework, August 22nd, 2023.

A qualitative examination of addiction disclosure and stigma among recovering adolescents

Background The stigma attached to alcohol or other drug use (AOD) disorders can lead to poorer treatment outcomes. Adolescents, who are developing their social identity, may hesitate to disclose their disorder and are vulnerable to stigmatizing experiences. Adolescents’ preferred ways of discussing AOD disorder have not been explored. Methods This study explores the experience of AOD disclosure in 16 adolescents with an AOD disorder (recruited nationwide in the United States from 2022 to 2023). Participants were 12–19 years old (M = 16.8; SD = 1.78; 56% Male, 31% Female, 13% Non-binary), had experienced problematic substance use, and used some form of treatment or recovery support. Participants completed an interview in which they reflected on their social network, their recovery, and experiences related to AOD disorder disclosure. The research team used constant comparative analysis to develop themes from the interview data. Results A primary theme was the level of control participants felt regarding the persons to whom they disclosed their AOD recovery, and how that information was disclosed. Although some participants felt supported, several felt that their peers/family were overly intrusive (e.g. by questioning actions). Some participants experienced enacted stigma in interactions with others. Conclusions These results support recommendations for family, peers, and youth-facing providers to engage youth in treatment. Future work should aim to increase disclosure skills and coping strategies for adolescents experiencing AOD recovery, and educational efforts for practitioners, families, and peers on ways to have conversations around AOD recovery with adolescents that best support their recovery.

A ABORDAGEM MULTIDIMENSIONAL DO ABUSO SEXUAL CONTRA CRIANÇAS E ADOLESCENTES: IMPACTOS PSICOLÓGICOS, SOCIAIS E JURÍDICOS, COM ÊNFASE EM ESTRATÉGIAS DE PREVENÇÃO E INTERVENÇÃO

The research addressed the topic “The Multidimensional Approach to Sexual Abuse against Children and Adolescents: Psychological, Social and Legal Impacts, with Emphasis on Prevention and Intervention Strategies”, examines the problem of child and youth sexual abuse through an integrated analysis psychological, social and legal aspects. Initially, it explores the profound psychological consequences, such as trauma, anxiety disorders and depression, that affect the development of victims, and highlights the importance of psychological support for recovery. In the social field, it analyzes the impact of abuse on the family environment and the community, discussing the stigma and challenges faced by victims and their families. In the legal sphere, the study investigates legal responses and public policies external to the protection of children and adolescents, emphasizing the importance of an intersectoral protection network and the implementation of laws that promote the effective defense of victims’ rights. Furthermore, prevention and intervention strategies are addressed, such as public policies, educational campaigns and family support programs, which play an essential role in building a safe environment and combating abuse. The research concludes that a multidimensional approach is essential to confront child sexual abuse, integrating psychological, social and legal efforts to promote an effective protection network and reduce the incidence of this crime.

Implementation strategies to support recovery support workers serving criminal legal involved people who use drugs

IntroductionRecovery support workers (RSWs) who provide social support interventions for people who use drugs (PWUD) often face challenges that can jeopardize the well-being, efficacy and sustainability of this essential workforce. To date, little has been reported on the types of implementation strategies used to support RSWs. We describe and evaluate a multifaceted implementation strategy package to support Reducing Opioid Mortality in Illinois (ROMI), a paired peer recovery coach and case manager (PRC-CM) intervention for PWUD with recent criminal-legal involvement in urban and rural settings. MethodsROMI utilized a remote, hub and spoke-administered multifaceted implementation strategy package to support PRCs-CMs to deliver evidence-based services to PWUD with criminal-legal involvement. The core strategies included: (a) comprehensive training; (b) individual clinical supervision; (c) group consultation; and (d) centralized technical assistance. We evaluated the implementation strategy package using a mixed-methods design including qualitative interviews with the intervention staff to explore their experiences with each strategy component, as well as a quantitative coding of topics discussed during supervision and group consultation meetings to estimate prioritization of issues and balance of topics between strategy type. ResultsBetween January 2019 and January 2024, the study interviewed 8 PRC-CMs and quantitatively coded 568 sessions (79 group consultations and 489 individual supervisory) for discussion themes. The hub-and-spoke model allowed for centralized access to highly skilled supervisory staff as well as knowledge sharing across geographically remote teams. The therapeutic space to process feelings and emotional support provided during individual supervision was noted to be an essential resource by PRC-CMs. Group consultation facilitated camaraderie, mutual support and continual learning through dynamic and responsive trainings. Frustrations around resource limitations and systemic barriers facing their clients remained a dominant concern for PRCs-CMs, and was incompletely addressed by the technical assistance strategy. ConclusionUnderstanding the practical components and individual strengths of the implementation strategies required to support the implementers of complex interventions such as social support and navigation for PWUD with criminal-legal involvement elucidates the organizational and professional capacities that may be required for real world implementation. Trial registrationNCT04925427

Development of a Clinical Decision-Making Framework to Address Parental Substance Use and Child Safety

SYNOPSIS Objective. Clinicians caring for families impacted by substance use disorder often feel uncomfortable assessing for child protective concerns in the setting of non-prescribed parental substance use. This leads to a lack of standardization of care, where some clinicians choose to not ask any questions about the care of children for fear of receiving information that will leave them in an uncomfortable position as a mandated reporter, while others may reflexively report any identification of substance use to child protective services. The primary aim of this descriptive manuscript is to present a framework developed by a multidisciplinary team in a medical setting to address concerns about a recurrence of parental substance use. Design. We highlight the development, implementation, and evolution of a clinical decision-making framework designed to help standardize clinicians’ discussions around whether substance use could be affecting a parent’s ability to safely care for their children. Discussion. Five main assessment areas are discussed, including: (1) Safety of the child while substance use is occurring; (2) Safety of parental use patterns; (3) Parental treatment engagement; (4) Willingness to escalate treatment services; and (5) Stability of the home environment. We will present a clinical scenario to highlight how the framework is used as an aid to determine action planning with respect to immediate safety concerns, treatment escalation, and opportunities to maximize recovery supports. We discuss the challenges we’ve experienced and opportunities that arise in attempting to incorporate the principles of harm reduction within the context of assessments of child safety and well-being.

A Cross-Sectional Study Investigating the Role of Meaning and Purpose in Life Among Older Individuals (≥50-Years Old) in Recovery from Alcohol Use Disorder/Problem Drinking

ABSTRACT Meaning and purpose in life (MPL) is an important domain of the recovery capital model. Yet, this important recovery support mechanism has received scant attention, particularly in relation to older individuals recovering from alcohol use disorder (AUD)/problem drinking. Framed within Viktor Frankl’s theory of meaning, the study used two measures, the Purpose in Life Test and the Meaning in Life Questionnaire, to collect the data of 381 older individuals (≥50-years old) in recovery. The data was analyzed against four independent variables: onset age of problem drinking (early- and late-onset), gender, continuous years in recovery and recovery pathways. The study found a significant relationship between MPL and continuous years in recovery, suggesting that as the length of time in recovery increases, so too, do levels of MPL.

The Unequal Impact of Disasters: Assessing the Interplay Between Social Vulnerability, Public Assistance, Flood Insurance, and Migration in the U.S

Extreme weather events, such as hurricanes with intense rainfall and storm surges, are posing increasing challenges to local communities worldwide. These hazards not only result in substantial property damage but also lead to significant population displacement. Federal disaster assistance programs are crucial for providing financial support for disaster response and recovery, but the allocation of these resources often unequal due to the complex interplay of environmental, social, and institutional factors. Relying on datasets collected from diverse sources, this study employs a structural equation model to explore the complex relationships between disaster damage (DD), social vulnerability (SV), public disaster assistance (PDA), the national flood insurance (NFI), and population migration (PM) across counties in the contiguous US. Our findings reveal that communities with lower SV tend to experience higher levels of DD across US counties. SV is negatively associated with PM, PDA, and NFI, both directly and indirectly. Furthermore, PDA is positively linked to PM, whereas DD has a direct negative effect on PM but an indirect positive effect through PDA.

Developing Risk Assessment Items of Treatment Interruption Among Vietnamese Patients with Tuberculosis in Japanese DOTS-A Quantitative and Qualitative Survey Using the Delphi Method.

The number of foreign-born patients with tuberculosis (TB) has been increasing in Japan, and the number of Vietnamese patients was the highest in 2019. Tuberculosis (TB) is the second leading cause of death from infectious diseases after coronavirus disease-2019 (COVID-19). As the prevalence of TB varies widely globally, measures must be tailored to local characteristics. The Directly Observed Treatment (DOTS) short-course was introduced by the World Health Organization as a global strategy to overcome these challenges. The purpose of this study is to develop an original risk assessment for treatment interruption for Vietnamese patients with TB to be used in Directly Observed Treatment (DOTS), a tuberculosis control measure. The researchers adopted the Delphi method. Public health nurses of mid-career or above (n = 15) who had conducted DOTS for several Vietnamese patients with TB were selected and surveyed about the content and surface validities of the draft risk assessment items for treatment interruption. The survey was conducted three times. The quantification of content validity and the review and modification of responses regarding each item were analyzed by the researchers. The results identified the following risk categories: "physical characteristics", "background of life during residence", "treatment environment", "understanding tuberculosis and disease acceptance", and "cultural and value trends". The results suggest the need to provide support for tuberculosis recovery from various perspectives, including the living environment of Vietnamese patients with TB, their social environment in Japan, and the culture and values of their country of birth and upbringing.

Identifying critical factors affecting the livelihood recovery following disasters: A comparative analysis of China and New Zealand

As damage and loss caused by natural hazards have increased worldwide over the past several decades, it is important for governments and aid agencies to have tools that enable effective post-disaster livelihood recovery to create self-sufficiency for the affected population. This study employs a comparative case study with a mixed method to compare the critical factors affecting livelihood recovery following disasters. Data were collected following the 2013 Lushan earthquake in China and the 2016 Kaikōura earthquake in New Zealand. The results show that the common factors from the comparative case study given by the respondents from both Lushan in China and Kaikōura in New Zealand are “community safety”, “availability of family support”, “level of community cohesion”, “external housing recovery support”, “level of a housing recovery”, and “availability of health and wellbeing support”. Factors that are only in Lushan include “access to income generation assets”, “level of community participation in decision making”, and "availability of skills training programmes”. Factors that are in Kaikōura not in Lushan included “effective governance”, "availability of social welfare support from the government”, and “distance to scenic spots”. Based on the differences and similarities between different factors, this study suggests various stakeholders require more international knowledge and policy sharing, effective communicative mechanisms and the promotion of livelihood transformation process.

Certified peer recovery support specialists and substance use related emergency department visits: A mixed methods study of the patient experience

IntroductionEmergency department (ED) peer-delivered interventions have been implemented across the country to improve outcomes for people who use drugs. In this study we describe what elements patients believe led to a positive interaction with a certified peer recovery support specialist (CPRSS) in the ED and discuss implications when those elements were missing. MethodsThis is a qualitatively driven mixed methods study embedded within a larger longitudinal study. Using a close and open-ended question interview guide, we interviewed 26 participants from 2018 to 2023 who met with a CPRSS in a Nevada ED for a substance use related concern. Interviews were recorded and transcribed verbatim. Thematic analysis was used to code the transcripts and generate themes. Quantitative data (satisfaction, therapeutic alliance, and social support) were analyzed using student-t, Fisher's exact, and one-way ANOVA tests. ResultsParticipants described numerous elements that they believed contributed to being satisfied with their CPRSS interaction, which we grouped into three categories: 1) how the CPRSS interaction felt, 2) how the CPRSS services were delivered, and 3) patient factors that influenced the interaction with a CPRSS. Elements that contributed to their satisfaction, including whether the CPRSS adapted to their current circumstances, if they received personalized referrals, and how their own mental and physical state impacted their receptivity to services. ConclusionsOur findings highlight areas to optimize implementation and increase program uptake for future ED-based CPRSS-delivered interventions, including training CPRSS in the philosophy of harm reduction, following up with the patient post-ED, and tailoring services to the patients' immediate needs.

Medications for opioid use disorder and other evidence-based service offerings in faith-affiliated treatment centers: Implications for implementation partnerships

IntroductionAmidst an ongoing surge of opioid use disorder (OUD) incidence, clinicians and policymakers are seeking partnerships with faith communities – including with faith-affiliated treatment centers (FATCs) – to expand access to evidence-based OUD treatment. However, little is known whether FATCs differentially offer such evidence-based treatment services, particularly medications for opioid use disorder (MOUD) and co-occurring mental health care. MethodsWe use the 2021 National Substance Use and Mental Health Services Survey (N-SUMHSS) to examine differences in provision of several OUD services, including MOUD, psychological treatments, mental health services, medical services, recovery support services, and services related to treatment accessibility, between self-identified FATCs and non-FATCs. We also explored differences in characteristics related to insurance, licensure, and accreditation. ResultsFATCs were less likely than non-FATCs to offer almost all measure of MOUD and more likely to refuse to accept clients who use MOUD. They were also less likely to report using telemedicine. However, they were more likely to offer residential treatment, Twelve Step facilitation, and transitional housing. We find little evidence that FATCs offer co-occurring mental health treatments at different rates than non-FATCs. ConclusionMore research is needed to examine the factors that drive these differences, especially in MOUD and transitional housing. When partnering with FATCs, clinicians and policymakers should seek common ground with FATCs and recognize the philosophies, values, and concerns that may potentially be driving these differences.

학교폭력 ‘학교장 자체해결제’의 학교현장 인식과 내실화 방안 연구

The purpose of this study is to examine the existing operation status and suggest future improvement plans in order to effectively and stably establish the school-based self resolution and operate it substantively. This study collected empirical data to establish and strengthen the school-based self resolution and examined the operation status and teachers' perceptions. As a result of the study, the need for supplementation and improvement at the cognitive and institutional levels was raised to strengthen the School-Based Self Resolution. First, the school-based self resolution was operated smoothly thanks to the expertise and enthusiasm of the person in charge and the interest and cooperation of fellow teachers. On the other side, It was found that the lack of cooperation from parents was acting as an impediment to the operation of the system. Second, at the cognitive level, there were efforts to create a school violence prevention culture, find effective recovery support measures at the school level, strengthen a smooth collaboration system among teachers, and improve parents' awareness. And at the institutional level, there were strengthening of the system to prevent school violence staff in charge of work exhaustion, support for cultivating the qualifications of school principals through expansion of school violence-related training, and expansion of training and continuing education to improve teachers' student guidance and counseling capabilities and strengthening parent training. It suggested revitalizing student awareness education and recovery programs for students who have been victims of crime, reinforcing the manual for the stable establishment of the school principal`s own solution system, establishing an expert support system, and activating connection to external resources. Based on this, the direction of School-Based Self Resolution are discussed.

Massed treatment of posttraumatic stress disorder, traumatic brain injury, and co-occurring conditions: the Home Base intensive outpatient program for military veterans and service members.

The two-week Home Base Intensive Clinical Program (ICP) provides treatment to veterans and active duty service members suffering from primary diagnoses of posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), anxiety, or depression. First launched in 2015, this paper provides a programmatic update, including new treatment components implemented since inception, and examines outcomes for all participants who entered the program from September 2015 to July 2024 (n = 2561). The Home Base ICP provides a massed care approach through daily individual Prolonged Exposure, Cognitive Processing Therapy, Unified Protocol, or cognitive rehabilitation, along with groups targeting coping skills. Participants entering the program are provided with core group programming, as well as individualized therapy sessions tailored to their unique needs and symptom presentation. Supplemental dual recovery support is also available for all participants with co-occurring substance use or behavioral addiction concerns. Participants' support people receive education, support, and case management services. Participants have a multidisciplinary team comprising therapists, psychopharmacology providers, case managers, nurses, and wellness providers. Results demonstrate that program participants exhibited statistically significant reductions in PTSD symptoms (Cohen's d = 0.80), depression (d = 0.68), post-concussion symptoms (d = 0.71), and increased satisfaction in social roles (d = -0.65). Completion rate was 94.60% (n = 2422), suggesting that the Home Base ICP is a well-received and effective model of care for veterans and service members.

Case Analysis of Women Experienced Abuse: with Special Reference to Beneficiaries of Parihar, Bangalore

Abstract Case Analysis in this article presents a consolidated analysis of five case studies of women who have experienced abuse, exploring the varying types of abuse, challenges faced, and systemic responses. The cases have been chosen from the individuals i.e women who especially approach the institution “Parihar” Bangalore seeking help or emotional support. span different cultural and socioeconomic contexts, highlighting the pervasive nature of abuse across the globe. Through detailed comparison, the article examines the role of economic dependency, legal protections, and social stigma in perpetuating abuse, as well as the importance of community and psychological support in recovery. The analysis underscores the need for stronger legal frameworks, community education, and economic empowerment to help women break free from abusive environments. “Parihar” is a charitable institution registered under the Karnataka Societies Registration act 1960, exempted under 80(G) of Income Tax Act. It is an initiative of Bengaluru City Police, and is managed by a dedicated, committed and successful team of professional counsellors, and police staff with vast experience in counselling and social work. Parihar undertakes charitable, philanthropic and socio–economic programs for the welfare of Women, Children and Family as a whole. Parihar’s implementation structure consists of mainly four important people, its Ex-officio President being the Commissioner of Police, Bengaluru City, Vice President and Nodal officer, is the Jt. Commissioner of Police (Crime) & Secretary is the Deputy Commissioner of Police(Admin) and Treasurer is the Deputy Commissioner of Police (Crime) “Parihar” stands out for its ‘vision’ and ‘mission’ to work for the upliftment of women and children in today’s society with various challenges and positive attitude to redress the issues in a holistic manner.

Short-term mechanical circulatory support in adults with congenital heart disease: indications and outcomes

Abstract Background An increasing number of adults with congenital heart disease (ACHD) present with heart failure (HF), which may require short- or long-term mechanical circulatory support (MCS), often around cardiac surgery or other interventions. Even though MCS has entered ACHD practice over the last few years, little is known on its indications and outcomes in this population. Purpose To assess the use and outcomes of short-term MCS in ACHD patients in a specialist centre, and assess the predictive power of the Survival After Veno-Arterial Extracorporeal Membrane Oxygenation (SAVE) score in this population. Methods Data on all ACHD patients who received MCS since 2008 in a single tertiary centre were collected. Immediate, short and longer-term outcomes were also collected, including death, complications, and weaning success. Logistic regression and ROC analysis were performed to identify predictors of in-hospital mortality. Result There were 65 episodes of MCS in 63 patients during the study period: age 36.9+-13.6 years, 61.5% male. Most patients had CHD of moderate or severe complexity (49.2% moderate and 10.8% severe according to ESC guidelines). The most common anatomical diagnoses were left outflow tract obstruction in 35.4%, Marfan syndrome in 20.0% and tetralogy of Fallot or pulmonary atresia in 10.8%. The most common indications for ECMO were perioperative support (not endocarditis) in 55.6%, HF in 14.3%, pneumonia in 12.7% and endocarditis-related surgery in 7.9%. A critical preoperative status was present in 26.8%; median PEACH score (a validated ACHD peri-operative risk score) was 1.0[1.0-3.0] and ACHS score was 0.6[0.6-1.0]. Median SAVE score was -4.0[-9.0–2.0], with 21(43.8%) in SAVE class 4 or 5. VA-ECMO was used in 69.2%, VV-ECMO in 21.5%, BiVAD-ECMO in 4.6% and RVAD support in 4.6% of patients. The median duration of ECMO support was 198.6[133.0-354.2] hours. Complications included ischemic stroke (15.4%), intracerebral bleeding (9.2%), and other thromboembolism (23.8%). Successful weaning was achieved in 56.2%, whereas 4.6% were switched to more definitive MCS. In-hospital mortality was 47.7%, and this was higher in patients receiving VA support (OR 4.92, 95%CI:1.32-23.93, p=0.03). For patients on VA-ECMO or BiVAD support, the presence of Marfan syndrome (OR 4.92, 95%CI:1.32-23.93, p=0.03) and a lower (worse) SAVE score (OR 1.3 per point reduction, 95%CI:1.11-1.59, p=0.004) were associated with in-hospital mortality. An adjusted SAVE score that accounted for the presence of heritable thoracic aortic diseases (HTAD, -3 points) performed well at predicting in-hospital mortality (AUC increasing from 0.73 to 0.8, Figure). Conclusions Short-term MCS is a useful temporary rescue intervention in patients with ACHD, as a bridge to recovery or durable support, with 1 in 2 patients surviving to hospital discharge. The SAVE score adjusted for HTAD can reliably predict outcomes in patients with VA-ECMO and requires external validation.Figure

Innovations in residential treatment that promote multi-drug addiction recovery

Abstract Background As the drug addiction crisis deepens in many countries across the globe, governments are rapidly expanding publicly funded treatment facilities. At the same time, the illicit drug market has evolved with many substances now containing multiple addictive drugs that complicate recovery. The evidence base for treatment remains primarily focused on single substances. The purpose of this study was to examine the lived experience of adults who attended in-patient treatment centres for multi-drug addiction in Canada. Methods This qualitative study was conducted in 2022 with 32 adults who voluntarily attended an in-patient treatment centre for drug addiction (44% female, 23-53 years). All had been addicted to multiple substances including opioids, crack and methamphetamines. Most (70%) were homeless before treatment. In 1-hour semi-structured interviews adults described the structures and programming that helped them recover in these facilities. Many tried multiple facilities and thus had a rich history of lived experience to draw from. Narrative inquiry was used to characterize qualitative themes across interviews using a phenomenological lens. Results Seven qualitative themes emerged from the data. Residential treatment centres that were effective at helping adults recover from multi-drug addiction: (1) provided flexible stays up to 100 days; (2) felt like a home not a prison; (3) permitted opioid replacement therapies; (4) provided a variety of recovery tools (e.g., cognitive behavioural therapy, Narcotics Anonymous, cultural supports); (5) helped adults reunite with family, find a safe place to stay, and find work before discharge; (6) provided transitional housing after discharge if needed; and (7) provided free long-term recovery support and check-ins after discharge. Conclusions The findings of this study highlight 7 actions that treatment facilities can adopt and test with their own clients in an effort to better support multi-drug addiction recovery. Key messages • A stronger evidence base is needed to inform in-patient multi-drug addiction treatment. • Findings underline 7 actions treatment facilities can take to promote multi-drug addiction recovery.

Recovery ecosystem: More than treatment

Andre L. Johnson, Psy.D., founder and CEO of the Detroit Recovery Project, shared his vision of a “recovery ecosystem” at the annual meeting of the Association of Addiction Professionals (NAADAC) in Washington, D.C. last week. “The world has changed, it's not the world of the 80s,” he said. Johnson, after he was sober for two years, went to Morehouse for an undergraduate psychology degree and went on to work at a hospital in Detroit, where he “sat down with CEOs and CFOs and learned how money is moved around and how programs are designed based on resources,” he said. After completing a clinical internship at Tarzana Treatment Center treating 12‐18‐year‐olds, he received a doctorate in clinical psychology from the Michigan School of Psychology. What he stressed at NAADAC was this: “we needed to develop a recovery support program.” Treatment alone wasn't working in the drug‐ravaged city. The time of 120 days in treatment was over.

Responding to location-based triggers of cravings to return to substance use: A qualitative study

IntroductionIndividuals with substance use disorders face many challenges in establishing and maintaining recovery, most notably from contextual factors such as people, locations, events, emotions, and other triggers of cravings that could spark return to use. We sought to understand how individuals experience and cope with locations as triggers. MethodsWe conducted 31 semi-structured in-depth interviews with individuals who had recently been in substance use treatment and reported problem levels of alcohol and opioid use according to screening instruments. Interviews were designed to explore how individuals experience location-based triggers. We coded these interviews according to concepts outlined in Marlatt and Gordon's cognitive behavioral model and used thematic analysis to generate themes in participant experiences. ResultsWe found that participants described triggers as interrelated and associated with multiple people, locations, events, or emotions. Participants commonly identified ‘home’ as a trigger, one that is particularly difficult to cope with. Participants most commonly employed avoidance as a coping strategy. Finally, participants described an expectation that substance use was associated with more time spent outside of ‘home’ while recovery was associated with limited travel and more time spent at home. ConclusionsLocation-based triggers represent a particularly challenging barrier to sustained substance use disorder recovery, partly due to the amorphous and interrelated nature of such triggers. The identification of ‘home’ as a primary trigger and common use of avoidance as a coping strategy suggest the need for additional recovery support and interventions. We plan to use these findings to develop and test an intervention promoting coping strategies.

The Role of Social Support in Substance Addiction Recovery: A Systematic Review

Recovery from substance addiction is a complex process that requires continuous physical and psychological support. Social support plays a crucial role in assisting individuals through the process of substance addiction recovery. This article presents a systematic review of the role of social support in substance addiction recovery by analyzing relevant studies from various academic sources. The findings indicate that social support, whether from family, friends, or community, significantly enhances individuals' motivation, resilience, and success in maintaining long-term recovery. Various forms of support, such as emotional, instrumental, and informational support, help individuals cope with the challenges of recovery. Additionally, participation in support groups and positive interpersonal relationships have been shown to accelerate the recovery process and prevent relapse. Therefore, social support is a key element not only in facilitating recovery but also in improving the quality of life for individuals dealing with substance addiction.

Supporting medication-assisted recovery in recovery residences: staff support, managing built environment threats, and building a supportive network

ABSTRACT Background: While medications for opioid use disorder (MOUD) are effective in reducing overdoses, widespread adoption and implementation of MOUD remains inadequate. Innovative approaches to promote MOUD use and to support people in their medication-assisted recovery (MAR) are needed. Recovery residences that serve people taking MOUD are steadily growing in number, yet little is known about how MOUD and the MAR pathway is promoted within the recovery residence setting. Objectives: The purpose of this qualitative analysis was to describe how recovery residences facilitate MOUD initiation and support residents’ MAR pathway. Methods: We conducted interviews with 93 residents (59.1% male; 38.7% female) living in recovery residences located in five Texas cities that served people taking medication for opioid use disorder. Results: We found that recovery residence staff addressed linkage to care gaps in their communities by connecting people who might benefit from MOUD to appropriate providers. Recovery residence staff also strengthened participants’ community of MAR-supportive peers by hosting or connecting residents to Medication-Assisted Recovery Anonymous meetings. Additionally, recovery residences helped some residents overcome common logistical barriers (e.g. transportation issues, housing instability, distance to providers) that hinder MOUD access. Conclusion: Recovery residences that serve people taking MOUD are a well-positioned recovery support service to promote MOUD initiation and the MAR pathway.