Addictions services: Support, mutual aid and recovery from dual diagnosis

Institute for Treatment and Services Research,National Development and Research Institutes, Inc., New York, NY 10048, USA.
Community Mental Health Journal (Impact Factor: 1.03). 11/2000; 36(5):457-76. DOI: 10.1023/A:1001982829359
Source: PubMed

ABSTRACT Recovery from substance abuse and mental health disorders (dual-diagnosis) requires time, hard work and a broad array of coping skills. Empirical evidence has demonstrated the buffering role of social support in stressful situations. This paper investigates the associations among social support (including dual-recovery mutual aid), recovery status and personal well-being in dually-diagnosed individuals (N = 310) using cross-sectional self-report data. Persons with higher levels of support and greater participation in dual-recovery mutual aid reported less substance use and mental health distress and higher levels of well-being. Participation in mutual aid was indirectly associated with recovery through perceived levels of support. The association between mutual aid and recovery held for dual-recovery groups but not for traditional, single-focus self-help groups. The important role of specialized mutual aid groups in the dual recovery process is discussed.

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Available from: Alexandre Laudet, Oct 13, 2014
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    • "Our participants had access to people who would cook them meals, take care of their possessions, loan them material resources, but also look after their children, provide them with a roof and encourage them to address their addictive behaviours (c.f. Alverson et al., 2000; Laudet et al., 2000; Neale et al., 2012; Neale, 2001). Often this support came from those who themselves might have limited social capital, including other hostel residents. "
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    ABSTRACT: Background Homeless people who use drugs and alcohol have been described as one of the most marginalised groups in society. In this paper, we explore the relationships of homeless drug and alcohol users who live in hostels in order to ascertain the nature and extent of their social and recovery capital. Methods Data were collected during 2013 and 2014 from three hostels. Each hostel was in a different English city and varied in size and organisational structure. Semi-structured interviews were conducted with 30 residents (21 men; 9 women) who self-reported current drink and/or drug problems. Follow-up interviews were completed after 4-6 weeks with 22 residents (16 men; 6 women). Audio recordings of all interviews were transcribed verbatim, systematically coded and analysed using Framework. Results Participants’ main relationships involved family members, professionals, other hostel residents, friends outside of hostels, current and former partners, and enemies. Social networks were relatively small, but based on diverse forms of, often reciprocal, practical and emotional support, encompassing protection, companionship, and love. The extent to which participants’ contacts provided a stable source of social capital over time was, nonetheless, uncertain. Hostel residents who used drugs and alcohol welcomed and valued interaction with, and assistance from, hostel staff; women appeared to have larger social networks than men; and hostels varied in the level of enmity between residents and antipathy towards staff. Conclusion Homeless hostel residents who use drugs and alcohol have various opportunities for building social capital that can in turn foster recovery capital. Therapies that focus on promoting positive social networks amongst people experiencing addiction seem to offer a valuable way of working with homeless hostel residents who use drugs and alcohol. Gains are, however, likely to be maximised where hostel management and staff are supportive of, and actively engage with, therapy delivery.
    International Journal of Drug Policy 10/2014; 26(5). DOI:10.1016/j.drugpo.2014.09.012 · 2.40 Impact Factor
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    • "The other barrier to dual recovery was the systemic barrier that persons encountered, that was described in three of the studies identified. These barriers emerged in the context of complex service systems and uncoordinated services (Brooks et al., 2007; Davidson et al., 2008; Laudet et al., 2000). Participants reported experiences of finding it difficult to navigate in these complex systems, and experienced a lack of coordinated services across agencies. "
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    ABSTRACT: Abstract Purpose – The co-occurrence of mental health and substance use problems is prevalent, and has been problematic both in terms of its complexity for the person and of the challenges it poses to health care practitioners. Recovery in co-occurring mental health and substance use problems is viewed as with multiple challenges embedded in it. As most of the existing literature on recovery tends to treat recovery in mental health and substance use problems separately, it is critical to assess the nature of our current understanding of what has been described as “complex” or “dual” recovery. The purpose of this paper is to identify and discuss what persons with co-occurring mental health and substance use problems describe as facilitators and barriers in their recovery process as revealed in the literature. Design/methodology/approach – The method used for this study was a small-scale review of the literature gleaned from a wider general view. Searches were conducted in CINAHL, Psych info, Medline, Embase, SweMedþ, and NORART. Findings – Three overarching themes were identified as facilitators of dual recovery: first, meaningful everyday life; second, focus on strengths and future orientation; and third, re-establishing a social life and supportive relationships. Two overarching themes were identified as barriers to dual recovery: first, lack of tailored help and second, complex systems and uncoordinated services. Originality/value – The recovery literature mostly focuses on recovery in mental health and substance use problems separately, with less attention being paid in the first-person literature to what helps and what hinders dual recovery. Keywords Dual diagnosis, Literature review, Co-occurent disorders, First-person perspectives, Recovery processes Paper type Literature review
    08/2014; 7(3):107-117. DOI:10.1108/ADD-02-2014-0007
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    • "Unfortunately, a significant gap exists in the current social capital/drug use literature among rural drug users. Most studies examining social capital and substance use have been conducted in international (Cheung & Cheung, 2003; Cullen, 2010; Johnell et al., 2006; Lindström, 2003, 2004; Lundborg, 2005; McIntosh & McKeganey, 2000; Radcliffe & Stevens, 2008) and/or urban populations (Cheung & Cheung, 2003; Cullen, 2010; Hawkins & Abrams, 2007; Kirst, 2009; Laudet et al., 2000; Radcliffe & Stevens, 2008; Weinberg, 2000); few have examined social capital and drug use in rural America. Appalachia is largely rural; in fact, 42% of the population lives in an area designated as rural. "
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    ABSTRACT: Studies have shown that position within networks of social relations can have direct implications on the health behaviors of individuals. The present study examines connections between drug use and individual social capital within social networks of drug users (n = 503) from rural Appalachian Kentucky, U.S.A. Respondent driven sampling was used to recruit individuals age 18 and older who had used one of the following drugs to get high: cocaine, crack, heroin, methamphetamine, or prescription opioids. Substance use was measured via self-report and social network analysis of participants' drug use network was used to compute effective size, a measure of social capital. Drug network ties were based on sociometric data on recent (past 6 month) drug co-usage. Multivariate multi-level ordinal regression was used to model the independent effect of socio-demographic and drug use characteristics on social capital. Adjusting for gender, income, and education, daily OxyContin(®) use was found to be significantly associated with greater social capital, and daily marijuana use was associated with less social capital. These results suggest that in regions with marked economic disparities such as rural Appalachia, OxyContin(®) may serve as a form of currency that is associated with increased social capital among drug users. Interventions focusing on increasing alternate pathways to acquiring social capital may be one way in which to alleviate the burden of drug use in this high-risk population.
    Social Science [?] Medicine 03/2012; 74(10):1602-9. DOI:10.1016/j.socscimed.2011.12.053 · 2.56 Impact Factor
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