John F Kelly

• PhD
• Professor at Harvard Medical School

Purpose of Review In this article, we systematically review the research on peer recovery support services (PRSS) for substance use disorder (SUD). Recent Findings We update our 2019 review on PRSS for SUD, with a focus on quantitative, multi-group studies (K = 28; N = 12,601). We searched four databases (December 2024), identifying 17 new studies...

Recovery housing, an abstinence-based living environment, is the most widely available form of substance use disorder (SUD) recovery support infrastructure. This systematic review characterized the randomized control trials (RCT) and quasi-experimental designs (QED) research on recovery housing. We conducted a search across PubMed, EMBASE, CINAHL,...

Introduction: Educational settings represent a prime opportunity for reaching adolescents and young adults (ages 12–27) experiencing substance use disorders (SUD). Recovery high schools (RHSs) were established to help adolescents in recovery finish their education while maintaining alcohol and other drug (AOD) abstinence and collegiate recovery pro...

This is the protocol for a Campbell systematic review. The objectives are as follows: (1) What kinds of mutual‐help organizations for drug use disorders have been studied with evidence available in the empirical literature? (2) What is the nature of the evidence with regard to the different types of mutual‐help organizations?—(a) To what extent are...

Background Substance use disorder (SUD) is a prodigious public health issue characterized by a substantial treatment gap. Despite challenges, millions have resolved a prior significant alcohol or drug problem, increasingly using online supports as a part of their recovery efforts (e.g., virtual mutual‐help group meetings, traditional social network...

[This corrects the article DOI: 10.1371/journal.pone.0295330.].

Background The definition of ‘recovery’ has evolved beyond merely control of problem substance use to include other aspects of health and wellbeing (known as ‘recovery capital’) which are important to prevent relapse to problematic alcohol or other drug (AOD) use. Developing a Recovery Oriented System of Care (ROSC) requires consideration of interv...

Protein-O-mannosylation (POM) is a form of O-glycosylation that is ubiquitous and has been studied extensively throughout in fungi and animals. The key glycosyltransferase, protein O-mannosyltransferase (PMT), a member of family GT-39, is also found in over 3,800 bacterial genomes but has only been minimally examined from prokaryotes. In prokaryote...

Aims Structured clinical interviewing is considered the gold standard in psychiatric diagnosis. The Diagnostic Assessment Research Tool (DART) is a novel modularized, non-copywritten, semi-structured interview; however, no studies have examined the psychometric properties of its alcohol use disorder (AUD) module. The primary aims of this study were...

Background: Collegiate Recovery Programs (CRPs) play a vital and expanding role in supporting students in recovery from substance use disorders and behavioral addictions at higher education institutions. Despite their importance, there is a lack of comprehensive research characterizing CRPs, including their program directors and the nature and inf...

Aims: Structured clinical interviewing is considered the gold standard in psychiatric diagnosis. The Diagnostic Assessment and Research Tool (DART) is a novel modularized semi-structured interview; however, no studies have examined the psychometric properties of its alcohol use disorder (AUD) module. The primary aims of this study were: (1) to vali...

Background and aims Alcohol use disorder (AUD) is characterized by low levels of engagement with effective treatments. Enhancing awareness of AUD treatments and how to navigate the treatment system is crucial. Many individuals use online sources (e.g. search engines) for answers to health‐related questions; web‐based results include a mix of high‐...

BACKGROUND Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregivers do (e.g., caregiving practices) during treatment to improve core adolescent treatment targets may facilitate the refinement and scalability of caregiv...

Background Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregiving practices during treatment improve core adolescent treatment targets may facilitate the refinement and scalability of caregiver-involved interventions...

Purpose Sexual minority (SM; e.g., gay, lesbian, bisexual) individuals are disproportionately impacted by alcohol and other drug (AOD) use disorders and psychosocial factors that can exacerbate AOD use disorders and hinder recovery. This study examines SM sub-group differences (monosexual [gay/lesbian] versus bisexual) regarding adaptation to recov...

Background: Social recovery capital (SRC) refers to resources and supports gained through relationships and is vital to adolescent addiction recovery. Much is known about how substance use relates to social networks, but little is known about how other dimensions of social networks influence recovery (e.g., network size/exposure, degree of conflict...

Objective: Social network analysis (SNA) characterizes the structure and composition of a person’s social relationships. Network features have been associated with alcohol consumption in observational studies, primarily of university undergraduates. No studies have investigated whether indicators from a person’s social network can accurately identi...

Enacted stigma (i.e., experiences of discrimination from others) is associated with engagement in drug use among people with a wide range of stigmatized statuses. This association may be particularly concerning among people receiving treatment for opioid use disorder (OUD), among whom continued drug use may undermine treatment outcomes and increase...

Background Alcohol or drug (AOD) problems are a significant health burden in the UK population, and understanding pathways to remission is important. Aims To determine the UK population prevalence of overcoming an AOD problem and the prevalence and correlates of ‘assisted’ pathways to problem resolution. Method Stage 1: a screening question was a...

Objective The medical community has become aware of its role in contributing to the opioid epidemic and must be part of its resolution. Recovery community centers (RCCs) represent a new underused component of recovery support. Methods This study performed an online national survey of all RCCs identified in the United States, and used US Census ZIP...

Background Mutual‐help organizations (MHOs) are effective community‐based, recovery support options for individuals with alcohol and other drug use disorders (i.e., substance use disorder; SUD). Greater understanding of second‐wave MHOs, such as SMART Recovery, can help build on existing research that has focused primarily on 12‐step MHOs, such as...

Aims The central aim of this study was to determine whether intentional, voluntary alcoholics anonymous (AA) participation showed any independent association with affect, over and above that which has been observed in association with other recovery-related behaviors, such as abstinence, among individuals with a history of alcohol use disorder. Add...

Introduction Prior research has found that different ways of describing opioid-related impairment influences the types and degrees of stigmatizing beliefs held by the American public. In this study we examined the extent to which different characteristics of the American public (i.e., age, gender, race/ethnicity, religiosity, sexual orientation, po...

Background and aims To date, no epidemiological survey has estimated the prevalence of adolescents identifying as being in recovery. This is necessary for planning and identifying the needs of youth with current and remitted substance use disorders. This study estimated the prevalence of recovery status in a large statewide epidemiological survey a...

Background and objectives: This pilot study tested the feasibility of tracking e-cigarette initiation over three months using a burst-of-measurement approach and examined reactivity to the ecological momentary assessment (EMA) data capture technique in this context. Methods: Adults who smoked daily and were interested in trying e-cigarette use rece...

Background The concept of recovery has increasingly become an organizing paradigm in the addiction field in the past 20 years, but definitions of the term vary amongst interested groups (e.g. researchers, clinicians, policy makers or people with lived experience). Although professional groups have started to form a consensus, people with lived expe...

Background Mutual‐help organizations (MHOs) play a crucial role for many individuals with alcohol use disorder (AUD) or other substance use disorders in achieving stable remission. While there is now substantial research characterizing who uses 12‐step MHOs, very little is known about who becomes affiliated with newer and rapidly growing MHOs, such...

Glycosylation is a key quality attribute that must be closely monitored for protein therapeutics. Established assays such as HILIC-Fld of released glycans and LC-MS of glycopeptides work well for glycoproteins with a few glycosylation sites but are less amenable for those with multiple glycosylation sites, resulting in complex datasets that are tim...

Protein- O -mannosylation (POM) is a form of O -glycosylation that is ubiquitous throughout all domains of life and has been extensively characterized in eukaryotic systems. However, in prokaryotes this process has only been investigated in terms of pathogenicity (in Mycobacterium tuberculosis ) even though there are many non-pathogenic bacteria th...

Substance use disorders (SUD) are prevalent, complex medical conditions. Individuals with SUD vary considerably in clinical severity, accompanying medical sequelae, degree of functional impairment, often struggle with comorbid psychiatric conditions. Cognitive-behavioral therapies for individuals with SUD and co-occurring mental health conditions h...

The actinobacterial species Cellulomonas fimi ATCC484 has long been known to secrete mannose-containing proteins, but a closer examination of glycoproteins associated with the cell has never been reported. Using ConA lectin chromatography and mass spectrometry we have surveyed the cell associated glycoproteome from C. fimi and collected detailed in...

Introduction Alcohol use disorder (AUD) remains one of the most pervasive of all psychiatric illnesses conferring a massive health and economic burden. In addition to professional treatments to address AUD, mutual-help organisations such as Alcoholics Anonymous (AA) and newer entities like Self-Management and Recovery Training (SMART Recovery) play...

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspective...

Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders. Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts...

Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and manag...

Objective: This report aims to identify US mutual help group (MHG) participants' psycho-socio-behavioral profiles. Method: We used data from the 2015-2018 National Survey on Drug Use and Health and the sample included 1022 adults with past-year substance use disorders (SUD). We conducted a latent class analysis to identify subgroups of MHG particip...

Mutual-help organizations (MHOs) such as alcoholics anonymous (AA) are the most commonly sought source of help for alcohol and other drug (AOD) problems in the United States. Popularity, however, is not commensurate with efficacy; hence, following a call for more rigorous research on AA and 12-step treatments from the Institute of Medicine in 1990...

Objective: Despite evidence that social support is beneficial for people living with opioid use disorders (OUDs), research has yet to investigate whether social support within certain relationships is more or less effective. The current study examined whether social support, relationship closeness with a disclosure partner, and/or the history of j...

Objective: Trait anger has been shown to be predictive of emotion-focused coping and alcohol use. Yet, the connection between cannabis use and trait anger remains poorly characterized. The present study sought to investigate the relationship between cannabis use and self-reported trait anger in youth seeking substance use treatment. Methods: A retr...

Opioid overdose deaths remain a major public health crisis. We used a system dynamics simulation model of the U.S. opioid-using population age 12 and older to explore the impacts of 11 strategies on the prevalence of opioid use disorder (OUD) and fatal opioid overdoses from 2022 to 2032. These strategies spanned opioid misuse and OUD prevention, bu...

The glycosylation of structural proteins is a widespread posttranslational modification in Archaea. Although only a handful of archaeal N-glycan structures have been determined to date, it is evident that the diversity of structures expressed is greater than in the other domains of life. Here, we report on our investigation of the N- and O-glycan m...

In March 2020, restrictions on in-person gatherings were introduced due to the coronavirus disease (COVID-19) pandemic, requiring alcohol use disorder (AUD) recovery resources to migrate to virtual platforms. This study investigated how these restrictions impacted recovery attempts and explored participant experiences with virtual resources using a...

Introduction Medications to treat opioid use disorder (MOUD) during pregnancy and in the postpartum period remain underutilized. A need exists to enhance our understanding of modifiable factors, facilitators, and barriers to MOUD utilization and adherence in the perinatal period to improve maternal and child outcomes. Methods The study conducted s...

Background Lesbian, gay, and bisexual individuals (“sexual minorities” [SMs]) are overrepresented among individuals suffering from alcohol and other drug (AOD) problems. However, little is known regarding differences, particularly in functioning and well-being, between SMs and heterosexuals in recovery from AOD problems. Method Cross-sectional, na...

Background Many people who report resolving an alcohol or other drug (AOD) problem continue some level of substance use. Little information exists, however, regarding the prevalence of this resolution pathway, or how continued substance use after resolving an AOD problem, relative to abstinence, relates to functioning, quality of life, and happines...

Background Mutual-help groups (MHGs) are an integral component of the substance use disorder (SUD) treatment system in the U.S., and growing evidence suggests that they are effective and cost-effective for SUD-related problems. However, not much is known about the MHG participation patterns in the U.S. Methods Using the 2002-2018 National Survey o...

This extensively revised new edition provides a practical guide to understanding, assessing and managing physical, psychological and social complications related to drug and alcohol use. It presents a clear review of the aetiology, epidemiology, prevention and treatment of the problematic use of and dependence on alcohol, illicit and prescribed dru...

Background Personal disclosure of opioid use disorder (OUD) recovery can lead to relationship outcomes such as social support, which is associated with greater treatment retention, or stigma, which is associated with risk of treatment dropout. Although disclosure may have important impacts on the relationships and ensuing recovery trajectories of p...

Background: Mutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategi...

Background There are many effective treatment options for substance use disorder (SUD), yet most individuals with SUD do not seek formal treatment services. Given the rising popularity of TikTok and need to foster innovative means through which to attract and engage individuals with SUD with treatment, we sought to characterize how TikTok users in...

Objective: In March 2020, restrictions on in-person gatherings were introduced due to the COVID-19 pandemic. As a result, integral alcohol use disorder (AUD) recovery resources migrated to virtual platforms. Given the importance of these resources for maintaining recovery, this study investigated how these restrictions impacted recovery attempts an...

Background Recovery from alcohol use disorders (AUDs) consists of salutary changes in behavior and affect. While evidence suggests that recovery‐related behavioral changes, such as abstinence, emerge in tandem with both neural and affective changes, the precise relationships among these changes are unknown. To understand these relationships, we exa...

Introduction Methadone and buprenorphine/naloxone medications are among the most effective treatment options for opioid use disorders, yet many people remain misinformed about their benefits and hold negative perceptions about the use of medications to treat opioid use disorders. Such perceptions, especially negative perceptions based on misinforma...

Background: Routine outcome monitoring (ROM) has been implemented across a range of addiction treatment services, settings and organisations. Mutual support groups are a notable exception. Innovative solutions are needed. SMART Track is a purpose built smartphone app designed to capture ROM data and provide tailored feedback to adults attending Aus...

Background Despite their proven efficacy, medications for opioid use disorder (MOUD) are underutilized. Negative beliefs and attitudes toward MOUD are quite common, yet rapidly expanding recovery community centers (RCCs) may offer a promising venue for fostering MOUD support as they operate under the maxim, “many pathways [to recovery], all should...

Background The health and well-being of students in recovery from substance use disorder are increasingly being recognized as a priority on college campuses. This scoping review maps the state of the existing literature evaluating collegiate recovery programming to highlight research gaps and inform policy. Method We conducted a systematic search...

Background: The postpartum year is a vulnerable period for women with opioid use disorder, with increased rates of fatal and non-fatal overdose, yet the continuation of the use of medications to treat opioid use disorder (MOUD) on a population-level remains unknown. Objectives: To examine the discontinuation of methadone and buprenorphine among...

Objective: Alcohol and other drug (AOD) use disorders impose a prodigious personal and societal burden. While most remit, little is known about the achievements accrued as people accomplish and sustain addiction recovery. Greater knowledge regarding the nature and prevalence of such achievements, when such achievements occur, what factors influenc...

Objective: To examine the extent to which colloquial phrases used to describe opioid-exposed mother-infant dyads affects attitudes toward mothers with opioid use disorder (OUD) to assess the role stigmatizing language may have on the care of mothers with OUD. Methods: We employed a randomized, cross-sectional, case vignette of an opioid-exposed...

Rationale Men who have sex with men (MSM) are disproportionately affected by HIV, substance use, and stigma related to co-existing or intersecting identities that are stigmatized or devalued by society (e.g., being a sexual minority male, a person living with HIV, or a person who uses substances). Evidence indicates that when stigma is internalized...

For people with current and remitted substance use disorder (SUD), the COVID-19 pandemic increases risk for symptom exacerbation and relapse through added stressors and reduced service access. In response, mutual-help groups and recovery community organizations have increased access to online recovery support meetings. However, rigorous studies exa...

Background For physical health conditions, earlier intervention typically results in better prognoses and improved quality of life (QoL). Despite some evidence that early intervention yields better subsequent functioning too for behavioral health conditions like alcohol and other drug (AOD) disorders, less is known. This study examined the relation...

Objective Recovery community centers (RCCs) have expanded across the U.S., serving as social “recovery hubs” that increase recovery capital (e.g., employment, housing) by providing resources that clinical care does not provide. While research supports RCCs' general utility, little is known about new participants' characteristics, predictors of enga...

Background and aims Several reports have documented risk factors for opioid use following treatment discharge, yet few have assessed sex differences, and no study has assessed risk using contemporary machine learning approaches. The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for...

Evidence demonstrates that exposure to the terms “abuse” and “substance abuser” increases stigmatizing and discriminatory attitudes toward individuals suffering from drug and alcohol problems, ultimately leading to suboptimal clinical care delivery and poorer treatment outcomes. The American Psychiatric Association has dropped the term “abuse” from...

BACKGROUND Mutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies...

Background and Aims Drug‐related impairment is persistently stigmatized delaying and preventing treatment engagement. To reduce stigma, various medical terms (e.g., “chronically relapsing brain disease”, “disorder”) have been promoted in diagnostic systems and among national health agencies, yet some argue that over‐medicalization of drug‐related i...

The health and well-being of students in recovery from substance use disorder is increasingly being recognized as a priority on college campuses. This scoping review maps the state of the existing literature evaluating collegiate recovery programming to highlight research gaps and inform policy. We conducted a systematic search of articles related...

The concept of "recovery" from alcohol use disorders (AUD) has garnered increasing scientific interest in recent years including attempts to explicate and measure its presumed component parts. In general, there is consensus that "recovery" should not be solely about abstinence or quantity-frequency measures of alcohol consumption and should include...

Background The COVID-19 pandemic and related social distancing public health recommendations will have indirect consequences for individuals with current and remitted substance use disorder (SUD). Not only will stressors increase risk for symptom exacerbation and/or relapse, but individuals will also have limited service access during this critical...

Objective: Substance use disorders (SUD) are frequently comorbid with other psychiatric conditions, but a comprehensive diagnostic assessment is often not feasible clinically. Efficient psychometrically-validated screening tools exist for commonly comorbid conditions, but cutoff accuracies have typically not been evaluated in addiction treatment s...

Motility in archaea is facilitated by a unique structure termed the archaellum. N-glycosylation of the major structural proteins (archaellins) is important for their subsequent incorporation into the archaellum filament. The identity of some of these N-glycans has been determined, but archaea exhibit extensive variation in their glycans, meaning th...

Background 12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples o...

Aims: A recently completed Cochrane review assessed the effectiveness and cost-benefits of Alcoholics Anonymous (AA) and clinically delivered 12-Step Facilitation (TSF) interventions for alcohol use disorder (AUD). This paper summarizes key findings and discusses implications for practice and policy. Methods: Cochrane review methods were followe...

Substance use problems undermine HIV treatment and secondary prevention efforts. Research is needed to better understand predictors of substance use among people living with HIV (PLWH). We examined whether internalized stigma and enacted HIV stigma are associated with three indicators of substance use among PLWH, including numbers of (1) substances...

Background Nicotine addiction through cigarette use is highly prevalent among individuals suffering from alcohol and other drug (AOD) problems and remains a prominent risk factor for morbidity, mortality, and healthcare utilization. Whereas most people agree that providing smoking cessation services (SCS) to this vulnerable population is vitally im...

Substance use disorders (SUDs) among young people have been linked with a range of adverse health consequences that can be successfully mitigated with early SUD treatment. According to the Social Identity Theory of Cessation Maintenance (SITCM), psychosocial processes including self-perceptions and benefit finding evolve with treatment, influencing...

Importance Racial and ethnic disparities persist across key health and substance use treatment outcomes for mothers and infants. The use of medications, such as methadone or buprenorphine, for the treatment of opioid use disorder (OUD) has been associated with improvements in the outcomes of mothers and infants; however, only half of all pregnant w...

Although 12-step participation is related to improved outcomes, young people’s 12-step involvement is rare. There is limited research on the role of 12-step philosophy and practices for supporting young people’s recovery or addressing why so few engage in 12-step practices. To explore these issues, content analysis was applied to qualitative data f...

Alcohol and other drug (AOD) use disorders exact a prodigious annual economic toll in the United States (U.S.), driven largely by lost productivity due to illness-related absenteeism, underemployment, or unemployment. While recovery from AOD disorders is associated with improved health and functioning, little is known specifically about increases i...

Background: Alcohol use disorder (AUD) confers a prodigious burden of disease, disability, premature mortality, and high economic costs from lost productivity, accidents, violence, incarceration, and increased healthcare utilization. For over 80 years, Alcoholics Anonymous (AA) has been a widespread AUD recovery organization, with millions of memb...

Les sociétés professionnelles European Pain Federation, International Association for Hospice and Palliative Care, International Doctors for Healthier Drug Policies, World Federation for the Treatment of Opioid Dependence, Collège Romand de Médecine de l’Addiction et Société Suisse de Médecine de l’Addiction ont invité les revues médicales à s’assu...

Background Recovery community centers (RCCs) are the “new kid on the block” in providing addiction recovery services, adding a third tier to the 2 existing tiers of formal treatment and mutual‐help organizations (MHOs). RCCs are intended to be recovery hubs facilitating “one‐stop shopping” in the accrual of recovery capital (e.g., recovery coaching...

Background: Much research over the past 25 years has focused on elucidating the mechanisms by which Alcoholics Anonymous (AA) affects behavioral change in its participants. In addition to research on the spiritual mechanisms for which AA is best known in the popular conception, research on mechanisms of recovery (MOR) has predominantly supported s...

Antibody-based therapeutics constitute a major growth area in medicine today. However, antibodies as drugs present significant analytical challenges as they are large, complex and heterogenous molecules produced in living cells. The key attributes that affect safety, stability and efficacy must be identified and controlled to ensure regulatory comp...

Background: Professional treatment and non-professional mutual-help organizations (MHOs) play important roles in mitigating addiction relapse risk. More recently, a third tier of recovery support services has emerged that are neither treatment nor MHO that encompass an all-inclusive flexible approach combining professionals and volunteers. The mos...

Background: More Americans than ever before are identifying as "spiritual but not religious". Both spirituality and religiousness (S/R) are of interest in the addiction field as they are related to alcohol and other drug (AOD) problems and are central to some recovery pathways. Yet, little is known overall about S/R identification among people in...

Background Individuals’ social networks exert a strong influence on alcohol use, but valid assessment of network drinking behavior is typically lengthy and high in participant burden. The aim of this study was to validate the Brief Alcohol Social Density Assessment (BASDA), an efficient measure of perceived alcohol use within a person’s social netw...