Robert Ashford

University of the Sciences · Substance Use Disorders Institute

Alcohol use disorder is by far the most prevalent substance use disorder in the general population and is a major contributor to disease worldwide. Recovery from the disorder is a dynamic process of change, and individuals take many different routes to resolve their alcohol problems and seek to achieve a life worth living. Total abstention is not t...

Background: While clinical interventions used to support the recovery process of U.S. adults are well understood, community-based solutions such as peer-based recovery support services delivered by a recovery community organization are not. Methods: Previously collected administrative data of 3,459 participants at 20 recovery community organizatio...

To understand how persons with substance use disorders (SUDs) achieve and maintain wellness, it is necessary to expand recovery science research. The experiences of individuals in recovery are rarely reflected in SUD research which, at times, discounts subjective experiences of recovery. Recovery-informed theory (RIT) offers new lines of inquiry in...

Background: Recovery support services, including in vivo (i.e., face to face) peer-based supports and social networks, are associated with positive effects on substance use disorder recovery outcomes. The translation of in vivo supports to digital platforms is a recent development that is mostly unexamined. The types of users and their engagement...

The world’s understanding of substance use and misuse has historically been a dynamic process. From moralism to medicalization, several social sciences and medical sciences have helped to mould our understanding, while also providing a basis for conceptualizations of recovery and remission. In the twenty-first century, substance use disorder recove...

The attitudes of individuals who receive, provide, or influence opioid use disorder (OUD) medication services, also called stakeholders, may enhance or hinder their dissemination and adoption. Individuals who have resolved a significant alcohol or other drug (AOD) problem are a group of key stakeholders whose OUD medication attitudes are not well u...

A large portion of substance use disorder recovery research has incorporated the study of mutual-aid 12-Step programs and faith-based programs. However, spirituality as a centerpiece of substance use disorder recovery, as an actionable or operationalized means of transformative change, is not well studied. As many individuals in recovery point to s...

Recent studies associate identifiers, such as “alcoholic/addict”, with stigma, discrimination, and service deficits. Yet, little is known about why and how self-identifiers are chosen. This study analyzed qualitative responses from individuals (N = 42) in recovery from substance use disorders (SUDs) concerning their use of “alcoholic/addict” or “pe...

Background: Peer-based support services are often used within harm reduction organizations, and more recently within recovery community organizations (RCO). Identifying the characteristics of individuals who engage with these novel RCOs is needed. Additionally, conducting collaborative research with communities of people who use drugs (PWUD) or are...

Opioid use disorder (OUD) and opioid-related overdose mortality are major public health concerns in the United States. Recently, several community-based and professional innovations - including hybrid recovery community organizations, peer-based emergency department warm handoff programs, emergency department buprenorphine induction, and low-thresh...

Substance use, misuse, and disorders (SUDs) are estimated to cost the United States over $500 billion annually. While there are effective SUD behavioral interventions and treatments, there is mounting evidence that technology-based, digital recovery support services (D-RSS) have the potential to prevent SUD, complement formal treatment, and improve...

Previous research has found language used to describe individuals with a substance use disorder (SUD; e.g., “addict,” “substance abuser”) contributes to and elicits negative bias among the general public and health care professionals. However, the prevalence in which recovering individuals use these labels to self-identify and the impact of such la...

Background: Public and private systems in the United States and around the World are impacted by substance use disorders (SUD). Despite recent attempts at bringing top down solutions, SUDs continue to be a leading cause of death, a leading correlate in violent crime, and a leading cause of lost productivity in the workplace. Community-based resourc...

Background: Labels such as “addict” and “substance abuser” have been found to elicit implicit and explicit stigma among the general public previously. The difference in the levels of this bias among individuals in recovery and those employed in the health profession has not yet been identified, however. The current study seeks to answer this questi...

Obstacles to intrapersonal and interpersonal growth, due to stigma and discrimination, may constitute a significant challenge to those in recovery. Engaging in recovery-related advocacy may serve as a buffer to the experience of stigma and discrimination. The purpose of this pilot study is to examine whether the perception of stigmatization is asso...

DYNAMIC LABELING DISCERNMENT Background: Individuals with substance use disorders (SUDs) are among the most stigmatised

A large portion of substance use disorder recovery research has incorporated the study of mutual-aid 12-Step programs and faith-based programs. However, spirituality as a centerpiece of substance use disorder recovery, as an actionable or operationalized means of transformative change, is not well studied. As many individuals in recovery point to s...

In order to better understand how persons with substance use disorders (SUD) achieve wellness and maintain health, there is a need to expand the study of the ways in which recovery processes might reverse the physiological alterations, maladaptive thought patterns, and reduced capacities that accompany the active-using stages of SUDs. The experienc...

Pre-print (Under review at Addictive Behaviors) Abstract: Opioid use disorder (OUD) and opioid-related overdose mortality are major public health concerns in the United States. Recently, several community-based and professional innovations-including hybrid recovery community organizations, peer-based emergency department warm handoff programs, em...

Purpose - Public perception has been found to be influenced by the words used to describe those with behavioral health disorders, such that using terms like "substance abuser" can lead to higher levels of stigma. The purpose of this paper is to identify additional stigmatizing and empowering terms that are commonly used by different stakeholders....

BACKGROUND Background: Research suggests that digital recovery support services (D-RSS) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSS in supporting individuals in recovery from substance use, but have yet to examine the use of D-RSS to support a combination of be...

Background Research suggests that digital recovery support services (D-RSSs) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSSs in supporting individuals in recovery from substance use but have yet to examine the use of D-RSSs in supporting a combination of behaviora...

A number of definitions exist for the concept of “recovery” in both the substance use disorder (SUD) and mental health (MH) fields. Previous attempts to define recovery have not reached consensus among experts within the field. Thus, the definition has remained diffuse at the expense of attempts to measure and evaluate treatment and recovery outcom...

As recovery from substance use disorder becomes more than a mere quantifiable outcome, there exists a need to discuss and propose the underlying theoretical constructs that ultimately describe and identify the science of recovery. In this abstract undertaking, we propose an initial formulation of a grand theory of recovery science, built upon the s...

It is well understood that cigarette smokers consume alcohol more frequently and in higher amounts than non‐smokers (Falk et al., 2006; Kahler et al., 2008; Kahler et al., 2010). In addition, among heavy drinkers in smoking cessation treatment, alcohol consumption is associated with increased risks of smoking relapse (Kahler et al, 2010). A recent...

BACKGROUND Problematic substance use in adolescence and emerging adulthood is a significant public health concern in the United States due to high recurrence of use rates and unmet treatment needs coupled with increased use. Consequently, there is a need for both improved service utilization and availability of recovery supports. Given the ubiquito...

Background: Problematic substance use in adolescence and emerging adulthood is a significant public health concern in the United States due to high recurrence of use rates and unmet treatment needs coupled with increased use. Consequently, there is a need for both improved service utilization and availability of recovery supports. Given the ubiqui...

The current opioid crisis has necessitated timely, grassroots social entrepreneurship from stakeholders involved in the substance-use disorder and recovery fields. One such innovation involves the use of peer-recovery-support services in acute settings in which points of contact are made with high-risk substance-using populations. These programs ha...

Background Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes...

Background: Previous research has found initial evidence that word choice impacts the perception and treatment of those with behavioral health disorders. These previous studies have relied on vignette-based methodologies, however, and a more quantifiable index of the stigma words can produce is needed. Method: The current study uses the Go/No-Go...

Objectives: To present a review of the existing research on college students living in recovery, including the research on students in recovery participating in collegiate recovery programs. Methods: Studies were included if they: a) were peer-reviewed or archived dissertations, b) were published between 1988 and 2017, c) directly involved studen...

Attendees will be provided with a brief history/timeline of collegiate recovery as a field, through the lens of research (with a focus on the explosive growth in knowledge in the last decade). This initial presentation will be followed by a synopsis of the current state of collegiate recovery science, focusing on recent studies in the field (CRP al...

Sensitivity did not vary by objective category ("substance abuse" (SA) or "person with substance use disorder" (SUD); F(1,36) = .001, p = .980), or by evaluative category ("good" or "bad"; F(1,36) = .109, p = .743). § Sensitivity also did not vary by presented order (GNAT first > Vignette, Vignette first > GNAT); SA + good, F(2,35) = .728, p = .399...

Previous research has found initial evidence that word choice impacts the perception and treatment of those with behavioral health disorders through explicit bias (i.e., stigma). A more robust picture of behavioral health disorder stigma should incorporate both explicit and implicit bias, rather than relying on only one form. The current study uses...

Background: The general public, treatment professionals, and healthcare professionals have been found to exhibit an explicit negative bias towards substance use and individuals with a substance use disorder (SUD). Terms such as “substance abuser” and “opioid addict” have shown to elicit greater negative explicit bias. However, other common terms ha...

The co-occurring prevalence of disordered eating (DE) with substance use disorders is estimated to be high among college students. Collegiate recovery programs (CRPs), primarily used for the support of students with mental health disorders and substance use disorders, are well positioned to potentially provide support for students with DE behaviors...

Of the 259 participants, 243 (94%) owned a cell phone (n=77, 30%) or smartphone (n=166, 64%), with no significant difference between generations (X 2 (2)=1.39, p=0.50). § 47.43% of respondents had seen information that made them want to use substances at least sometimes on digital media platforms § 66.09% of respondents believe that social media pl...

Objectives The current study analyzes a large set of Twitter data from 1,384 US counties to determine whether excessive alcohol consumption rates can be predicted by the words being posted from each county. Methods Data from over 138 million county-level tweets were analyzed using predictive modeling, differential language analysis, and mediating...

Background: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. Objective: The aims of this paper were to provide d...

Collegiate recovery programs (CRPs) support students in or seeking recovery from substance use disorders or mental health disorders while enrolled in college. Collegiate recovery has been established as a field of study since the 1970s. To date, a number of qualitative studies have been completed on the programs and students served, along with a si...

Background: The US is in the midst of one of the largest public health crises in recent history with over 63,000 drug poisoning deaths in 2016 and a projected annual economic cost of over $420 billion. With the rise of deaths and economic burden related to substance use, it is paramount that systemic barriers within the treatment industry be ident...

As a relatively new field of practice, collegiate recovery programs (CRP), have used a practice-informed approach as a means of establishing best practices and pedagogy. While research on collegiate recovery programs and populations of students in recovery is growing, much of the qualitative studies have yet to be synthesized into a useful organizi...

Campus-based recovery programs have been shown to support students in recovery from substance use disorders, as well as mental health disorders. However, this support has been historically delivered in isolation. This study highlights preliminary outcomes from a novel collegiate recovery program, one that uses a model of recovery with integrated su...

The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations – Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences amongst those involved in the substance use disorder and recovery professio...

Previous research showing that parents tend to underestimate adolescent substance use is consistent with concerns that adolescent substance use may develop because parents delay in reacting to it. However, little research has examined parental decisions regarding how and when to intervene on adolescent substance use. This study examines the actions...