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Recovery capital: A primer for addictions professionals

White, W. & Cloud, W. (2008). Recovery capital: A primer for addictions
professionals. Counselor, 9(5), 22-27.
Recovery Capital:
A Primer for Addictions Professionals
William L. White, MA and William Cloud, PhD
From Pathology to Resiliency and Recovery
The history of addiction treatment in America contains within it a
history of key ideas that have transformed service philosophies and
practices. In the early history of modern treatment, for example, chemical
dependency emerged as a core idea that helped integrate what were then two
separate fields: one focused on alcoholism, the other on drug addiction.
Other concepts, such as codependency, dual diagnosis, gender-specific,
developmental appropriateness, cultural competence, trauma-informed,
evidence-based, stages of change, motivational enhancement, recovery
management, and recovery coaching helped, or are now helping, transform
addiction treatment into a more person-centered, holistic, family-centered,
and recovery-focused system of care.
Addiction professionals across America are witnessing the field’s
paradigmatic shift from a pathology and intervention focus to a recovery
focus (White, 2004, 2005). Attention on the lived solution to alcohol and
other drug (AOD) problems is reflected in the growing interest in defining
recovery, conducting recovery prevalence surveys, illuminating the varieties
of recovery experiences, and mapping the patterns, processes, and stages of
long-term recovery (Betty Ford Institute Consensus Panel, 2007; White &
Kurtz, 2006).
One of the key ideas at the core of this shift is that of recovery capital.
This article defines recovery capital and explores how attention to recovery
capital can be integrated into the service practices of front-line addiction
Recovery Capital Defined
Recovery capital (RC) is the breadth and depth of internal and
external resources that can be drawn upon to initiate and sustain recovery
from severe AOD problems (Granfield & Cloud, 1999; Cloud & Granfield,
2004). Recovery capital is conceptually linked to natural recovery, solution-
focused therapy, strengths-based case management, recovery management,
resilience and protective factors, and the ideas of hardiness, wellness, and
global health. There are three types of recovery capital that can be
influenced by addictions professionals.
Personal recovery capital can be divided into physical and human
capital. A client’s physical recovery capital includes physical health,
financial assets, health insurance, safe and recovery-conducive shelter,
clothing, food, and access to transportation. Human recovery capital
includes a client’s values, knowledge, educational/vocational skills and
credentials, problem solving capacities, self-awareness, self-esteem, self-
efficacy (self-confidence in managing high risk situations),
hopefulness/optimism, perception of one’s past/present/future, sense of
meaning and purpose in life, and interpersonal skills.
Family/social recovery capital encompasses intimate relationships,
family and kinship relationships (defined here non-traditionally, i.e., family
of choice), and social relationships that are supportive of recovery efforts.
Family/social recovery capital is indicated by the willingness of intimate
partners and family members to participate in treatment, the presence of
others in recovery within the family and social network, access to sober
outlets for sobriety-based fellowship/leisure, and relational connections to
conventional institutions (school, workplace, church, and other mainstream
community organizations).
Community recovery capital encompasses community
attitudes/policies/resources related to addiction and recovery that promote
the resolution of alcohol and other drug problems. Community recovery
capital includes:
active efforts to reduce addiction/recovery-related stigma,
visible and diverse local recovery role models,
a full continuum of addiction treatment resources,
recovery mutual aid resources that are accessible and diverse,
local recovery community support institutions (recovery centers /
clubhouses, treatment alumni associations, recovery homes, recovery
schools, recovery industries, recovery ministries/churches), and
sources of sustained recovery support and early re-intervention (e.g.,
recovery checkups through treatment programs, employee assistance
programs, professional assistance programs, drug courts, or recovery
community organizations).
Cultural capital is a form of community capital. It constitutes the
local availability of culturally-prescribed pathways of recovery that resonate
with particular individuals and families. Examples of such potential
resonance include Native Americans recovering through the “Indianization
of AA” or the “Red Road,” or African Americans recovering within a faith-
based recovery ministry or within an Afrocentric therapeutic orientation
(Coyhis & White, 2006; White & Sanders, in press).
In total, recovery capital constitutes the potential antidote for the
problems that have long plagued recovery efforts: insufficient motivation to
change AOD use, emotional distress, pressure to use within intimate and
social relationships, interpersonal conflict, and other situations that pose
risks for relapse.
Early Scientific Findings
Modern addiction science has illuminated critical factors that
contribute to the onset and complicate the course of substance use disorders,
e.g., a family history of AOD problems, childhood victimization, early age
of unsupervised AOD use, multiple drug use, injection drug use, long delay
from onset of AOD problems to first treatment, high emotional distress (co-
occurring psychiatric illness), and enmeshment in an AOD-saturated social
milieu (See White, in press/a for a review). But the protective factors that
can offset such risk factors or increase one’s odds of successful long-term
addiction recovery have yet to be fully charted. The following key findings
from recent scientific studies and reviews underscore the potential
importance of recovery capital.
Recovery capital—both its quantity and quality—plays a major role in
determining the success or failure of natural and assisted recovery
(e.g., recovery from AOD problems without or with participation in
professional treatment or a recovery mutual aid society) (Granfield &
Cloud, 1996, 1999; Moos & Moos, 2007; Kaskutas, Bond, &
Humphreys, 2002).
Increases in recovery capital can spark turning points that end
addiction careers, trigger recovery initiation, elevate coping abilities,
and enhance quality of life in long-term recovery (Cloud & Granfield,
in press; Laudet, Morgan, & White, 2006).
Such turning points, both as climactic transformations and
incremental change processes, may require the accumulation of
recovery capital across several years and multiple episodes of
professional treatments (Dennis, Foss, & Scott, 2007).
Elements of recovery capital vary in importance within particular
stages of long-term recovery (Laudet & White, in press).
Recovery capital is not equally distributed across individuals and
social groups. Members of historically disempowered groups often
seek recovery from addiction lacking assets that are taken for granted
by those seeking recovery from a position of privilege (Cloud &
Granfield, 2001).
Post-treatment recovery check-ups, and, when needed, early re-
intervention can help preserve the recovery capital developed through
addiction treatment (Dennis, Scott, & Funk, 2003).
Most clients with severely depleted family and community recovery
capital gain little from individually-focused addiction treatment that
fails to mobilize family and community resources (Moos & Moos,
Long-term recovery outcomes for those with the most severe AOD
problems may have more to do with family and community recovery
capital than the attributes of individuals or a particular treatment
protocol (Bromet & Moos, 1977; Humphreys, Moos, & Cohen, 1997;
Mankowski, Humphreys, & Moos, 2001).
Science is confirming what front-line addiction professionals have
long known: “environmental factors can augment or nullify the short-term
influence of an intervention” (Moos, 2003, p. 3). This suggests that
therapeutic processes in addiction treatment must encompass more than a
strictly clinical intervention (Simpson, 2004). Strategies that target family
and community recovery capital can elevate long-term recovery outcomes as
well as elevate the quality of life of individuals and families in long-term
recovery (White, in press/b).
Recovery Capital and Clinical Practice
Heightened attention to recovery capital can significantly influence
one’s service delivery practices. The following prescriptions reflect such
1. Support screening and brief intervention (SBI) programs that reach
people before their recovery capital is depleted and substance use disorders
have become severe, complex, and chronic (Cloud & Granfield, 1994a).
SBI programs are sometimes viewed as tools of case finding and induction
for addiction treatment, but their greatest value is in helping people resolve
AOD problems using personal, family, and community resources before
specialty-sector professional treatment is needed. To achieve such a goal,
we must all become students of the processes through which AOD problems
in the larger community are resolved.
2. Engage people with low recovery capital through aggressive
programs of community outreach. “Hitting bottom” only has meaning when
there is still personally meaningful recovery capital to be lost. When
recovery capital is exhausted, people will die before such a mythical bottom
is reached. The obstacle to recovery under such conditions is not
insufficient pain, but the absence of hope, connectedness, and potential for
fulfillment. People with severely depleted RC have unfathomable
capacities for physical and psychological pain. We must go get people with
high problem severity and extremely low recovery capital rather than wait
for their pain or coercive institutions to bring them to us. The catalytic
turning point for those with depleted recovery capital is more likely to be
one of seeing an achievable top than hitting bottom.
3. Assess recovery capital on an ongoing basis. Traditional
assessment technologies in addiction treatment are distinctly pathology-
focused. Addiction professionals have been trained to employ assessment
instruments and interview protocols to generate a problems list that forms
the basis of treatment planning activities. Growing evidence on the role of
recovery capital in AOD problem resolution calls for a more strengths-based
approach to the assessment process. The fact that recovery capital ebbs and
flows through both addiction and recovery careers also calls for a continual
assessment process that can identify subtle but crucial shifts in recovery
assets. The AOD cessation capacity of each individual at a particular point
in time might well be thought of as the interaction between problem severity
and recovery capital.
4. Use recovery capital levels to help determine level of care
placement decisions.
Traditional placement models link problem severity and intensity of care.
Those with high problem severity and complexity are placed in the most
restrictive levels of care, e.g. inpatient and residential programs, and are
provided the longest course of professional care. This formula misses the
crucial influence on recovery capital. The figure below illustrates four
potential interactions between problem severity/complexity and recovery
capital (Figure and discussion abstracted from White, in press/a).
Figure 1: Recovery Capital / Problem Severity Matrix
High Recovery Capital
High Problem Severity
/ Complexity
Problem Severity /
Low Recovery Capital
Factoring in the unique combination of a client’s problem severity can
alter placement decisions.
A client with moderate problem severity but high recovery capital
arriving at a treatment agency in response to a positive drug test might
be quite appropriate for screening and brief intervention. Such
individuals often terminate addictions on their first attempt without
professional or peer assistance and without embracing an
addiction/recovery-based personal identity (Granfield & Cloud, 1996;
Cloud & Granfield, 1994b). They can also often be helped through
non-specialty helping institutions, culturally indigenous support
institutions (e.g., cultural revitalization movements), or from peer-
based recovery support groups without facing the cost, life disruption
or stigma associated with addiction treatment (Cloud & Granfield,
1994a,b). This same individual with multiple risk factors (e.g., family
history, early onset of use, etc.) might be appropriate for SBI followed
by periodic recovery check-ups as a means of lowering the risks for
future problem escalation.
A client with high problem severity and complexity but exceptionally
high recovery capital might be appropriate for outpatient
detoxification and outpatient treatment despite a level of problem
severity that, viewed in isolation, would justify inpatient care.
Assertive linkage to recovery mutual aid groups in tandem with
motivational interviewing and ongoing recovery check-ups might well
serve as an alternative to inpatient or residential treatment.
A client with low problem severity but high risk factors and extremely
low recovery capital might be in greater need of residential treatment
and step down care than the above profiled clients, even though he or
she is likely to end up with SBI or outpatient treatment within current
assessment and placement systems.
A client with high problem severity/complexity and extremely low
recovery capital requires services of high intensity, broad scope (e.g.,
outreach, assertive case management, and sustained recovery
coaching), and long duration (Cloud & Granfield, 2001, 2004; White,
in press,a). Providing such clients brief treatment isolated from their
natural environment and then “graduating” them into that same
environment without substantial community-based supports is a set-up
for failure. Clients from historically disempowered communities are
often punished (e.g., lost custody of children, incarceration) following
such “failures” on the grounds that they “had their chance” (White &
Sanders, in press).
5. Target all three spheres of recovery capital within professionally-
directed treatment plans and client-directed recovery plans. The question is:
What resources need to be mobilized within the individual, the family/social
milieu, and the community to support the long-term recovery of each client?
The Native American Wellbriety movement uses the metaphor of the
“healing forest” to underscore the inextricable link between personal, family,
and community health. Treatment and recovery plans that reflect this
understanding include interventions to elevate family and community
recovery capital and assertively link clients and families to other individuals,
families, and community institutions rich in recovery capital.
6. Support recovery-linked cultural revitalization and community
development movements. One of the ways addiction professionals can
increase the recovery capital of the individuals and families they serve is to
actively support local movements aimed at increasing recovery support
services and creating a community milieu within which recovery can
flourish. Such support could include serving on the board of a recovery
community organization, volunteering at a recovery support center,
encouraging those seeking to start a new recovery support group,
participating in recovery education or recovery celebration events, and
providing financial contributions to help promote and conduct such events.
7. Use changes in levels of recovery capital to evaluate your program
and your own professional performance. The most effective addiction
treatment programs help build community recovery capital beyond their own
service programs. This can be done by regularly assessing aggregate
community recovery capital, issuing a periodic report card on community
recovery resources, and by allocating organizational resources to support
recovery community development activities. If non-treatment community
recovery capital decreases in tandem with the growth of treatment services,
the community is being inadvertently wounded by treatment expansion. One
of the best ways to assess the impact of treatment resources is to evaluate
whether they generate long-term increases or decreases in community
recovery capital.
At a personal level, we tend to evaluate our effectiveness based on
what is subtracted from the lives of our clients (e.g., AOD use, criminal
activity, threats to public safety, financial problems, high health care
consumption, and emotional distress). But the short-term elimination or
reduction of these ingredients may or may not have any linkage to the
prospects of long-term recovery. A better predictor of long-term recovery
may be what has been added to the lives of the individuals and families with
whom we work, e.g., radically altered perceptions of alcohol and other
drugs, physical and emotional health, increased coping and communication
skills, improved family relationships, new family rules and rituals,
safe/stable housing and employment; clean and sober friends, membership in
a community of recovering people, and life meaning and purpose.
The concept of recovery capital reflects a shift in focus from the
pathology of addiction to a focus on the internal and external assets required
to initiate and sustain long-term recovery from alcohol and other drug
problems. As this concept permeates the field, addiction treatment programs
will increase their involvement with families and communities, and
addiction professionals will become more involved in recovery community
building activities. Recovery capital has a contagious quality. It is time we
all became its carriers.
About the Authors: William White ( is Senior
Research Consultant at Chestnut Health Systems and author of Slaying the
Dragon: The History of Addiction Treatment and Recovery in America.
William Cloud is Professor at the Graduate School of Social Work,
University of Denver. Much of his teaching, research, and writing has been
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... Drawing on four broad domains of recovery capital, we synthesized and organized our findings according to physical, human, social/family, and community/cultural capital (Cloud & Granfield, 2008;White & Cloud, 2008). Physical capital encompasses physical health and financial or material resources, including having basic needs met. ...
... Another participant emphasized the important influence of community dynamics on long-term wellbeing, noting that, "We're all going to be around each other for the rest of our lives, so what's the point of trying to judge someone?" Turning Points White and Cloud (2008) describe "turning points" on the path to recovery, during which there is an accumulation of recovery capital that catalyzes significant positive change in an individual's life. Within the context of this study, participants' accumulation of recovery capital seemed to translate into tangible change across several areas of their lives. ...
... Across domains of recovery capital, participants often discussed the quality of their relationships, ranging from appreciation for the kindness and support of assessment staff to the tensions and evolving relationships that exist within their families, social networks, and broader community. These results speak to the importance of creating social connections that align with an individual's needs and priorities and that are supportive and conducive to recovery and healing (White & Cloud 2008). The emphasis on interpersonal connection and support was especially apparent in participant discussions of their program mentors, which builds on evidence of the importance of relational approaches to FASD work within Indigenous communities (Pei et al., 2019a). ...
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Individuals with fetal alcohol spectrum disorder (FASD) can experience multiple layers of adversity that increase vulnerability to justice involvement. Given the systemic overrepresentation of Indigenous Peoples in the justice system, community-based interventions are important for supporting Indigenous individuals with FASD who are justice-involved, yet little is known about individual experiences with such interventions. In this community-based study, we conducted interviews with 12 adults in an FASD-informed Indigenous justice program, revealing stories of coping, growth, and hope. Findings suggest that blending FASD assessment with restorative justice approaches can contribute to physical, human, family/social, and community/cultural resources that support wellbeing. We describe tangible strengths and processes to leverage in practice and policy for supporting justice-involved individuals with FASD across settings and communities.
... Signi cant associations were observed between personal RC and all HRQOL dimensions and between total RC and four HRQOL dimensions (excluding mobility). Personal RC includes mental and physical health and education/vocational skills [36,37]. ...
... Our nding is novel compared to previous researchers that reported signi cant associations between social RC and HRQOL [38,40, 64]. Social and personal RC are stronger predictors of long-term recovery, with high social RC regulating the impact of low personal RC [37]. Contrarily, using HRQOL as a proxy for long-term recovery, personal RC is a stronger predictor of long-term recovery, and social RC does not regulate the effect of low personal RC in our sample. ...
... RC comprises ve resources: social, personal, physical, community, and cultural [36]. However, social and personal RC may be stronger predictors of long-term recovery, with high social RC regulating the impact of low personal RC [37]. Social RC is the bene ts obtained from social networks and relationships that support recovery, including social support and social expectancies [36,37]. ...
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Background Recovery from opioid use disorder (OUD) includes improvements in health-related quality of life (HRQOL) and is supported by recovery capital (RC). Little is known about RC and HRQoL among recovery residents taking medication for OUD (MOUD). Methods Cross-sectional analyses of data collected from 355 residents in 14 recovery homes were conducted. We described HRQOL (EQ-5D-5L health dimensions- mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and RC (the Assessment of Recovery Capital scores) and examined their associations using T-, Chi-squared, and Fisher's exact tests. Results Most participants were 35 + years (50.7%), male (58.9%), non-Hispanic White (68.4%), heterosexual (82.8%), and unemployed (66.0%). The majority reported anxiety/depression (78.4%) and pain/discomfort (55.7%) problems. Most participants had high social (65.4%), personal (69.0%), and total (65.6%) RC. Age, sex, marital status, sexual orientation, and comorbid diagnoses were associated with HRQOL. Low personal RC was associated with mobility problems (aOR = 0.43, CI = 0.24–0.76). Low personal (aOR = 0.13, CI = 0.04–0.41) and total (aOR = 0.20, CI = 0.07–0.60) RC were associated with problems conducting self-care. Low personal (aOR = 0.25, CI = 0.11–0.57) and total (aOR = 0.43, CI = 0.22–0.83) RC were associated with problems conducting usual activities. Low personal (aOR = 0.37, CI = 0.20–0.68) and total (aOR = 0.55, CI = 0.34–0.90) RC were associated with pain/discomfort problems. Low personal (aOR = 0.33, CI = 0.15–0.73) and total (aOR = 0.20, CI = 0.10–0.41) RC were associated with anxiety/depression problems. Social RC was not associated with HRQOL. Conclusions Personal and total RC predict HRQOL. Our findings underscore the importance of ensuring residents are not only linked to MOUD but their RC should be routinely assessed and enhanced to support their recovery and improve HRQOL.
... Central to the RC theory is the notion that more RC and fewer recovery barriers and unmet needs lead to better recovery outcomes, in comparison with less RC and more barriers and unmet needs (Best and Hennessy 2022); therefore, targeting recovery strengths and barriers can be used to support recovery journeys. The precise composition of these resources and capacities remains largely untested and differ across conceptual models, specifically how they should be categorized into distinct 'domains', determining which ones are most crucial for specific populations (Best and Hennessy 2022), and whether a negative component should be included in the model (Cloud and Granfield 2008;White and Cloud 2008;Best and Laudet 2010). Commonly, the resources and capacities have been categorized across three main levels: a) an individual level (personal RC), b) an inter-individual level (social RC), and c) a broader environmental level (community RC) (Hennessy 2017). ...
... The 36-item RCQ (Burns and Marks 2013; 2019; Burns and Yates 2022) was developed for practical use based on the models by Cloud and Granfield (2008) and White and Cloud (2008). The questionnaire has four subdomains measuring social, physical, human, and community RC. ...
... The RSQ (Rettie et al. 2019) was developed based on the model by White and Cloud (2008). The measure has two subdomains: 'external strengths' and 'within-group strengths'. ...
... While all RC domains were represented in our cases, mentions of human (N)RC were particularly present in the case files and patient's recovery goals. The case files mainly reported on negative human RC, which is in line with the scientific literature describing individuals with MBID, SUD, and/or psychiatric comorbid disorders as a vulnerable, at-risk population [13,18,23]. As such, these enumerations of negative human RC could be seen as a typical example of the risks and vulnerabilities this population faces. ...
... By considering the areas of concern and strengths that individuals bring to SUD treatment, personalized care can be provided. For example, the recovery capital/problem severity matrix, as proposed by White and Cloud [23], takes into account the complexity and severity of problems as well as the level of available recovery capital, in order to determine the optimal level of care. Such approaches facilitate that treatment plans aligns with each individual's unique needs and resources, maximizing the likelihood of successful recovery. ...
Full-text available
Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce. This study offers an initial exploration of the viability of (N)RC in three individuals with SUD, psychiatric comorbidities, and an intellectual disability (a triple diagnosis) in inpatient addiction treatment. We collected case file data, ranked recovery goals, and conducted follow-up interviews. The data were subjected to template analysis, using (N)RC domains as codes. All domains were prevalent and relevant, showing dynamic and reciprocal effects, influenced by critical life events acting as catalysts. Notably, during treatment, patients prioritized individual skill development despite challenges in other domains. RC emerges as a valuable concept for mapping recovery barriers and facilitators in individuals with a triple diagnosis, serving as an alternative to the medical model and complementing the biopsychosocial model. It provides a systematic framework to assess critical factors for recovery in complex cases and accordingly align interventions. Future studies should explore the intersections of NRC domains and the dynamic nature of (N)RC to enhance the understanding of the challenges faced by individuals with a triple diagnosis.
... Original domains of recovery capital resources included: physical/financial, human and social [34]. However, expanded models of recovery capital propose domains of cultural [35], community, family, personal [36], growth [37] and health [38]. An assessment of recovery from addictive disorders should consider more than changes in consumption, and the presence of observable condition-related consequences [39]. ...
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Issues: Consideration of an individual's quality of life (QoL) can benefit assessment and treatment of addictive disorders, however, uncertainty remains over operationalisation of the construct as an outcome and the appropriateness of existing measures for these populations. This systematic review aimed to identify and evaluate QoL and health-related QoL outcome instruments used in addiction-related risk and harm research and map their conceptualised domains. Approach: Three electronic databases and a specialised assessment library were searched on 1 February 2022 for QoL or health-related QoL outcome instruments used with addiction-related risk and harm populations. PRISMA reporting guidance was followed and included outcome instruments were appraised using mixed methods. Psychometric evidence supporting their use was summarised. The COSMIN risk of bias tool was used to assess validation studies. Key findings: A total of 298 articles (330 studies) used 53 outcome instruments and 41 unique domains of QoL. Eleven instruments' psychometric properties were evaluated. No instrument was assessed for any parameter in at least five studies for meta-analytic pooling. Cronbach's alpha (α) internal consistency was the most widely assessed parameter with the AQoLS, WHOQOL-BREF, ALQoL-9, Q-LES-Q-SF, SF-12, DUQoL, QLI and SF-36 displaying promising statistics (α > 0.70). Implications and conclusion: Many instruments have been utilised. However, a significant proportion of studies applied a small number of instruments with minimal high-quality validation evidence supporting their use within addiction-related risk and harm. Promising instruments are recommended, however, the paucity of supporting evidence limits confidence in the reliability and validity of QoL measurement in these populations.
... However, apart from one SP which proposed workforce training as a means to implementing trauma-informed practice, no other SPs explained how trauma-informed practice would be implemented and by whom. Since many studies have shown an association between lower socioeconomic position and increased risk of traumatic events (48), a range of interventions to tackle underlying health inequalities, including stigma as a reinforcer of health inequalities (49), is likely to be required, as well as unconscious bias that health professionals may have towards PWSUDs which can lead to behaviours which exacerbate trauma (50). ...
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Background Stigma is a significant barrier to the successful implementation of public health policies which aim to reduce harm from substance use disorders. Despite attention being given to stigma in the literature for at least a decade, evidence on what works to reduce it is limited and inconclusive. Without clear guidance, policymakers could be limited in their ability to develop evidence-informed strategies for reducing stigma. In response to a steep incline in drug-related deaths in Scotland since 1996, the Scottish Government has committed to tackling stigma in national drug policy. Scotland’s 31 Alcohol and Drug Partnerships are responsible for developing local strategies that aim to tackle harm from substance use disorders. This qualitative review explored how well these strategies respond to stigma and identified approaches mentioned that could have implicit implications for tackling stigma. Methods The strategic plans of Alcohol and Drug Partnerships across Scotland were identified and thematically analysed to identify key themes relating to stigma. Content of strategic plans was initially coded under a coding scheme of four broad categories: content that explicitly mentioned stigma; identity, status and power; deservedness of support; and attribution of responsibility for SUDs. Results Twenty-four strategic plans were identified and analysed, with four themes emerging: (1) limited clarity and consistency on how stigma will be directly tackled by ADPs; (2) recognition of the positive contribution that people with substance use disorders can make towards decisions about treatment and support; (3) diversion of people with substance use disorders away from the criminal justice system towards quality support underpinned by human rights; and (4) recognition of the complex determinants of substance use disorders and that everyone has a role to play. Conclusion Alcohol and Drug Partnerships acknowledged the importance of tackling stigma in their strategic plans but provide limited clarity on how this will be done. This review calls for the inclusion of more evidence-informed strategies for tackling stigma within the Scottish local policymaking context. This requires academic, policymaking and lived experience communities to collaborate to test and evaluate innovative responses to tackling in stigma to strengthen understanding of what works in which contexts.
... Thus, SRC facilitates an individual to bond with their family and others in their community, and, in turn, these bonds lead to accessing further resources through one's network. White and Cloud (2008) further suggested that evidence of SRC in one's network is indicated by several social factors including the 'willingness of intimate partners and family members to participate in treatment, the presence of others in recovery within the family and social network, access to sober outlets for sobriety-based fellowship/leisure, and relational connections to conventional institutions' (p. 2). ...
Este artículo de reflexión explora los tipos predominantes de relacionamiento propios de las esferas de la vida pública y privada, características de las sociedades altamente diferenciadas y desiguales o post-tradicionales. La racionalidad funcional preside jerárquicamente la esfera 1 El término post-tradicional lo acuñó Anthony Giddens para referir el contexto cultural de la modernidad tardía, en el cual la tradición pierde su función ordenadora de la vida social, con lo cual los individuos ganan espacios para asumir reflexivamente el mundo social al cual pertenecen. De esa manera, adquieren mayor discrecionalidad para tomar decisiones sobre cómo actuar y lo que quieren hacer con sus vidas. En el pensamien-to de Giddens, la cultura post-tradicional lleva al individuo a comprender su propia identidad como una narrativa biográfica que se construye activa y reflexivamente a lo largo de la vida; cada cual es responsable de su propia identidad. Ver Anthony Giddens. Modernity and self-identity: Self and society in the late modern age, Stanford, Stanford University Press, 1991.
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Este artículo de reflexión explora los tipos predominantes de relacionamiento propios de las esferas de la vida pública y privada, características de las sociedades altamente diferenciadas y desiguales o post-tradicionales. La racionalidad funcional preside jerárquicamente la esfera 1 El término post-tradicional lo acuñó Anthony Giddens para referir el contexto cultural de la modernidad tardía, en el cual la tradición pierde su función ordenadora de la vida social, con lo cual los individuos ganan espacios para asumir reflexivamente el mundo social al cual pertenecen. De esa manera, adquieren mayor discrecionalidad para tomar decisiones sobre cómo actuar y lo que quieren hacer con sus vidas. En el pensamien-to de Giddens, la cultura post-tradicional lleva al individuo a comprender su propia identidad como una narrativa biográfica que se construye activa y reflexivamente a lo largo de la vida; cada cual es responsable de su propia identidad. Ver Anthony Giddens. Modernity and self-identity: Self and society in the late modern age, Stanford, Stanford University Press, 1991.
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Despite the widely accepted view that formal treatment and twelve-step groups are essential for overcoming dependencies on alcohol and drugs, each year large numbers of former addicts quietly recover on their own, without any formal treatment or participation in self-help groups at all. Coming Clean explores the untold stories of untreated addicts who have recovered from a lifestyle of excessive and compulsive substance use without professional assistance. Based on 46 in-depth interviews with formerly addicted individuals, this controversial volume examines their reasons for avoiding treatment, the strategies they employed to break away from their dependencies, the circumstances that facilitated untreated recovery, and the implications of recovery without treatment for treatment professionals as well as for prevention and drug policy. Because of the pervasive belief that addiction is a disease requiring formal intervention, few training programs for physicians, social workers, psychologists, and other health professionals explore the phenomenon of natural recovery from addiction. Coming Clean offers insights for treatment professionals of how recovery without treatment can work and how candidates for this approach can be identified. A detailed appendix outlines specific strategies which will be of interest to addicted individuals themselves who wish to attempt the process of recovery without treatment.
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Communities of color have been ill-served by acute care models of treating severe alcohol and other drug (AOD) problems that define the source of these problems in idiopathic (biopsychological) terms and promote their resolution via crisis-elicited episodes of brief, individual interventions. This article explores how approaches that shift the model of intervention from acute care (AC) of individuals to a sustained recovery management (RM) partnership with individuals, families, and communities may be particularly viable for historically disempowered peoples. The advantages of the RM model for communities of color include: a broadened perspective on the etiological roots of AOD problems (including historical/cultural trauma); a focus on building vibrant cultures of recovery within which individual recoveries can be anchored and nourished; a proactive, hope-based approach to recovery engagement; the inclusion of indigenous healers and institutions with the RM team; an expanded menu of recovery support services; culturally grounded catalytic metaphors and rituals; and a culturally-nuanced approach to research and evaluation.
There is an unknown but very large number of individuals who have experienced and successfully resolved dependence on alcohol or other drugs. These individuals refer to their new sober and productive lifestyle as “recovery.” Although widely used, the lack of a standard definition for this term has hindered public understanding and research on the topic that might foster more and better recovery-oriented interventions. To this end, a group of interested researchers, treatment providers, recovery advocates, and policymakers was convened by the Betty Ford Institute to develop an initial definition of recovery as a starting point for better communication, research, and public understanding. Recovery is defined in this article as a voluntarily maintained lifestyle composed characterized by sobriety, personal health, and citizenship. This article presents the operational definitions, rationales, and research implications for each of the three elements of this definition.
The literature on cessation of drug and alcohol dependency without benefit of treatment or participation in self-help groups spans nearly forty years. While this literature is substantial and analyses of the processes of natural recovery well-developed, discussions directed at treatment providers around the value of these analyses for practice has been sparse. Drawing on our study as well as the research of others, this paper explores two dimensions of natural recovery that hold important implications for treatment providers who work with substance dependent clients. These include the common strategies used by remitters and the concept of recovery capital as a way to capture the embeddedness of these natural recovery strategies within a unique structural context of personal attributes and social environments.
Examined the characteristics of middle-class alcoholics and drug addicts who terminated their addictions without the benefit of treatment. Using what is commonly referred to as natural recovery processes, respondents terminated their addictions without formal treatment or self-help group assistance. Data for this study were based on in-depth interviews with 46 alcoholics and drug addicts. The postaddict identities of the Ss were examined to see how they viewed themselves in relation to their addictive past. Their reasons for avoiding treatment and self-help groups were also explored, as were factors in the Ss' lives that promoted natural recovery. Relevance for clinical treatment and social policy are examined. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The majority of people presenting for publicly-funded substance abuse treatment relapse and receive multiple episodes of care before achieving long-term recovery. This Early Re-Intervention experiment evaluates the impact of a Recovery Management Checkup (RMC) protocol that includes quarterly recovery management checkups (assessments, motivational interviewing, and linkage to treatment re-entry). Data are from 448 adults who were randomly assigned to either RMC or an attention (assessment only) control group. Participants were 59% female, 85% African American, and 75% aged 30–49. Participants assigned to RMC were significantly more likely than those in the control group to return to treatment, to return to treatment sooner, and to spend more subsequent days in treatment; they were significantly less likely to be in need of additional treatment at 24 months. This demonstrates the importance of post-discharge recovery management checkups as a means to improve the long-term outcomes of people with chronic substance use disorders.