Research by William L. White from the special "Recovery" issue of the Journal of Substance Abuse Treatment. The addiction field's failure to achieve consensus on a definition of “recovery” from severe and persistent alcohol and other drug problems undermines clinical research, compromises clinical practice, and muddles the field's communications to service constituents, allied service professionals, the public, and policymakers. This essay discusses 10 questions critical to the achievement of such a definition and offers a working definition of recovery that attempts to meet the criteria of precision, inclusiveness, exclusiveness, measurability, acceptability, and simplicity. The key questions explore who has professional and cultural authority to define recovery, the defining ingredients of recovery, the boundaries (scope and depth) of recovery, and temporal benchmarks of recovery (when recovery begins and ends). The process of defining recovery touches on some of the most controversial issues within the addictions field. J Subst Abuse Treat 2007; 33: 229-241.
This is the lead article in a special "Recovery" issue of the Journal of Substance Abuse Treatment that also includes four background papers and three commentaries on defining and measuring recovery. Recovery is defined with three elements–sobriety, personal health, and citizenship–with rationale and research implications for each. This landmark work is the consensus of a group of researchers, treatment providers, recovery advocates, and policymakers convened in 2006 by the Betty Ford Institute. J Subst Abuse Treat 2007; 33: 221-228.
Commentary by Congressman Jim Ramstad, Minnesota's third district, from the special "Recovery" issue of the Journal of Substance Abuse Treatment. J Subst Abuse Treat 2007; 33: 273.
Research by Alexandre Laudet Ph.D. from the special "Recovery" issue of the Journal of Substance Abuse Treatment. Recovery is a ubiquitous concept but remains poorly understood and ill defined, hindering the development of assessment tools necessary to evaluate treatment effectiveness. This study examines recovery definitions and experiences among persons who self-identify as “in recovery.” Two questions are addressed: (a) Does recovery require total abstinence from all drugs and alcohol? (b) Is recovery defined solely in terms of substance use or does it extend to other areas of functioning as well? Inner-city residents with resolved dependence to crack or heroin were interviewed yearly three times (N = 289). Most defined recovery as total abstinence. However, recovery goes well beyond abstinence; it is experienced as a bountiful “new life,” an ongoing process of growth, self-change, and reclaiming the self. Implications for clinical and assessment practice are discussed, including the need to effect paradigmatic shifts from pathology to wellness and from acute to continuing models. J Subst Abuse Treat 2007; 33: 243-256.
Commentary by Stuart Gitlow from the special "Recovery" issue of the Journal of Substance Abuse Treatment. J Subst Abuse Treat 2007; 33: 277-278.
Research by Marc Galanter published in the special "Recovery" issue of the Journal of Substance Abuse Treatment. Alcoholics Anonymous (AA) and other 12-step programs are widely employed in the addiction rehabilitation community. It is therefore important for researchers and clinicians to have a better understanding of how recovery from addiction takes place, in terms of psychological mechanisms associated with spiritual renewal. A program like AA is described here as a spiritual recovery movement, that is, one that effects compliance with its behavioral norms by engaging recruits in a social system that promotes new and transcendent meaning in their lives. The mechanisms underlying the attribution of new meaning in AA are considered by recourse to the models of positive psychology and social network support; both models have been found to be associated with constructive health outcomes in a variety of contexts. By drawing on available empirical research, it is possible to define the diagnosis of addiction and the criteria for recovery in spiritually oriented terms. J Subst Abuse Treat 2007; 33: 265-272.
The authors, Marc Galanter et. al., developed a six-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and demonstrated its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. Three treatment settings were used: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities. J Subst Abuse Treat 2007; 33: 257-264.
Commentary by Stephan Arndt and Pat Taylor from the special "Recovery" issue of the Journal of Substance Abuse Treatment. J Subst Abuse Treat 2007; 33: 275.