Long Term Recovery From Substance Use

This cross-Europe analysis explores crucial aspects of long term recovery from substance use. Leading experts set out the evolving needs of people who have sought to change their use of substances and the factors in their progress. The book concludes with clear recommendations for improving future research, policy and practice.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

In this much-needed text, leading international experts explore crucial aspects of people’s experience of long-term recovery from substance use. Centred around the voices of people who use substances, the book examines the complex and continuing needs of people who have sought to change their use of substances, investigating the ways in which personal characteristics and social and systemic factors intersect to influence the lives of people in long-term recovery. With perspectives from Sweden, Norway, Germany, Belgium, Iceland and the United Kingdom, it also considers the role and needs of family members, and puts forward clear recommendations for improving future research, policy and practice.

In February 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore options for expanding the Substance Abuse and Mental Health Services Administration's (SAMHSA) behavioral health data collections to include measures of recovery from substance use and mental disorder. Participants discussed options for collecting data and producing estimates of recovery from substance use and mental disorders, including available measures and associated possible data collection mechanisms. This publication summarizes the presentations and discussions from the workshop.

Six guiding principles key to lasting recovery from addiction to alcohol and other drugs. Why they’re important, how they relate to the Twelve Steps, and why they work. Anyone who has recovered from addiction to drugs or alcohol knows that getting sober is only the beginning. Working the Steps, patching life back together, and living sober are where the real work lies. While the Twelve Steps provide a program of lifelong recovery, recovery experts Sterling Shumway and Thomas Kimball have identified six essential values, or principles, that reinforce the Steps and that are key to achieving lasting recovery:Hope: A reawakening after despair; to live with greater confidenceHealthy Coping Skills: Managing the pain and stress of lifeSense of Achievement and Accomplishment: Moving beyond the limits of addiction toward personal goalsCapacity for Meaningful Relationships: The positive support and connection with family and peersUnique Identity Development: The emergence of a unique positive identityReclamation of Agency: The internal knowledge that you have choices in your behaviorUsing their research, personal stories, and guided journals and exercises, Shumway and Kimball thoroughly unlock these complex principles for recovering addicts and their families, and provide practical steps for applying them to a long-term recovery program.

We live in an era of substance misuse colliding with public health shortcomings. Consequences of mass incarceration and other racial disparities of the "drug war" are felt acutely in the neighborhoods and communities least equipped to deal with them. More than 600,000 people are released from US prisons each year; nearly two-thirds of returning citizens have a substance use disorder (SUD) and have limited access to treatment. Even among the general public, only one in ten people with SUD receive any type of specialty treatment. Community organizations make important contributions to improve access and help to heal these societal fractures. Using a social ecology of resilience model, Addiction Recovery and Resilience is a yearslong ethnographic case study of a faith-based health organization with a focus on long-term recovery. It explores the organization's triumphs and missteps as it has worked to respond to the opioid crisis and improve the health of affiliates and the neighborhood for nearly twenty years. Addiction Recovery and Resilience concludes with best practices for individual, organizational, and community health and public policy at a time when nontraditional health care providers are increasingly important.

Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the “disease model” of addiction is wrong and illuminates the path to recovery. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease, based on evidence that brains change with drug use. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it’s supposed to do—seek pleasure and relief—in a world that’s not cooperating. Brains are designed to restructure themselves with normal learning and development, but this process is accelerated in addiction when highly attractive rewards are pursued repeatedly. Lewis shows why treatment based on the disease model so often fails, and how treatment can be retooled to achieve lasting recovery, given the realities of brain plasticity. Combining intimate human stories with clearly rendered scientific explanation, The Biology of Desire is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.