First-of-its kind survey begins to measure the effect of recovery

life_surveyResearchers have been investigating addiction for decades. What causes addiction? What is its impact on society? How many Americans are battling addiction?  How do we treat it?

But when it comes to the effect of recovery from addiction, research has been noticeably absent.

As the first step toward bridging this gap, Faces and Voices of Recovery (FAVOR), a nonprofit organization that advocates for public action and works to promote recovery, released the results last month from the first-ever nationwide survey looking at the effects of recovery over time.

“Because of healthcare’s focus on the causes and costs of substance use disorder, combined with widespread social disapproval of addicts, the research community has largely ignored the many success stories,” Michael Dahr writes for The Fix.

The study was overseen by Dr. Alexandre Laudet, an internationally recognized expert in addiction recovery and longtime advocate for building the science of recovery.

According to FAVOR, there are over 23 million Americans in recovery from addiction. The report, “Life in Recovery,” attempts to measure and quantify the effects of recovery over time and highlights the need to remove discriminatory barriers to it.

Results show dramatic improvements associated with recovery that affect all areas of life, including:

  • A ten-fold decrease in involvement with the criminal justice system and use of costly emergency room departments
  • Steady employment increased by over 50 percent relative to active addiction
  • Financial problems such as debt and bankruptcy were reduced by 50 percent
  • Over 80 percent of people in recovery paid taxes, compared to just more than half in active addiction
  • A 50 percent increase in participation in family activities
  • Domestic violence dropped from over 40 percent down to 10 percent
  • Two-thirds of those in active addiction had untreated mental health problems, but those numbers decreased by a factor of more than four with recovery
Source: FAVOR's "Life in Recovery"

Source: FAVOR’s “Life in Recovery

“These findings underline the fact that recovery is good not only for the individual, but also for families, communities, and the nation’s health economy,” the report concludes.

“It’s time to take action to end discrimination facing people in or seeking recovery from addiction,” former Congressman Patrick Kennedy said in a statement. “As this survey from Faces & Voices documents, recovery benefits everyone.”

Faces & Voices Board chair Dona Dmitrovic said the survey provides evidence, for the first time ever, that investing in recovery makes sense.

The study also found that discriminatory practices in housing, employment, health insurance coverage and elsewhere remain tremendous barriers to recovery. FAVOR advocates for action against these barriers.

“We call on states and the Congress to reform drug policy by addressing and removing discriminatory barriers; ensuring access to and financing for a full range of health care and other services to support Americans in initiating and sustaining their recovery; and to invest in research to identify quality and cost-effective recovery-promoting policies and practices,” Dmitrovic said.

Research limitations and challenges

This report represents a first step toward understanding the nature of long-term recovery and clearly has significant limitations.

Of the of limitations noted by Laudet, the most apparent is the likelihood that the survey population does not adequately represent the nation’s recovery population. The survey was conducted exclusively online over a relatively short period (two months) and racial minorities are underrepresented, as are individuals without a college education or who are unemployed.

Another potential limitation of this survey centers on reporting bias—namely, the possibility that respondents over-reported negative experiences in active addiction and/or positive ones in recovery. The study also failed to differentiate responses by substance.

“The failure of a celebrity to achieve stable recovery garners great cultural attention, while the masses of those in long-term recovery pass invisibly through our culture each day.”

In a review of 415 scientific studies of recovery outcomes published last March William White highlighted the challenges of conducting research studies on recovery and of drawing conclusions based on evidence from these studies.

“Efforts to measure recovery are challenged by the lack of professional and cultural consensus on the definition and measurement of key constructs (recovery, remission, abstinence, and subclinical/asymptomatic/controlled/moderate use) and by conflicting rates of recovery–rates reported across clinically and culturally diverse populations in studies marked by widely varying methodologies, follow-up periods, and follow-up rates.”

In short, so many divergent portrayals of “recovery,” often results in an “apples and oranges” comparison.

This is not, however, reason to shrug our shoulders and leave the question blank.

There are grave consequences, White argues, to disregarding the effects of recovery and focusing instead on the effects of addiction:  “The pessimism flowing from such selective attention feeds misunderstanding and fuels stigma and its far-reaching consequences.”

And popular media has primarily muddied the waters.

“The constant media onslaught of celebrities heading back to ‘rehab’ after their latest falls from grace has produced a public unsure of exactly what ‘recovery’ means and whether it is really attainable for all,” White observed.

“The failure of a celebrity to achieve stable recovery garners great cultural attention, while the masses of those in long-term recovery pass invisibly through our culture each day.”