Nady El-Guebaly1. 1. Addiction Division, Department of Psychiatry, University of Calgary, Calgary, AB, Canada. nady.el-guebaly@albertahealthservices.ca
Abstract
OBJECTIVE: To review the evolution of the paradigm of recovery in addiction and its implications. METHOD: A systematic literature review was conducted using the MEDLINE and PsychInfo databases over the past 10 years and key references from the retrieved literature. FINDINGS: The historical evolution of the concept of recovery has been shaped by several driving forces, including consumer experience, the need to better define our treatment outcome and parallel elaboration of the concepts of health, quality of life, and chronic disorders. Similarities and differences with the concept of "recovery" in mental health and other biomedical fields are identified.The empirical basis is growing in support of various proposed attributions and features of recovery along with the temporal benchmarks involved. The various forms of recovery, such as "natural," "transformational," or "medication-assisted," describe a choice of pathways to a common goal.The management implications are far-reaching and call for system shifts from acute stabilization to sustained recovery, including the growth of alternative institutions, and roles complementary to mutual help. Tools for the sustenance of recovery, including educational kits, recovery workbooks, and e-recovery initiatives, are developing. CONCLUSIONS: Although first-person accounts of recovery abound, a more systematic empirical investigation of the concept has just begun, including demographic and cultural differences. Management implications are derived from the experience with other "mainstream" chronic disorders with treatment providing stabilization and initiation of recovery and a range of long-term resources becoming available to sustain it.
OBJECTIVE: To review the evolution of the paradigm of recovery in addiction and its implications. METHOD: A systematic literature review was conducted using the MEDLINE and PsychInfo databases over the past 10 years and key references from the retrieved literature. FINDINGS: The historical evolution of the concept of recovery has been shaped by several driving forces, including consumer experience, the need to better define our treatment outcome and parallel elaboration of the concepts of health, quality of life, and chronic disorders. Similarities and differences with the concept of "recovery" in mental health and other biomedical fields are identified.The empirical basis is growing in support of various proposed attributions and features of recovery along with the temporal benchmarks involved. The various forms of recovery, such as "natural," "transformational," or "medication-assisted," describe a choice of pathways to a common goal.The management implications are far-reaching and call for system shifts from acute stabilization to sustained recovery, including the growth of alternative institutions, and roles complementary to mutual help. Tools for the sustenance of recovery, including educational kits, recovery workbooks, and e-recovery initiatives, are developing. CONCLUSIONS: Although first-person accounts of recovery abound, a more systematic empirical investigation of the concept has just begun, including demographic and cultural differences. Management implications are derived from the experience with other "mainstream" chronic disorders with treatment providing stabilization and initiation of recovery and a range of long-term resources becoming available to sustain it.
Authors: Enrico G Castillo; Bowen Chung; Elizabeth Bromley; Sheryl H Kataoka; Joel T Braslow; Susan M Essock; Alexander S Young; Jared M Greenberg; Jeanne Miranda; Lisa B Dixon; Kenneth B Wells Journal: Harv Rev Psychiatry Date: 2018 Mar/Apr Impact factor: 3.732