By OLIVIA PENNELLE
A new study shows potential for creating the optimum environment for sustainable recovery in the local community.
In this groundbreaking theoretical exercise, researchers Robert Ashford, Austin Brown, Rachel Ryding and Dr. Brenda Curtis evaluate whether individual recovery capital — social supports, spirituality, religion, life-meaning and mutual-aid groups — can be extended to a community setting, in an attempt to build more supportive communities.
It is these community-based resources that have shown to positively affect substance use disorder (SUD) and SUD recovery by directing stakeholders toward the problem and creating continuity among support services. And innovations within communities have proven to scale recovery efforts and improve the chances of sustained recovery for those living within such communities.
The timing of this research could not be better. The United States faces one of the largest social welfare and public health concerns of its time, with behavioral health disorders costing over $420 billion annually. Sadly, that is not the greatest cost: 88,000 people die from alcohol-related causes each year, and 64,000 die from drug-related causes. Globally, 31 million people suffer with SUD. Since 2001, there has been a 240 percent increase in opioid-related deaths, with the worldwide death toll from opioid-related reasons as high as 127,490.
Despite the staggering economic and social cost, less than 11 percent of the 24 million Americans with SUD received treatment. For those who do seek recovery, much of their success is attributed to the use of recovery capital. But just what is recovery capital?
According to writer and researcher William White, the concept of recovery capital was first introduced by Robert Granfield and William Cloud in a series of articles and a book, Coming Clean: Overcoming Addiction without Treatment.
“[The authors] define recovery capital as the volume of internal and external assets that can be brought to bear to initiate and sustain recovery from alcohol and other drug problems,” says White.
“Recovery capital, or recovery capacity, differs from individual to individual and differs within the same individual at multiple points in time,” he continues. “Recovery capital also interacts with problem severity to shape the intensity and duration of supports needed to achieve recovery. This interaction dictates the intensity or level of care one needs in terms of professional treatment and the intensity and duration of post-treatment recovery support services.”
This capital — or to put it more simply, support — is most successful when it’s part of a continuum of care model that is oriented toward recovery (known as a recovery-oriented system of care, or ROSC) within the community. These “wrap-around” systems of care support individuals in the recovery journey.
However, this model does have its limitations: “The ROSC model is focused on coordinating the current services and resources of a community and does not provide a framework or model for evaluating all of the components in a community that may improve the recovery process of individuals,” the study authors state. Those components include medical and specialist treatment, prevention services, harm reduction services, recovery support services, education, employment, peer services, house, recovery community organizations, mutual-aid organizations, re-entry support services, law and policy, and advocacy efforts.
In an attempt to build upon the ROSC model, researchers Ashford et al. approached the recovery process from a social-ecological perspective. They created a model that identifies assets to promote recovery success and assess gaps within the community that may impact recovery outcomes. Their concept — the Recovery Ready Ecosystems Model (RREM) — includes a framework that provides suggestions based on the availability and accessibility of community resources to increase the community’s ability to support the recovery process.
Figure 1 – Recovery Ready Ecosystems Model ROSC also considers the interplay between services and resources across different levels: individual, community, institutional and policy.
“It gives a functioning model for community elements that can be enacted in service of recovery in the broader area,” Brown says. “It provides a service model that can be adapted. I think the real value in it is that it offers a chance to begin testing how ‘recovery-oriented’ different ROSC models are. For collegiate recovery programs, this has implications for their work in the local community and their ties to community anchor points with partners and systems.”
The researchers suggest that the RREM builds on the work of ROSC, highlighting support structures such as harm reduction, education recovery programs and other traditional community support structures. It can be used in the community to assess needs and identify gaps in community supports. Although further testing of the way community recovery capital is quantified in the model is needed, the RREM provides a promising development to increase the success and longevity of recovery within communities.
Figure 2 – Recovery Ready Community Framework This research is supported by key stakeholders within recovery communities. Someone who knows all about building recovery communities is Brent Canode, executive director of the Alano Club of Portland and the innovator behind Alano’s Recovery Toolkit Series — a yearlong calendar of activities intended to help individuals in recovery gain the skills to support a long-term, self-directed recovery.
“Building recovery-ready communities is what we all should be driving toward, as advocates, policymakers and health professionals. That work must include the full continuum of supports, from harm reduction to abstinence-based recovery and every point in between. When I exited treatment 14 years ago, I was handed a list of local AA meetings,” he says.
He continues: “Increasingly, research suggests that instead of a one-size-fits-all approach to recovery, individuals are more likely to achieve and maintain long-term sobriety when they have access to a tailored and robust set of personal and community assets that enhance and sustain recovery capital and are essential to navigating stressors and situations that may lead to a return to use. While 12-step programs remain an important recovery tool, we now understand that a person-centered, strengths-based, community-involved strategy is much more likely to help recovering individuals stay that way, enjoying greater health, wellness and quality of life throughout their recovery journey.”
Writer and wellness advocate Olivia Pennelle (Liv) passionately believes in a fluid and holistic approach to recovery. Her popular site, Liv’s Recovery Kitchen, is a resource for the journey toward health and wellness. You will find Pennelle featured among top recovery writers and bloggers, published on websites such as recovery.org, The Fix, Intervene, Workit Health, iExhale, Sapling, Addiction Unscripted, Transformation Is Real, Sanford House, Winward Way and Casa Capri.