Why Recovery Research Matters
Alongside others in the treatment industry, Life of Purpose’s Andrew Burki continues to push and expand the fight for collegiate recovery.
America has a problem: Young adults age 18 to 25 outpace all other Americans in their use and misuse of drugs and alcohol. It’s a recognized problem government agencies and private organizations throw money at and conduct research on to understand, control and combat. They poll college students and their non-enrolled peers about their substance use. They publish infographics to raise awareness. They investigate the whys, wheres and whens of addiction.
What they do not do, however, is research what can be done once a young person is addicted and seeking recovery. Research about recovery is limited, yet it is as important as addiction research. Thus, as part of his mission to make a meaningful difference in collegiate recovery, Andrew Burki, founder and CEO of Life of Purpose Treatment in Boca Raton, Florida, has started pushing for more recovery research.
Why Recovery Research Is Necessary
“There are millions of people in abstinence-based recovery, but there’s not much research on it,” Burki says. “We need to show that abstinence-based recovery works and specifically that the quality of life is better [for those in] collegiate recovery.”
Burki is not alone in his beliefs. John Kelly, director of the Recovery Research Institute at the Massachusetts General Hospital, the Elizabeth R. Spallin Associate Professor of Psychiatry in Addiction Medicine at Harvard Medical School and one of the foremost experts in the field, also believes in the importance of recovery research.
Although the recovery industry has anecdotal evidence about the success of collegiate recovery communities (CRCs) and collegiate recovery programs (CRPs), “We need empirical evidence,” he says. “Our own impressions as service providers and program administrators are susceptible to bias in our estimates of program effectiveness. We tend naturally to overestimate their effectiveness. So, without having a more objective study conducted that uses a comparison condition (e.g., college participation without CRP participation), we cannot estimate the relative benefit of CRP participation. With research, we can also understand more about why it works and for whom and what the cost-effectiveness of the program is. Having objective, validated and rigorously conducted research helps to convince funders and policymakers that these are services worthy of greater investment.”
Until recently, it’s largely been big pharmaceutical companies, aka “Big Pharma,” that have had the money to conduct research — and their research tends to support the drugs they sell and often shows that drug-supported recovery works. Few people in the collegiate recovery industry refute the research. What they reject is the notion that only drug-supported recovery works.
“The issue is that medication-assisted treatment went very quickly to meaning only one medication,” Burki says. “We also take issue with the continuation of physical addiction to opiates and prefer safer medication-assisted treatment approaches, such as Vivitrol. Long-term maintenance protocols have played an important role for the past half-century with medications such as methadone. They’ll continue to have a place going forward, but let’s not confuse the quality of life afforded by sustained recovery with simply trying to prevent death through any level of recovery engagement an individual is willing to accept.
“We know that abstinence-based recovery, which is what is practiced in CRPs, works for long-term recovery and offers an opportunity for improved quality of life,” Burki says.
Research is expected to provide the empirical data necessary to support that claim. Once that data is available, Burki and the rest of the recovery industry will use it to prove why CRCs and CRPs are more cost-effective for long-term recovery.
Both Kelly and Burki acknowledge that there are people — lawmakers; policymakers at the federal, state and local levels; police departments; and others — who think it’s too expensive to take care of young people with substance use disorders.
“This stuff gets talked about from city council meetings to the White House,” Burki says. “If we don’t produce the research that proves that collegiate recovery works — that it’s the smart thing to do, the cheaper thing to do, and the best thing to do to maintain wellness and move away from the revolving door of acute care — then we risk squandering kids who could make a difference in the world to death or incarceration.
“It’s vastly less expensive to focus on long-term care,” he continues. “It’s vastly less expensive to do it through higher education or trade schools, where the cost is built into the infrastructure at the same time [young people] are advancing their lives. Collegiate recovery provides the best return on investment in the entire recovery space. You have one director who costs about $50K a year, and that person can directly prevent millions of dollars that would otherwise go to ERs, incarceration and repeated triage treatment.”
Kelly expects to see a lot more research on recovery services systems over the next five to 10 years. He is already working with a government agency to do a systematic review of collegiate recovery services systems, which he takes as a positive sign. It means that there is a shift at the national level to understand how to support long-term recovery and to look at it systematically from a public health perspective. “It’s good news,” he says.
Where the Research Comes From
Although some federal government agencies are conducting studies and the Recovery Research Institute is involved in additional ones, the field needs more.
Enter Burki and Life of Purpose. To encourage more research into recovery, he is developing relationships with colleges and universities to set up research offices on their campuses. He approaches school administrators with the idea, offers financial support and helps raise additional donated funds to get the research office operating.
Life of Purpose helped open the Office of Substance Use Disorder, Mental Health and Recovery Research at Florida Atlantic University’s (FAU) Boca Raton campus through the university’s School of Social Work within the College for Design and Social Inquiry in 2015. Life of Purpose provided $100,000 in seed money and encouraged other companies in the region to come on board, which they did.
In 2016, Burki turned his attention to the University of North Texas (UNT) in Denton, already ranked a tier one research university by the Carnegie Classification of Institutions of Higher Education. Again, he provided $100,000 in seed money and encouraged other companies to help establish the Office of Substance Misuse and Mental Health Recovery Research on campus.
Life of Purpose continues to support UNT by presenting the annual Recovery Conference, the proceeds from which support the university’s recovery research office. The fifth conference was held in September 2017 and welcomed some of the top researchers in the world as presenters, including Kelly; Noah Levine, teacher and author; and Andrew Finch, associate professor in the Department of Human and Organizational Development at Vanderbilt University.
Life of Purpose also originated the Recovery Research Awards and Summit to honor the researchers and their studies into recovery. The 2017 event will be Dec. 1 at George Washington University in Washington, D.C. Burki and Life of Purpose will pass the metaphorical baton to the Association of Recovery in Higher Education (ARHE) and the Association of Recovery Schools (ARS), which will host and present the event in sub-sequent years.
“We want these things run by ARHE and ARS,” Burki says. “It makes it pure and legitimate if they’re the ones hosting it because they are composed of the universities and high schools and it is university researchers doing the work.”
ARHE is more plugged into what is coming out of research universities, he says. He shares an example of how a researcher at Tulane University in New Orleans is using virtual reality (VR) technology to assist with recovery. The technology takes participants into a college party where known triggers are in place. The VR experience ends, and a therapist immediately follows up with the participant in a session about triggers.
“We used to do these things verbally as part of relapse prevention,” Burki says, “but this VR is cool, helpful and advanced. We wouldn’t know about this if the Recovery Research Awards and Summit weren’t hosted by ARHE.”
The Heart of Life of Purpose
A staunch supporter of collegiate recovery — and in recovery himself — Burki believes in addressing all sides of the issue, which is why he continually stays on top of ways to bring attention to collegiate recovery. Nevertheless, he remains true to his original charge: Life of Purpose.
Instead of being a treatment center with a track for students in recovery, Life of Purpose was established to specifically treat that population. Burki calls it “academically focused care.” Four levels of care are available: primary, intensive outpatient, academically focused aftercare and Life in Progress luxury transitional housing. Students may enter at the level of care that best suits their needs. A lot of them transfer from nationally renowned primary care facilities (upon completion of that primary care) into a transitional level of care with Life of Purpose. The intention of this transition is to enable young people to receive support for their academic goals as part of their discharge and aftercare plans. No matter the level of care, clients can participate in classes. Life of Purpose wants to see young people pursue an education to be their best selves. Burki passionately believes that having a purpose — “I’m a student!” — gives young people a reason to maintain long-term recovery.
Although the headquarters and primary residential treatment center remain in Florida, Life of Purpose opened a second location at UNT. The treatment center is housed at Chilton Hall, adjacent to the office of the UNT CRP. It serves clients seeking intensive outpatient care and academically focused aftercare.
“The establishment of a Life of Purpose facility, not just on another university campus but actually physically located within an academic college, signifies a successful leap forward for the Life of Purpose academically focused substance use disorder treatment model,” Burki said in a statement. “The reality that emerging adults in early recovery thrive in higher education, with the proper clinical and academic support, has already been demonstrated in several hundred cases at our Florida Atlantic University facility.”
Life of Purpose followed the opening of its UNT center with another expansion in Murfreesboro, Tennessee, near Middle Tennessee State University and right outside of Nashville. Like FAU and UNT, it offers intensive outpatient treatment and academically focused aftercare and provides transitional housing for male and female students in recovery. Known as Life in Progress, the residence provides a safe and supervised environment, academically focused case managers, and easy access to Middle Tennessee State University.
This fall, Life of Purpose will open a fourth location in Cherry Hill, New Jersey. Burki is particularly excited about this facility, which will offer the same services as the one in Tennessee, because it will serve 101 schools in a 50-mile radius of Philadelphia.
“There are a lot of inpatient [facilities] already there,” he says, “but there’s a need for step-down care. Our facilities are filling a gap. We help people figure out how to transition from clinical care to CRPs. We are essentially discharge planning during the course of treatment. Our goal is to get every single kid capable of succeeding in school who is in recovery to transition to collegiate recovery.”
The recovery research Life of Purpose promotes is just another way to support that mission.