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Addiction recovery and recovery capital – lessons to be learned in the UK

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While it is generally recognised that addiction is a chronic and relapsing condition, in recent years it has become apparent that the majority of people with a lifelong substance addiction (even to drugs like heroin and cocaine) will eventually achieve stable and abstinent recovery, resulting in a better quality of life, active participation in their communities and some form of ‘giving back’ to repair the harms they have done.

We now have a science for how that happens, based on a concept known as ‘recovery capital’ which refers to the strengths and breadth of internal and external resources a person can call upon to support their recovery journey. For the last 10 years my work has been around how to make measuring recovery capital more accurate and effective and how it can be presented in a form that is engaging, acceptable and meaningful to people on their own recovery journeys.

This has culminated in the development of the REC-CAP (first published in 2017), an online measurement and review tool that has now been completed by around 20,000 people in the UK, United States, Canada and New Zealand. Most people who have completed the REC-CAP are based in recovery residences in the United States. Indeed, it is not possible for a residence provider to get state funding for recovery housing if they do not use the REC-CAP in the state of Virginia and this is likely to happen in Michigan in the near future as well.

This work has allowed us to test who does well and who is at greater risk of drop-out and relapse to use, with the accompanying dangers of offending and returning to prison. In the UK, we are hoping to start a pilot run of the REC-CAP in a number of adult male prisons, but there are some big lessons from the US that we could learn here, including:

  • A commitment to evidence-based practice and a government commitment to both recovery research and applying that research in everyday practice;
  • The understanding that recovery is a process in which a safe place to live is essential and that a recovery model requires a commitment to sober living facilities for people early in their recovery journeys; and
  • More generally, the lesson from our work in the US is about the transition from a clinical model based on deficits to a strengths-based approach where peers are central and where there is a recognition that recovery happens in communities, not in specialist clinics.

I have been very fortunate to be able to champion this work across seven states in the US and I was recently presented with a Recovery Innovations award by the National Association of Recovery Residences at its annual conference in Richmond, Virginia. Not only that, but several housing providers offered personal testimonies about how the REC-CAP and the broader model of strengths-based working had transformed their working lives.

The US will remain at the forefront of innovation and science in this area but the publication of a new drug strategy for the UK (“From Harm to Hope”) offers a meaningful opportunity for real change, where innovative practice must be matched by a commitment to recovery science, and a new way of addressing a complex and growing challenge to families and communities.

David Best is a Professor in Criminology at Leeds Trinity University’s Faculty of Social and Health Sciences.

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