STASH, Vol. 20(13) – How do you define recovery? Perspectives from a U.S. sample

Recovery from addiction can come in many forms. A person who misuses opioids may perceive recovery differently than someone in their social network, and these varying perceptions can impact an individual’s treatment-seeking behavior. This week, STASH reviews a study by Olivia Golan and colleagues that examined how the U.S. population defines recovery and the resources they perceive to be most valuable for recovery.

What were the research questions?
(1) Do definitions of recovery, and the perceived helpfulness of recovery resources, vary depending upon the person’s relationship with opioid misuse? (2) Are there any racial/ethnic differences in these perspectives?

What did the researchers do?
The researchers surveyed 6,351 individuals from the AmeriSpeak Panel. Participants were divided into three groups – those with a personal history of opioid misuse, those who had family or friends with a history of opioid misuse, and those with no history of opioid misuse. Using a pre-determined list of recovery definitions and resources, participants were asked to rank their personal definition of recovery and their perspective on the helpfulness of recovery resources. The researchers conducted ordinal logistic regressions to compare the differences in rankings by group, while exploring differences according to participants’ demographic characteristics.

What did they find?
On average, the most highly rated definition of recovery among all participant groups was “seeking professional help” (see Figure). However, among participants with a history of opioid misuse, this definition was closely followed by “having a sense of purpose in life;” participants with a personal history rated this definition, as well as “enhanced quality of life,” higher than participants in the other two groups. On the other hand, those with a personal or family history ranked “abstaining from any substance use” as less important to recovery than did those without a history. Among all groups, the recovery resource with the highest average helpfulness rating was “residential rehabilitation programs.” The researchers discovered some differences according to participants’ race. For instance, compared to White participants, Black and Hispanic participants perceived religious or spiritual recovery resources to be more helpful, and compared to White participants, they perceived some forms of professional treatment, including psychotherapy, to be less helpful.

Figure. Highest and lowest ranked recovery definitions, resources, and supports identified by participants with personal opioid misuse history, family/friends with misuse history, or no misuse history. Adapted from Golan et al. (2024). Click image to enlarge.

Why do these findings matter?
Among people with a personal history of opioid misuse, recovery means reaching out for help and living a more purposeful life – not necessarily abstinence. In light of this observation, clinicians might wish to incorporate interventions that focus on a client’s strengths and resiliency, such as reinforcing social relationships and prioritizing non-substance related activities. Additionally, treatment services should be culturally informed. To increase engagement and retention among Black and Hispanic individuals, it is important that these services and the messaging around them include aspects of recovery that they often value, such as religion and spirituality.

Every study has limitations. What are the limitations in this study?
Due to the subjective nature of the term “opioid misuse,” it is likely that the researchers may have underestimated the actual number of individuals who had an opioid misuse history. Additionally, the list of recovery resources and supports were primarily treatment-focused. Future work should include resources, such as employment, housing, and recreational outlets.

For more information:
If you are worried that you or someone you know is experiencing addiction, the SAMHSA National Helpline is a free treatment and information service available 24/7. For more details about addiction, visit our Addiction Resources page.

— Nakita Sconsoni, MSW

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