We Need a More Cohesive Definition of “Recovery”

Our time would be better spent trying to help people recover in whatever way is most effective for them rather than pushing and shaming everyone into one particular recovery pathway.

I’ve lost count of the number of times I’ve heard someone say that a person might be sober, but that they’re not in recovery, or describe them as a “dry drunk,” because the person doesn’t attend some defined program of recovery. I find that attitude divisive, dogmatic, and unhelpful, particularly because it shames others to believe in only one gold standard of recovery.

This simply isn’t true. And it’s harmful; we have too many people dying of substance use disorder. Our time would be better spent trying to help people recover in whatever way is most effective for them rather than pushing and shaming everyone into one particular recovery pathway.

This kind of mindset originates from 12-step fellowships — where members often believe that these programs, combined with abstinence, are the only effective way to recover — and from the outdated professional definition of recovery provided by organizations like the American Society of Addiction Medicine (ASAM). However, with the emergence of recovery science, this outlook is beginning to change. Leading researchers are painting a much broader, more inclusive picture of recovery. Instead of accepting dogmatic perspectives, we can now turn to science, which shows us how people recover, the impact of the language we use, the complexities we face as people in recovery such as trauma and co-occurring disorders, and offers more cohesive definition of recovery.

In 2005, according to ASAM: “A patient is in ‘a state of recovery’ when he or she has reached a state of physical and psychological health such that his/her abstinence from dependence-producing drugs in complete and comfortable.” Over the years, this definition has evolved. Other thought and policy leaders in addiction recovery have also updated their definitions, including the Betty Ford Institute (2006), William L. White (2007), the UK Drug Policy Commission (2008), the Scottish government (2008), the Substance Abuse and Mental Health Services Administration (SAMHSA, 2011), researchers John Francis Kelly and Bettina Hoeppner (2014), and the Recovery Research Institute (2017).

One of the most popular definitions, and one I’ve favored as a writer in this field, is SAMHSA’s: “Recovery from mental disorders and substance use disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” What I like particularly is that SAMHSA doesn’t define how someone should recover and they have no opinion on abstinence or the use of medication in the process of recovery.

Cognizant of the varying definitions and the lack of general consensus among experts in the field, recovery scientists and professionals from across the country came together to formulate a new concept. The Recovery Science Research Collaborative (RSRC) met in December 2017, evaluated various definitions of recovery, and reviewed essential components of recovery in order to more clearly define the process.

I spoke with Robert Ashford, one of the recovery scientists in the collaborative, about the process of formulating a new definition…

Olivia goes on to talk with Robert Ashford about previous definitions of “recovery,” a new concept of recovery, and more in the original article How Do You Define “Recovery”? at The Fix.

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