The chronic relapsing nature of alcohol and other drug use disorders has given rise to models of continuing care that are analogous to the long-term disease management models seen in primary care settings, such as for diabetes and hypertension. During the past ten years, in order to support recovery management in addiction, an array of recovery support services have emerged including recovery community organizations (RCOs) and recovery community centers (RCCs) with the aim of providing tangible community-based recovery support that will sustain remission and help build recovery capital and enhance quality of life. Nationally, there are more than 80 RCCs with a high density of these evident in the New England region of the United States (k=34). Despite their increasing growth, popularity, and support from city, state, and federal agencies, very little is known regarding the types, nature, and scope of services such centers provide, to whom they are provided, over what period, and to what effect. The ultimate aim of this proposed line of investigation is to evaluate the clinical and public health effects and cost-effectiveness of providing RCCs in US communities. As a first step, this exploratory/ developmental R21 investigation has three linked aims: 1) To systematically characterize RCCs using standardized measures to aid cross-comparison across centers and states;2) Administer a cross-sectional survey to characterize current RCC clients (NH 510) and assess perceptions of and experiences with RCCs;and 3) Conduct a proof- of-concept investigation of the RCC model by following a sample of new clients (N=300) from a sub-group of the highest impact/quality RCCs (k H 5)over a 3 month period to assess clients'utilization/discontinuation rates, and test for the effects of RCC utilization on abstinence and remission and the accrual of recovery capital and enhanced quality of life. Controlling for baseline predictors of outcomes (e.g., addiction severity recovery motivation, psychiatric symptoms) we will estimate the effects of frequency of RCC use on outcomes using mixed model analyses. If this initial exploratory/developmental study finds evidence of recovery benefits for individuals using the best RCCs, it would provide preliminary validation of the RCC concept. This would then lay the foundations for further experimental research efforts to determine the extent to which addiction treatment, criminal justice, social welfare and other agencies might facilitate linkage with RCCs and whether and how such linkage ultimately helps sustain recovery and prevent costly re-hospitalizations and re-incarceration.

Public Health Relevance

Alcohol and other drug use disorders are often chronically relapsing conditions requiring ongoing support and management. Recovery community centers (RCCs) are emerging as low-cost recovery resources providing tangible support and linkage for people in, or seeking, recovery. Despite their rapid growth, however, there is currently a dearth of information regarding the nature, scope, and effectiveness of these prevalent recovery resources. This exploratory/developmental R21 investigation will characterize and provide estimates of service user characteristics, RCC service utilization, discontinuation, and benefits, and provide preliminary estimates of the clinical and public health utility of RCCs across New England and New York State.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Exploratory/Developmental Grants (R21)
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Health Services Research Review Subcommittee (AA)
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Hagman, Brett Thomas
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Massachusetts General Hospital
United States
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