The term 'recovery'is widely used in the research literature. It also appears in NIAAA's strategic plan, and in the title of one of its divisions. Recovery is a goal of alcohol treatment. Alcoholics who no longer drink, and are trying to pursue an improved way of living/being, say that they are 'in recovery.'Yet for all its use, and seeming centrality, there is no agreed upon definition of the term within the alcohol literature. Lacking a definition, recovery usually is equated with abstinence or symptom remission in research, even though it is not so narrowly circumscribed by those who say they are in recovery. This alcohol methods development study aims to develop a Recovery Scale that is based on how people who have been through the experience of recovery define the term. To develop potential items for the scale, we will conduct surveys and qualitative interviews (n=200) with members of alumni groups from sober living and treatment programs, members of recovery organizations (many of whom will not have attended Alcoholics Anonymous/AA or treatment), and recovering individuals recruited from newspaper and online advertisements. This sampling strategy will reach diverse individuals who have achieved recovery with and without treatment, and with and without AA involvement. An Expert Panel (including alcohol researchers and alumni group and recovery organization representatives) will be convened to further advise us on recruitment and item construction. The resultant items, and other relevant instruments (such as the World Health Organization/WHO Quality of Life scales and the Addiction Severity Index) will be administered to the sampling frames from which the 200 individuals were drawn (estimated n of respondents = 11,240) in order to study the performance of the potential scale items and their relationship with other relevant measures. We will conduct intensive psychometric analyses to develop a parsimonious and reliable Recovery Scale with strong convergent and discriminant validity. We will analyze how recovery (defined by the WHO scales, and by the new Recovery Scale) differs based on age, gender, ethnicity, involvement in treatment and in 12-step groups, and stage of recovery (1 year-early;2-5 years- sustained;and over 5 years-stable). A psychometrically validated scale of addictions recovery that reflects diverse perspectives, pathways, and lengths of recovery among a demographically heterogeneous population will be used extensively by researchers conducting clinical trials of new alcohol treatment options, epidemiological studies of alcohol dependence and remission in the general population, and health services research on recovery without addiction treatment. A comprehensive Recovery Scale will illustrate the personal and social qualities associated with recovery that can be expected, and will provide a framework for educating the public and policymakers about what recovery from alcohol and drug dependence entails.

Public Health Relevance

Our Recovery Scale will provide a framework for educating the public and policymakers about what can be realistically expected when people with serious alcohol problems quit drinking. It will lead to more appropriate evaluations of alcohol treatment programs and health services, and to higher levels of help-seeking among alcoholics. Unlike those in recovery from other chronic disorders, such as cancer, many people in recovery from alcohol addiction (and their families) are cautious about announcing their recovery status. Dissemination of research based on the Recovery Scale should help to dispel the stigma of alcoholism that those in recovery still face, because it will measure the positive life changes and the personal and social qualities that recovery represents.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Health Services Research Review Subcommittee (AA)
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Chiapella, Page
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Borkman, Thomasina Jo; Stunz, Aina; Kaskutas, Lee Ann (2016) Developing an Experiential Definition of Recovery: Participatory Research With Recovering Substance Abusers From Multiple Pathways. Subst Use Misuse 51:1116-29
Witbrodt, Jane; Borkman, Thomasina J; Stunz, Aina et al. (2015) Mixed methods study of help seekers and self-changers responding to an online recovery survey. Alcohol Alcohol 50:82-8
Kaskutas, Lee Ann; Ritter, Lois A (2015) Consistency between beliefs and behavior regarding use of substances in recovery. Sage Open 5:
Witbrodt, Jane; Kaskutas, Lee Ann; Grella, Christine E (2015) How do recovery definitions distinguish recovering individuals? Five typologies. Drug Alcohol Depend 148:109-17
Kaskutas, Lee Ann; Witbrodt, Jane; Grella, Christine E (2015) Recovery definitions: Do they change? Drug Alcohol Depend 154:85-92
Subbaraman, Meenakshi Sabina; Laudet, Alexandre B; Ritter, Lois A et al. (2015) Multi-source recruitment strategies for advancing addiction recovery research beyond treated samples. J Community Psychol 43:560-575
Kaskutas, Lee Ann; Borkman, Thomasina J; Laudet, Alexandre et al. (2014) Elements that define recovery: the experiential perspective. J Stud Alcohol Drugs 75:999-1010
Subbaraman, Meenakshi Sabina; Witbrodt, Jane (2014) Differences between abstinent and non-abstinent individuals in recovery from alcohol use disorders. Addict Behav 39:1730-5