WFTC Conference Bangkok, Thailand, October 31th 2018
“Life in Recovery” – myth or reality
Presented by Boro GoicChairman of RUN – Recovered Users Network
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Recovered Users Network (2013)
Platform of EURAD – A network for prevention, treatment and recovery
Specific advocacy platform
CSO (57 organizations), individuals and groups of people who are engaged in
recovery work, supporting concept of recovery
Vision ‘’raise the voice of the recovery movement, by contributing to constructive
and respectful drug policies, for individuals, families and communities’’
Mission ‘’a network which provides a voice for recovered drug users to promote
and share the experience of recovery, on both political and practical levels’’
RUN
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Debate that belongs to the past!
AbstinenceHarm reduction
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What do people want when they ask for services?
Neil McKeganey , Centre for Drug Misuse Research at the University ofGlasgow
n=12043
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Why do we need ROSC - Recovery Oriented Systems of Care?
The ambition for more people to recover is legitimate and deliverable.
Ultimate goal is to enable individuals to become free from their dependence; something we
know is the aim of the vast majority of people entering drug treatment.
In a review of evidence for the (SAMHSA), Sheedy and Whitter (2009) estimate that of all
those who have a lifetime alcohol or drug dependence 58% will achieve stable recovery. (>5y.)
White (2012) also estimates a recovery rate of approximately 50% based on an extensive
review of literature.
This represents a rather optimistic prognosis for what is often categorized as a chronic
relapsing condition (O’Brien & McLellan, 1996; White, Boyle, & Loveland, 2003) and is
consistent with a model of recovery based on hope and belief that change is possible.
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RECovery PATHways (Life in Recovery) rec-path.co.uk
LiR is a research conducted by Sheffield Hallam University, lead by Prof David Best
First done in the US, Australia, the UK, Canada and South Africa, currently ongoing in
Europe (UK, Belgium, Netherlands) and four Balkan countries
Inclusion criteria are being a minimum age 18 years and being in recovery from
problematic illicit drug use for at least 3 months.
The concept of “recovery” is self-defined by respondents and could mean complete
abstinence from illicit drugs but could also mean that respondents are still using illicit
drugs but no longer in a problematic way.
Recovery from alcohol use is not examined in this study.
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Life in Recovery study
The aim of the REC-PATH (Life in Recovery) study is to map pathways to recovery in populations engaging with different mechanisms of behavior change for recovery: - peer-based support, - mutual aid, - residential and community treatment, - specialist treatment: (maintenance and abstinence oriented) - through their own “natural recovery” endeavors
First major comparative study of addiction recovery undertaken in Balkan region and will allow us to look at what mechanisms help to initiate and support recovery and how this differs by gender.
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Table 1: What country do you live in?
Country Frequency Percent
Bosnia & Herzegovina 72 27.4
Serbia 123 46.8
Croatia 53 20.2
Montenegro 15 5.7
Total 263 100.0
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In terms of the proportions who saw particular substances as a problem:
Alcohol 61.6%Heroin 79.8%Cocaine 57.4%Crack cocaine 6.5%Amphetamines 57.8%MDMA 59.7%Cannabis 81.0%Prescribed methadone51.0%Prescribed BPN 22.8%Tobacco 80.2%Prescription drugs 64.6%
Addiction careers
Average age of first drug use 15.5 years
Average age of last drug use 30.5 years
Average age of first help seeking 24.1 years
Average of 7.2 years since participants used drug problematically
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Table 2: Breakdown in recovery status
Percent
Early recovery (<1 year) 26.2
Sustained recovery (1-5years) 26.6
Stable recovery (>5 years) 47.1
Total 100.0
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Table 3: How do you see yourselves
Percent
In recovery 23.6
In medication assisted recovery 10.6
Recovered 37.6
Use to have drug problem, but don’t now 17.9
Another status 10.3
Total 100.0
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Table 4: Sources of lifetime help-seeking
12-step 8.0%
PBRSS 9.1%
Residential rehab, TC or detox 63.9%
Specialist out-patient treatment 53.2%
Other service (such as a church) 44.9%
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Table 5: Life problems in the last 30 days
Housing 6.1%
At risk of eviction 6.5%
Injected drugs 1.1%
Offending 0.4%
Involved in the criminal justice system 5.7%
Continuous working full time 49.4%
Continuous working part-time 22.1%
Education 14.8.%
Volunteering 30.0%
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Table 6: Health factors in active addiction and in recovery
Did you: In active addiction In recovery
Exercise regularly 8.0% 36.1%Experience untreated emotional or mental health problems
77.2% 47.9%
Visit emergency rooms frequently 23.6% 6.8%Frequently use health care services 30.4% 27.8%Get regular dental check-ups 17.1% 47.9%Have a GP or family doctor 57.8% 75.7%Have healthy eating habits 15.6% 77.6%Use tobacco products 87.8% 49.4%Take care of your health 16.7% 76.0%
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Table 7: Legal factors in active addiction and in recovery
Did you: In active addiction In recovery Maintain your driving license 59.7% 65.8%Have your driving license suspended 19.0% 6.5%Get your driving license back 19.0% 7.6%Drive under the influence of drugs 66.2% 11.4%Damage property 70.3% 14.1%Get arrested 63.9% 10.3%Had criminal charges against you 54.8% 10.3%Complete a conditional sentence, such as parole
39.5% 11.0%
Served a prison sentence 31.2% 8.4%
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Table 8: Financial factors in active addiction and in recovery
Were you: In active addiction In recovery
Unable to pay your bills 66.9% 22.1%Have had debts or credit 65.0% 12.9%Have credit restored 12.9% 29.7%Maintain a bank account 28.9% 59.7%Owe back taxes 14.1% 8.4%Pay your personal debts 50.2% 56.3%Usually pay bills on time 15.2% 66.2%Paid back taxes 6.5% 23.2%Pay taxes on time 8.4% 39.5%Have stable housing 79.1% 87.8%
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Table 9: Employment factors in addiction and in recovery
Did you: In active addiction In recovery
Remained steadily employed 36.9% 54.4%
Get good job evaluations 31.2% 64.3%
Frequently miss school or work 65.8% 6.5%
Further your education or training 31.2% 41.1%
Get fired or suspended from work 44.5% 7.2%
Lost your professional or occupational license 6.5% 4.9%
Started your own business 17.1% 25.1%Dropped out of school or university 47.1% 11.0%
Restored professional or occupational license 2.7% 11.4%
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Table 10: Family and social factors in addiction and in recovery
Did you: In active addiction In recovery
Participate in family activities 33.5% 78.7%
Plan for the future 20.2% 80.2%
Lose custody of children 5.3% 2.3%
Regain custody of children - 1.1%
Experience or perpetrate family violence 41.8% 8.7%
Volunteer in the community 6.1% 52.9%
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Recovery definition!
Recovery is a process through which an individual is enabled to move on from their
problem drug use, towards a drug free life as an active and contributing member
of society. (Scottish Government 2008)
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Recovery definition!
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Recovery definition!
Recovery is not a homogenous, linear process
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Study conclusions
Very clear transition from unhealthy to healthy behaviours It is critical that people seeking recovery have options and choices for their recovery journey and sustained support along the way. There is growing momentum around this body of work and identifying the commonalities across cultures and the specific features of individual contexts.This database is vital to increase public awareness of recovery and challenge stigma and exclusion, which are devastating consequences of addiction and substantial barriers to recoveryThe evidence is also critical to insure that policy makers, treatment providers, peers, researchers understand the broad experiences of people in recoveryThis database needs to inform them in developing recovery-oriented systems of care
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Why do we need ROSC - Recovery Oriented Systems of Care?
Instead of focusing primarily on reducing the harms caused by drug misuse,recovery oriented drug policies approach is to go much further and offer every support for people to choose recovery as an achievable way out of dependency. We must therefore, put the individual at the heart of any recovery system Supporting people to live a drug-free life is at the heart of any recovery oriented
drug policy ambition. Recovery is focused on strengths and assets of a person, and not their weaknesses
and deficits Assessment and recovery plans should address the totality of people’s lives, not
only addiction
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Recommandations
Acknowledging that abstinence is a goal for many drug users seeking help.
Recovery should be incorporated as an important facet of any global or local drug policy
Strengthening the evidence base around recovery based treatment, including the role of family and close friends, and role of social integration, a better understanding of these interventions is greatly needed.
Recognizing the potential of recovered users and assist them in their way back to the society and acknowledge their potential to help their peers.
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Thank you for your attention
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