How Can Communities Support Addiction Recovery?

Austin McNeill Brown

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Recovery from addiction is a long-term process that involves the development of physical and psychosocial improvements across many facets of life. Defined as “a dynamic, intentional, and relational process that seeks to improve wellness,1 recovery often requires medical care, professional treatment, non-professional support groups, and community-based supports.2 Despite the clinical needs of early recovery, the bulk of the growth process usually occurs in the spaces and communities of everyday life and continues for years. Given that most recovery growth occurs well outside of professional and clinical areas, it is essential to consider how communities can support recovery in everyday settings.3,4 Research indicates that there are many ways a community can help those living in recovery, from employment opportunities to housing and education. One of the best ways for cities and towns to address substance use issues in the local population is to provide recovery-friendly community supports that help foster a flourishing recovery community.

Recovery-Friendly Employment
Employment is one of the most predictive variables of recovery sustainability.5 One of the most significant ways communities can support individuals in recovery is to provide stable employment at supportive businesses and non-profits. Those in early recovery can benefit from workplaces that keep them connected to others who are in recovery. They can also benefit from employers who are aware of the recovery commitments a person may have outside of work. People in recovery make ideal employees as well, and some businesses specifically hire individuals in recovery for this reason.

Recovery Community Organizations
Recovery community organizations (RCOs) are another way to support recovery through peer-delivered services.6,9 These non-profit organizations provide a wide array of services, space, and resources for people through local drop-in centers that help improve quality of life. Several states have well-established RCOs, such as Vermont and Connecticut.

Cities like Philadelphia, Portland, and Atlanta also provide recovery-specific programming, such as peer-recovery workshops, peer support training, mindfulness-based activities, and various mutual aid groups. They may also employ a pool of peer-recovery support specialists, who provide a range of services from post-overdose support in local emergency rooms, to supporting local harm reduction initiatives, assessments, and motivational interviews for people struggling with substances. Peer recovery specialists also serve as personal liaisons to the recovery community and help those with substance issues explore various recovery pathways.  

Supporting Educational and Vocational Opportunities
Collegiate recovery programs in universities and community colleges can help students navigate their education by providing on-campus activities and space for those living in recovery.6, 7 There are hundreds of collegiate recovery programs across the country. Community colleges, which generally have commuter populations, can also help students with checkered academic pasts get back in the swing of higher education while supporting their recovery. Finally, recovery-cognizant job skill training, co-ops, and industrial training can help students in early recovery learn new trades and specialties while supporting their recovery commitments and values.

Recovery Housing
Recovery housing is another way that communities can support recovery.6 Fear of increased crime and property devaluation are often cited as reasons for community resistance to recovery homes, however, studies demonstrate these are unfounded.11 Such housing is a substance-free living environment with built-in accountability mechanisms that help people in early recovery or post-treatment to have an affordable, safe place to get back on their feet. Up to one-third of people entering recovery come from unstable housing situations. These houses can be non-profit, privately owned, and even clinically based. In general, such homes are managed and operated by residents or owners who are in recovery. Oxford Houses are perhaps the most well-known and well-studied recovery homes. A 2010 8 review of Oxford Houses found that the likelihood of substance use at 24 months was less than half of the rate of aftercare services alone and that just over 80% of participants who formerly resided in the houses reported abstinence a year later.  Recovery residences are one of the most valuable ways cities, towns, and communities can support the local recovery population.

Supporting Recovery is Beneficial to Communities
Contrary to popular belief, recovery is not a single event and often requires multiple attempts.10 Recovery is a process that takes daily commitment. Rebuilding one’s life and restoring missed opportunities can often be a daunting task. What those in early recovery need most of all are everyday opportunities that also support them in their recovery endeavors. When communities invest in recovery support, they demonstrate a belief that success in recovery matters.

By providing necessities such as employment, housing, community spaces, and educational or vocational opportunities, communities can help stabilize individuals using simple evidence-informed methods. As a result, those in recovery can become mutually supportive and productive citizens who often give back to the people and places that have invested in their recovery.

References:

1. Ashford, R. D., Brown, A., Brown, T., Callis, J., Cleveland, H. H., Eisenhart, E., … & Whitney, J. (2019). Defining and operationalizing the phenomena of recovery: a working definition from the recovery science research collaborative. Addiction Research & Theory27(3), 179-188.

2.  Martinelli, T. F., van de Mheen, D., Best, D., Vanderplasschen, W., & Nagelhout, G. E. (2020). Are members of mutual aid groups better equipped for addiction recovery? European cross-sectional study into recovery capital, social networks, and commitment to sobriety. Drugs: Education, Prevention and Policy, 1-10.

3. White, W. L. (2009). The mobilization of community resources to support long-term addiction recovery. Journal of substance abuse treatment36(2), 146-158.

4. White, W. L., & Evans, A. C. (2013). The recovery agenda: The shared role of peers and professionals. Public Health Reviews35(2), 4.

5. Magura, S., & Marshall, T. (2020). The Effectiveness of Interventions Intended to Improve Employment Outcomes for Persons with Substance Use Disorder: An Updated Systematic Review. Substance Use & Misuse55(13), 2230-2236.

6. Jason, L. A., Salomon-Amend, M., Guerrero, M., Bobak, T., O’Brien, J., & Soto-Nevarez, A. (2021). The Emergence, Role, and Impact of Recovery Support Services. Alcohol Research: Current Reviews41(1).

7. Brown, A. M., & Bohler, R. (2019). Achieving a 15% relapse rate: A review of collegiate recovery and physician health programs. Alcoholism Treatment Quarterly37(1), 109-122.

8. Jason, L. A., & Ferrari, J. R. (2010). Oxford house recovery homes: Characteristics and effectiveness. Psychological services7(2), 92.

9. Ashford, R. D., Brown, A., Canode, B., Sledd, A., Potter, J. S., & Bergman, B. G. (2021). Peer-based recovery support services delivered at recovery community organizations: Predictors of improvements in individual recovery capital. Addictive Behaviors119, 106945.

10. Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, B. B. (2019). How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering US adults. Alcoholism: Clinical and Experimental Research43(7), 1533-1544.

11. Jason, L. A., Groh, D. R., Durocher, M., Alvarez, J., Aase, D. M., & Ferrari, J. R. (2008). Counteracting “Not in My Backyard”: The positive effects of greater occupancy within mutual‐help recovery homes. Journal of Community Psychology36(7), 947-958.

Acknowledgments
The author would like to thank the staff at the Lerner Center for Public Health Promotion, along with Dr. Shannon Monnat for their contributions, edits, and promotion of this article.

About the Author
Austin is currently a Ph.D. student in the Social Science Program at the Maxwell School and an affiliated researcher with the Lerner Center for Public Health Promotion. Email:abrown48@syr.edu