Addiction, Treatment and Recovery

“Recovery” means many things to many people.

So many things to so many people, that the meaning of this word/concept/lifestyle has taken on a mysterious or even “fringe” quality that has prevented popular understanding and acceptance.

The challenge of the inaugural Betty Ford Institute Consensus Conference was to try to develop a definition of “recovery” that would have utility for clinicians and researchers alike.

In the Fall of 2006, a blue-ribbon panel of researchers, policy makers, clinicians and members of the recovering community, met in Rancho Mirage, California to discuss – and try to define – “recovery.” Erica Goode, a science editor at The New York Times, served as moderator.

The definition that emerged is this: Recovery from substance dependence is a voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship. [See box on p.2.]

Why was “recovery” chosen as the central theme of the first Betty Ford Institute conference? Because, says Dr. Thomas McLellan, CEO of Treatment Research Institute, “There’s a critical need for a measurable definition of ‘recovery.’ Millions of individuals successfully addressing their dependence on alcohol or other drugs refer to their new sober and productive lifestyle as being ‘in recovery.’”

“Though the term is widely used, the lack of a standard definition has hindered public understanding, recovery-oriented public policies and research that might foster more and better recovery-oriented interventions.”

According to Betty Ford Center CEO John Schwarzlose, who observed the panel’s two days of deliberations, “Everyone – the researchers, the counselors, the policy-makers and the clients themselves – needs a shared understanding, a common metric against which they can set goals and measure progress.”

A damning indicator of the extent to which the existing muddy notion of ‘recovery’ has tended to inhibit meaningful and much-needed research is that of 8,400 studies published in the four most-cited research journals in the addiction field over the past 10 years, only a tiny number (54) made specific reference to ‘recovery.’

This is important – and devastating – because the current healthcare mantra calls for “evidence-based” procedures, clinical practices and therapies.

A paper examining and explaining the rationale for the Betty Ford Institute-developed definition of “recovery” will appear in a special recovery-oriented edition of the Journal of Substance Abuse Treatment, to be published later this year. That “umbrella” paper will be accompanied by four others commissioned from experts in various research fields; those four papers were distributed to panel participants in advance of the consensus conference, and helped form the basis for the often spirited discussions.

Both the Betty Ford Center’s John Schwarzlose and Treatment Research Institute’s Dr. Thomas McLellan caution that the consensus definition currently at hand is probably not definitive.

“In fact,” the two stated in a joint release, “our definition does not necessarily reflect the positions of all stakeholders in the discussion process – only their shared view that a starting point definition was needed. We also felt that a respected, neutral body like the Betty Ford Institute needed to get the ball rolling.”

“We hope this will spark an even wider dialogue. We have not reached a destination. We have begun a journey.”

Related posts:

1. Betty Ford Institute Formed; Convenes Consensus Conference
2. Betty Ford Institute Names CEO