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      How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study

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          Abstract

          Individuals with a substance use disorder (SUD) often have fewer social support network resources than those without SUDs. This qualitative study examined the role of social relationships in achieving and maintaining stable recovery after many years of SUD. Semi-structured interviews were conducted with 18 participants, each of whom had been diagnosed with a SUD and each of whom had been abstinent for at least 5 years. A resource group of peer consultants in long-term recovery from SUDs contributed to the study planning, preparation, and initial analyses. The relationship that most participants described as helpful for initiating abstinence was recognition by a peer or a caring relationship with a service provider or sibling. These findings suggest that, to reach and maintain abstinence, it is important to maintain positive relationships and to engage self-agency to protect oneself from the influences of negative relationships. Substance use disorder service providers should increase the extent to which they involve the social networks of clients when designing new treatment approaches. Service providers should also focus more on individualizing services to meet their clients on a personal level, without neglecting professionalism or treatment strategies.

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          Conceptualizing recovery capital: expansion of a theoretical construct.

          In order to capture key personal and social resources individuals are able to access in their efforts to overcome substance misuse, we introduced the construct of recovery capital into the literature. The purpose of this paper is to further explore the construct and include discussions of implications unexplored in our previous writings. In this paper we reveal the relationship between access to large amounts of recovery capital and substance misuse maintenance and introduce the concept of negative recovery capital. In doing so, we examine the relationships between negative recovery capital and gender, age, health, mental health, and incarceration.
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            Recovery capital as prospective predictor of sustained recovery, life satisfaction, and stress among former poly-substance users.

            Many recovering persons report quitting their drug use because they are "sick and tired" of the drug life. Recovery is the path to a better life, but that path is often challenging and stressful. There has been little research on the millions of recovering persons in the United States, and most research has focused on substance use outcomes rather than on broader functioning domains. This study builds on our previous cross-sectional findings that recovery capital (social supports, spirituality, religiousness, life meaning, and 12-step affiliation) enhances the ability to cope with stress and enhances life satisfaction. This study (a) tests the hypothesis that higher levels of recovery capital prospectively predict sustained recovery, higher quality of life, and lower stress one year later, and (b) examines the differential effects of recovery capital on outcomes across the stages of recovery. Recovering persons (N = 312), mostly inner-city ethnic minority members whose primary substance had been crack or heroin, were interviewed twice at a one-year interval in New York City between April 2003 and April 2005. Participants were classified into one of four baseline recovery stages: under 6 months, 6-18 months, 18-36 months, and over 3 years. Multiple regression findings generally supported the central hypothesis and suggested that different domains of recovery capital were salient at different recovery stages. The study's limitations are noted and implications of findings for clinical practice and for future research are discussed, including the need for a theoretical framework to elucidate the recovery process.
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              Conditioning factors in drug abuse: can they explain compulsion?

              There is a good deal of clinical evidence suggesting that compulsion to resume drug taking is an important part of the addiction syndrome. The symptoms comprising motivation to resume drug use, namely craving and compulsion, have been studied experimentally in human subjects. While much work remains to be done, there is evidence showing that these symptoms are influenced by learning. The research has been guided by animal studies demonstrating that drug effects can be conditioned. Much attention has been directed toward demonstrating the existence of drug conditioning in human addicts and exploring the neurological structures that may underlie such learned responses. We do not yet know the relative importance of learning in the overall phenomenon of relapse, and treatments based on conditioning principles are still under investigation.
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                Author and article information

                Journal
                Subst Abuse
                Subst Abuse
                SAT
                spsat
                Substance Abuse: Research and Treatment
                SAGE Publications (Sage UK: London, England )
                1178-2218
                09 March 2019
                2019
                : 13
                : 1178221819833379
                Affiliations
                [1 ]Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal, Norway
                [2 ]Inland Norway University of Applied Sciences, Faculty of Social and Health Sciences, Elverum, Norway
                [3 ]Yale Program for Recovery and Community Health, Yale School of Medicine, Yale University, New Haven, CT, USA
                [4 ]SERAF —Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
                [5 ]District Psychiatric Centre Gjøvik, Innlandet Hospital Trust, Brumunddal, Norway
                [6 ]Faculty for Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
                [7 ]Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
                Author notes
                [*]Henning Pettersen, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway. Email: henningpettersen@ 123456hotmail.com
                Article
                10.1177_1178221819833379
                10.1177/1178221819833379
                6410387
                30886519
                c71ef39f-453a-426b-be5e-5e7067a692fb
                © The Author(s) 2019

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 5 January 2019
                : 18 January 2019
                Categories
                Original Research
                Custom metadata
                January-December 2019

                Health & Social care
                substance use disorder,client experiences,social relationships,recovery capital,collaborative research,narrative approach

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