The term “Recovery Capital,” used widely within the sphere of addiction treatment, describes the available resources, support networks, and social mechanisms a person already has at their disposal to assist in long-term, sustainable recovery from their addiction.
However, the term has been “hijacked” (or, at least, profoundly misused) in recent years by those who continue to believe substance addiction is not an actual disease, and who further believe that a “wealth” of recovery capital cannot only lead to successful abstinence from substance use, but it can also sustain a long-term addiction recovery, all without the need for any evidence-based professional treatment.
Getting and staying sober is very challenging, but with the right support network and tools, it's completely attainable.
Naturally, many addiction experts disagree and believe that recovery capital should be seen, among other factors, as more of a positive predictor of recovery, not as the predisposition of a certain and successful recovery, and it should be utilized not as an alternative to existing treatment, but as a welcome addition to that treatment.
The “Disease Model” of Substance Addiction & Other Theories
Although the “disease model” of substance addiction is widely recognized by both the scientific and medical community, globally, as it is in the U.S., there are those that believe it is wrong to label addiction as a “disease,” and, by doing so, we are limiting an addicted individual’s choices in how they see and perceive their own addiction, and in how they can find and maintain an addiction recovery.
The disease model or theory, as defined by the U.S. National Institutes of Health, states that substance addiction is defined as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”
Furthermore, “it is considered a brain disease because drugs change the brain; they change its structure, and how it works. These brain changes can be long lasting, and can lead to many harmful, often self-destructive, behaviors.”
Other theories, however, do exist.
Natural Recovery: “Overcoming Addiction Without Treatment”
In their controversial 1999 book “Coming Clean: Overcoming Addiction without Treatment,” Robert Granfield and William Cloud dispute the entire “disease” model-theory, and state that recovery without treatment, or “natural recovery,” is actually the most common way people overcome their addictions.
The book’s Preface is clear: “This book is about overcoming addiction to intoxicating substances unaided by treatment or participation in self-help groups. The title, Coming Clean, denotes two distinct meanings. First, we use it as a way of invoking the popular metaphor for the process of terminating addictions. However, we also use this phrase as a metaphor for lifting the veil of secrecy surrounding the fact that most people overcome their addictions without ever entering formal treatment or participating in 12-Step groups.”
Because people can, and do, on occasion, find a sustainable recovery without treatment, the authors surmise that, therefore, addiction cannot fit into any disease model. However, addiction experts who are “pro-disease”- the vast majority, it must be said, counter this argument with the following:
- People with a mild substance use disorder (SUD) can recover with little or no treatment. In contrast, people with a serious form of substance addiction usually require a program of intensive, evidence-based treatment, which is then followed by the continuous management of the disease.
- Certainly, there are cases of people with a severe addiction who find a way to stop their substance use without treatment, but this is usually after experiencing a serious personal crisis of some description, eg. a family, social, occupational, physical or spiritual crisis.
- There are also cases where people have achieved a long-term addiction recovery through their continuous and regular attendance at 12-Step meetings, again without receiving professional treatment.
Regardless, it would appear that the first reference to the term “Recovery Capital,” clearly derived from the earlier, accepted use of the term “Social Capital,” is made in the “Coming Clean” book, and, therefore, the label can be attributed to its authors, Granfield and Cloud.
Without a doubt, there will always be many theories about the origin and nature of addiction until the day finally arrives when scientific researchers can fully clarify why exactly it develops, and how it can finally be cured. Yes, cured. If, of course, that particular day ever arrives.
Let’s return to our topic of ”Recovery Capital”:
What is “Recovery Capital”? [Comprehensive Guide]
In their book (1999), Granfield and Cloud defined recovery capital as “the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery from AOD [alcohol and other drug] problems.”
Furthermore, the authors summarise the evidence of individuals who (i). did not seek professional treatment, or (ii). participate in mutual aid support groups, eg. 12-Step meetings. They link the personal successes of these people with the quality and the quantity of recovery capital they had during their recovery.
Additionally, Granfield and Cloud argue that a person’s recovery capital not only plays a major role in predicting their recovery success, either in or out of professional addiction treatment, but that the continued growth of their recovery capital can result in a pivotal “turning point” in their substance use.
In 2009, Garfield and Cloud redefined this original concept and subsequently stated that, for the group of available resources – the recovery capital of an individual – to be fully effective, there has to be the presence of a number of key components. These are then defined as:
- Social Capital: Regarded as the sum of resources that a person has as a result of their personal, social and familial relationships, social capital includes the support from the groups the person belongs to, and any associated obligations to that group in return. For example, being in a family group will provide support, but it does require obligations and commitments to the other members of the family.
- Physical Capital: Defined as “tangible assets,” such as owning property, and having money that could increase the person’s recovery options; for example, the ability to move away from existing friends and social networks where substance use and abuse is common, or the ability to pay for an expensive medical detox.
- Human Capital: These are the skills, health, personal goals and hopes the person possesses – the personal resources that will enable the individual to prosper. For example, a high standard of education and a high level of intelligence are seen as key aspects of a person’s human capital, as these will help the person with problem-solving during their addiction recovery.
- Cultural Capital: This is the capital that applies to a person’s values, beliefs and attitudes that have been formed by social conformity.
Is Recovery Capital Measurable?
There are a few methods available for measuring an individual’s recovery capital, but none of them have achieved the status of being used as standard practice within addiction treatment. One of the more common measurement scales is the Strengths And Barriers Recovery Scale (SABRS), as discussed in the research article, “Measuring Capital in Active Addiction & Recovery,” and developed by European university researchers and R.U.N., the Recovered Users Network: Europe, an international network for recovered users, and their supporters.
Using data from the international Life In Recovery (LiR) surveys – 3,228 surveys from U.S. participants – the researchers identified the various changes experienced by those in addiction recovery. They found that the longer a person is in recovery, “the better their recovery strengths and achievements.” However, as there was no recognized scale to measure these changes, the research team developed their own: the Strengths And Barriers Recovery Scale (SABRS). This new scale would provide “a single score for both current recovery strengths and barriers to recovery.”
Note: You can see how an individual’s overall score is actually calculated here.
By analyzing the LiR data, they found that “there are stepwise incremental changes in recovery strengths at different recovery stages, but these occur with only very limited reductions in barriers to recovery, with even those in stable recovery typically having at least two barriers to their quality of life and wellbeing.”
The SABRS scale works by assessing collected data into recovery strengths and recovery barriers and uses this new information to create overall strengths and barriers scores. Furthermore, it measures this form of “recovery capital” across the different stages of recovery, as defined by the Betty Ford Group, who state addiction recovery is a “voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship.”
Furthermore, the Betty Ford Group specifically differentiates those stages:
- Early Recovery: Up to 1 year
- Sustained Recovery: Between 1 and 5 years, and
- Stable Recovery: More than 5 years
Recovery Paths: How Do People Find Recovery?
Following the Betty Ford Group’s definition of recovery (2007), the UK Drug Policy Commission (UKDPC) further improved their own definition of recovery: “voluntarily sustained control over substance use which maximizes health and wellbeing and participation in the rights, roles, and responsibilities of society.”
Interestingly, both definitions – Betty Ford and the UKDPC – involve 3 specific elements:
- Wellbeing and quality of life
- Community engagement or citizenship, and
Both also agree that the essence of recovery is a lived experience, with an improved quality of life, and a sense of empowerment.
Let’s quickly return to Messrs. Garfield and Cloud, who clearly stated in their book that the majority of people find such recovery through pathways other than recognized treatment – a “natural recovery,” as they term it. If only that were true, and substance addiction was a far weaker condition to conqueror, or to escape from.
Using the data collected from the LiR surveys, as mentioned above, and with more than 3,000 participants, which recovery paths, in reality, were seen to be the most common? Professional, evidence-based treatment, or medically-assisted treatment (MAT), or with the support of mutual aid groups, like 12-Step meetings, or a more natural route to recovery, with no treatment whatsoever?
Here are those findings:
- 71% of participants in recovery had received professional addiction treatment at some time in their lives
- 18% had received MAT and were prescribed medications to deal with their substance use, e.g., methadone, buprenorphine, or Vivitrol
- Most respondents also reported high rates of participation in mutual aid self-help groups:
- 95% had attended 12-step fellowship meetings (e.g., Alcoholics Anonymous), and
- 22% had participated in non-12-step recovery support groups (e.g., LifeRing, SMART Recovery, Rational Recovery)
However, the LiR survey data provides far more than simply proving the point that it is through professional, evidence-based addiction treatment, and participation in mutual aid meetings and fellowship, that the majority of people look to find a sustainable recovery, compared to seeking a treatment-free recovery by an attempt to “self-cure.”
Life is Better in Recovery
First and foremost, the LiR surveys were a landmark study – the first time a group of those in active recovery, their chosen pathways to that recovery, all their social and medical data, their recovery lengths, and the benefits they have enjoyed from being in recovery, have been fully studied and analysed.
Furthermore, the study clearly demonstrates that life is far, far better in recovery – for all concerned; for example:
- People in recovery in employment, paying taxes and bills, voting, volunteering in their communities, and taking care of their health and their families, and
- Survey findings also found recovery from substance addiction is good not only for the individual, but also for their families, their communities, and the nation’s health and economy.
Recovery Capital: Predicting Sustained Recovery
In another research study, entitled, “Recovery Capital as Prospective Predictor of Sustained Recovery, Life Satisfaction & Stress among Former Poly-Substance Users (2008),” which tested the concept that recovery capital is be a predictor of a sustained recovery, a better quality of life, and lower stress, the collected data focused on those in early recovery (up to 1 year, as defined by the Betty Ford Group), but did include information about longer recoveries (over 1 year).
Its findings showed that it was only in the areas of 12-Step involvement (not just regular attendance at meetings) and in life quality that recovery capital as a whole was deemed a good predictor of a continuing recovery. In fact, the study showed that a better quality of life and lower stress were only seen consistently in those whose recoveries were over 1 year, and the longer the recovery, the better the results.
Furthermore, the study’s authors concluded, “Recovery is a dynamic process. Different factors promote positive outcomes at successive stages of the recovery process.”
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