What is Addiction Treatment Really Like?

Summary: Addiction treatment is really like a lifelong journey from a state of physical, emotional, social, psychological, and spiritual distress and dysfunction to a state of ongoing healing, growth, personal awareness, and overall wellbeing.

Key Points:

A helpful way to understand what addiction treatment is really like is to reframe it as a recovery journey.
The journey is different for each person, but there are challenges unique to the recovery experience where people in treatment find common ground and shared experiences.
A comprehensive report published in 2022 gathered first-hand accounts from individuals on the recovery journey to help others understand what addiction treatment is really like.

What People Who’ve Been There Say About the Recovery Journey

The first two questions people ask when they embark on their recovery journey are often these:

What have I signed up for? What is addiction treatment really like?

A new publication from the non-profit group The Addiction Policy Forum (APF) provides an excellent answer to this question, and offers valuable insight on the treatment and recovery process, soup to nuts, starting with initiation of substance use and ending with the ongoing, post-treatment care.

In this article, we’ll share the key findings of that study, and include five key recommendations that we can implement, moving forward, to better support people with SUD, a.k.a. addiction.

The Recovery Experience: The Life History of a Person With Addiction

The study itself is called “Patient Journey Map: Substance Use Disorder Treatment and Recovery Experiences.” Here’s how the authors and researchers describe the project:

“Addiction Policy Forum’s (APF) Patient Journey Map was developed through the input of patients in treatment and recovery from substance use disorder (SUD). The map underscores the obstacles and positive points patients encounter across seven distinct phases, from treatment to finding long-term, stable recovery.”

We’ll describe the study now, starting with its participants.

Participants:

60 residents of U.S. or Canada. Gender: 55% female, 45% male. Age: 18-29: 15%, 30-44: 40%, 45-49: 35%, 60+: 10%. Ethnicity: Non-Hispanic White: 60%, Hispanic/Latin: 17%, Black or African American: 10%, Native American/Alaskan Native: 3%, Asian or Asian-American: 3%, Multiracial: 7%, SUD status: Single substance: 72%, Polysubstance: 28%, Alcohol use disorder (AUD): 32%, Opioid use disorder (OUD): 22%, Stimulant use disorder: 14%, Marijuana use disorder: 3%.

Next, an explanation of the study design.

Study Design:

The APF collected data between August 12th and December 12th, 2021.

The interviews were conducted by trained staff who were themselves in recovery from a substance use disorder. The interviews were Life Course History interviews, based on life course theory. This theory defines the life course of an individual as a “a sequence of socially defined events and roles that the individual enacts over time.” Life Course History interviews allow participants “to provide a subjective account of their life over a certain period of time, described in their own words, across their own personal timelines.”

This qualitative approach to interviewing allowed researchers to create a map that demonstrates “how complex interactions over the course of an individual’s life contribute to the onset, progression, and treatment of a SUD and the elements of long-term recovery.”

In other words, these interviews create a framework for an individual to tell their own life story, identify key moments, and offer their insight on how specific events led them to where they were at the time of the interview.

Life Course History interviews include questions on the following topics:

Substance use
Trauma
Adverse childhood experiences
Treatment experiences
Facilitators to seeking treatment and recovery
Barriers to seeking treatment and recovery
Other information related to lived experience with addiction and recovery
Open questions to increase engagement

The Life Course History interviews were qualitative, which means, essentially, they revolved around things that can’t be described by numbers or by counting, but rather focus on the quality – i.e. the subjective experience or feeling – of an event, rather than a specific numerical value, or quantity.

Metrics and Assessments Completed by Participants

Severity of SUD:
- Addiction Severity Index (ASI)
Physical, Psychological, Social and Emotional Consequences of SUD:
- Inventory of Drug Use Consequences (InDUC)
Early/Childhood Trauma:
- Adverse Childhood Experiences Screening
Biological, psychological, and social Needs (biopsychosocial):
- Global Appraisal of Individual Needs (GAIN)

That’s the relevant information on the participants and the way the ADF conducted the study.

Now let’s take a look at the results.

What’s it Really Like? Challenges, Successes, Outcomes

After reviewing the extensive life history narratives collected during the first phase of their work, the research team defined seven core components of addiction recovery, i.e. the recovery journey, and formulated a Patient Course Map. We’ll report on all seven phases of the map, with details that will benefit anyone who wants to know what addiction treatment is really like.

This map can help people thinking about committing to treatment, people already in treatment, as well as friends and family of anyone thinking about/currently in treatment or on their own recovery journey.

Ready?

There’s a significant amount of information to process, here, but we promise: knowing all this information is helpful on a variety of levels. The most important, though, is to help individuals answer the question we pose above: