Recovery, Rehabilitation, and Social Reintegration

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Looking for a referral to, or more information about, mental health or substance use treatment services? The American Board of Preventive Medicine can assist you with locating physicians who are certified as specialists in Addiction Medicine.

The federal Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline at 1-800-662-HELP (4357). "SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information."
SAMHSA's website also offers a free, confidential Behavioral Health Treatment Services Locator.

Page last updated June 9, 2020 by Doug McVay, Editor/Senior Policy Analyst.

11. Role of Social Capital in Recovery

"The research literature on substance abuse treatment has consistently reported evidence to support the view that the relationships people maintain with their families, friends and other social contacts are critical to understanding why people start to abuse drink and drugs, why they persist to the point of addiction, and how they respond to treatment designed to move them to abstinence.

"The most successful treatment programmes are those that recognise the role of social capital and develop interventions that provide support via self-help groups, peer support, and families. Effective recovery programmes need to address other elements of substance abusers’ social environments, including the need for stable accommodation, the capacity to manage financial affairs, and constructive activities that provide a positive alternative to relapse. While good cost-benefit analyses have yet to be done, the available evidence suggests that recovery programmes are likely to be cost-effective. Savings can be made by reducing demand for health care, enabling people to make a positive contribution to their communities.63"

Munton AG, Wedlock E and Gomersall A (2014) The role of social and human capital in recovery from drug and alcohol addiction. HRB Drug and Alcohol Evidence Review 1. Dublin: Health Research Board.

12. Drug Courts, Social Reintegration, and Stigmatization of Drug Users

"Although drug courts provide an alternative to the immediate incarceration of drug users, these courts are still connected to a criminal justice system that treats drug use as a crime. Therefore, when participants enter the drug courts, there is an institutionalized stigma attached to drug use.192 Drug courts perpetuate this stigma because they are based on a system of rewards and punishments. When participants act 'badly' (either by testing positive for drugs or breaking other imposed conditions that create a presumption of drug use), they are treated as pariahs, not patients. For continuing 'bad' behavior, drug court participants can be eventually incarcerated, which is the ultimate representation of societal segregation and ostracism."

Woods, Jordan Blair, "A Decade after Drug Decriminalization: What can the United States learn from the Portuguese Model?" University of the District of Columbia Law Review (Washington, DC: The University of the District of Columbia David A. Clarke School of Law, 2011) Volume 15, Number 1, p. 30.

13. Treatment Effectiveness at Reducing Levels of Offending

"Overall, lower levels of acquisitive offending and high-cost offending were recorded at follow-up. Among those who continued to offend, improvements in offending behaviour at follow-up, in terms of a decrease in its volume and/ or the costs associated with it, were observed. Crack users, injecting users, users with high SDS [Severity of Dependence Scores] scores, and those with previous treatment experience were more likely to offend than others at any point. However, neither referral source nor the type of treatment modalities received, were significantly associated with the level of acquisitive offending at any point (within the adjusted model)."

Andrew Jones, et al., "Research Report 24: The Drug Treatment Outcomes Research Study (DTORS): Final Outcomes Report" (London, England: UK Government, Home Office Ministry, Research, Development & Statistics Directorate, December 2009), p. 10.

14. Effectiveness of Treatment on Employment and Social Reintegration

"The Drug Treatment Outcomes Research Study (DTORS) was one example of European research with encouraging results regarding employment (Jones et al., 2009). This study investigated drug use, health and psychosocial outcomes in 1 796 English drug users attending a range of different types of treatment service. Follow-up interviews were conducted between 3 and 13 months after baseline (soon after initial treatment entry). Regardless of the type of treatment received or drug use outcomes, employment levels increased from 9 % at baseline to 16 % at follow-up. This was accompanied by a corresponding increase in the amount of legitimate income earned per week. The proportion reporting being unemployed but actively looking for work decreased slightly from 27 % to 24 %, reflecting the increase in employment and a 5 percentage point increase in those reporting being unable to work (because of long-term sickness or disability). The proportion of participants classed as unemployed and not looking for work also fell from 24 % to 11 %. Treatment attendance was also associated with changes in housing status; the proportion staying in stable accommodation increased from 60 % to 77 % at follow-up. It should be noted that the findings of this study were weakened by use of a non-experimental design, failure to separate outcomes according to client type and treatment modality, and insufficient detail on the nature of the employment obtained."

European Monitoring Centre for Drugs and Drug Addiction, EMCDDA Insights Series No 13, "Social reintegration and employment: evidence and interventions for drug users in treatment" (Luxembourg: Publications Office of the European Union, 2012), ISBN: 978-92-9168-557-8, doi: 10.2810/72023, p. 67.