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Recovery From Opioid Problems in the US Population

Prevalence, Pathways, and Psychological Well-Being

Hoffman, Lauren A. PhD; Vilsaint, Corrie PhD; Kelly, John F. PhD

doi: 10.1097/ADM.0000000000000561
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Objectives: Research has enhanced our understanding of opioid misuse prevalence and consequences, but few studies have examined recovery from opioid problems. Estimating national recovery prevalence and characterizing individuals who have resolved opioid problems can inform policy and clinical approaches to address opioid misuse.

Methods: We conducted a cross-sectional investigation of a nationally-representative sample of US adults who reported opioid problem resolution (OPI). For reference, OPI was compared with an alcohol problem resolution group (ALC). Analyses estimated OPI/ALC prevalence, differences in treatment/recovery service use, and psychological well-being, within 2 recovery windows: <1 year (early recovery) and 1 to 5 years (mid-recovery) since OPI/ALC problem resolution.

Results: Of those who reported alcohol or drug use problem resolution, weighted problem resolution prevalence was 5.3% for opioids (early recovery 1.2%, mid-recovery 2.2%) and 51.2% for alcohol (early recovery 7.0%, mid-recovery 11.5%). In mid-recovery, lifetime use of formal treatment, pharmacotherapy, recovery support services, mutual help, and current pharmacotherapy were more prevalent in OPI than ALC. Service utilization did not differ between early-recovery OPI and ALC. Common services used by OPI included inpatient treatment (37.8%) and state/local recovery organizations (24.4%) in mid-recovery; outpatient treatment (25.7%) and recovery community centers (27.2%) in early recovery; Narcotics Anonymous (40.2%–57.8%) and buprenorphine-naloxone (15.3%–26.7%) in both recovery cohorts. Regarding well-being, OPI reported higher self-esteem than ALC in early recovery, and lower self-esteem than ALC in mid-recovery.

Conclusions: An estimated 1.2 million American adults report resolving an opioid problem. Given the service use outcomes and longer-term problem resolution of mid-recovery OPI, early-recovery OPI may require encouragement to utilize additional or more intensive services to achieve longer-term recovery. OPI beyond recovery-year 1 may need enhanced support to address deficient self-esteem and promote well-being.

Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA (LAH, CV, JFK).

Send correspondence to Lauren A. Hoffman, PhD, Recovery Research Institute, 151 Merrimac Street, 6th Floor, Boston, MA 02114. E-mail: lhoffman1@mgh.harvard.edu

Received 23 February, 2019

Accepted 11 July, 2019

Funding: This research was supported by the Recovery Research Institute at the Massachusetts General Hospital, Harvard Medical School.

Financial disclosures: Dr Hoffman was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number F32 DA047741. Dr. Vilsaint and Dr Kelly were supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Numbers F32AA025823 and K24AA022136, respectively. The authors declare no financial or other conflict of interests that could affect the integrity or veracity of this work.

© 2019 American Society of Addiction Medicine