“This story is only starting to be told.
We have much work to do … to challenge the stereotypes of both the general public and our own professionals.
Addiction may well be a chronic, relapsing condition but people can and do recover.
They can change and that change is not only personal but social and societal.”
US & AUSTRALIAN LIVES IN RECOVERY
In the US, a total of 3,228 people completed the online survey and as in the Australian survey just over half of the sample was female.
The samples were also very similar in that the mean length of the substance using career was 18 years in the US and 18.6 years in Australia. The average ages of recovery initiation were also very similar – 34.8 years in Australia and 36 years in the US.
While 75.2% of the US sample described themselves as being ‘in recovery’ and 13.7% as recovered, this was true for 79.8% and 6.3% respectively in Australia.
In terms of problem profile, primary alcohol was the problem for 29% in the US and 35% in Australia, drugs only for 13% in the US and 11% in Australia, and both alcohol and drugs for 57% in the US and 54% in Australia.
In terms of their pathway to recovery, 70.5% of the US sample had received formal treatment, compared to 69.8% in Australia; 94.6% of the US recovery group had attended 12-step meetings compared to 82.0% of the Australian sample. Although a wide range of other mutual aid groups was reported, there was much less frequent use of mutual aid groups other than 12-step in Australia.
There is a higher rate of lifetime mental health problems in Australia – while 62.4% of the US sample had been treated for a mental health condition, 91.5% of the Australian sample reported lifetime mental health problems and 56.8% reported current involvement with mental health services. In the US, 55.6% had a bachelor or graduate degree, while this was true for 41.4% in Australia. At the time of the survey, 70.8% of the US sample was employed compared to 68.2% of the Australian participants. Thus, it is reasonable to conclude that the histories and careers of the Australian sample were very similar to their American counterparts.
THE IMPACT OF RECOVERY IN THE US AND AUSTRALIA
The most dramatic and powerful findings of the US survey, that addiction involves “many heavy costs … to the individual and to the nation” and that “recovery from alcohol and drug problems is associated with dramatic improvements in all areas of life” (FAVOR, 2013, page 1) are clearly replicated in the Australian context.
As in the US, where 4 out of 10 individuals experienced financial problems while in recovery, this was also the case for around one in 3 in Australia who owed back taxes and / or had bad debts. However, there were dramatic effects in Australia as in the US of family functioning with significant reductions in domestic violence.
The Australian study also successfully replicates the US findings around health and criminal justice – with marked improvements in positive health markers such as regular exercise, registering with a GP and regular dental check-ups and significant reductions in negative health factors such as ED attendance and untreated psychological problems.
As in the US sample just over half of the Australian sample had a lifetime arrest history (although significantly fewer Australians in recovery had been incarcerated following sentence), the reduction in arrests and in any involvement with the criminal justice system was even more dramatic – around 40% of the US sample and 90% of the Australian sample had no criminal justice system involvement while in recovery.
There were similarly positive differences in work and study – showing the same overall pattern of reduced burden to the taxpayer and the same improvement in personal, family and community wellbeing and connectedness.
Similarly, there is a dramatic reduction in involvement with the criminal justice system from around half to less than one in ten, particularly involving the areas of drink-driving and criminal damage. There is also a dramatic improvement in both employment and education, and in successful engagement and retention of jobs. This is a story of overcoming adversity and transforming lives to make a significant and positive contribution in their families, in their communities and to society. These results are consistent with the findings of the US Life in Recovery Survey (Laudet et al, 2013) in showing dramatic reductions in pathology and improvements in wellbeing from active addiction to recovery. This is the first attempt at undertaking a recovery survey in Australia and the results are unequivocal in showing that there is an accessible population of Australians who will classify themselves as being in recovery or recovered and who are willing to complete a survey about their experiences.
There is a critical message here for policy makers and treatment providers – that people in Australia can and do recover from addiction problems.
However, there are two nuanced factors that are important to emphasise.
The first is that this is a long and challenging journey for many people and that there will still be residual and ongoing problems for many throughout the recovery journey.
However, there are two nuanced factors that are important to emphasise. The first is that this is a long and challenging journey for many people and that there will still be residual and ongoing problems for many throughout the recovery journey
The findings also emphasise the fact that those in recovery are a very diverse population and that there is no single road to recovery, with a proportion of those participating describing themselves as in ‘medication-assisted recovery’ and a much larger population having ongoing contact with specialist services for addiction or mental health issues.
Nonetheless, the transition reported from active addiction to recovery is a dramatic one.
This is particularly striking in key areas around social and family functioning where the rate of involvement in domestic violence decreased from more than 50% to less than 10% and in volunteering where participation increased from less than 20% to more than 50%.
Similarly, there is a dramatic reduction in involvement with the criminal justice system from around half to less than one in ten, particularly involving the areas of drink-driving and criminal damage. There is also a dramatic improvement in both employment and education, and in successful engagement and retention of jobs.
This is a story of overcoming adversity and transforming lives to make a significant and positive contribution in their families, in their communities and to society.
These results are consistent with the findings of the US Life in Recovery Survey (Laudet et al, 2013) in showing dramatic reductions in pathology and improvements in wellbeing from active addiction to recovery
Those in recovery for the longest term report markedly higher levels of psychological wellbeing and quality of life and much lower levels of need for professional support for emotional or mental health issues.
The other more surprising domain of consistency with the US results is around the demographics and career factors of those who took part. Average age at time of survey completion, average duration of recovery and average length of addiction career are all markedly similar across two countries with differing cultures, treatment systems and philosophies around addiction and recovery.
It is critical that the implications from the Australian Life in Recovery survey are acknowledged and addressed at a federal, state and local level to ensure that the achievement of recovery is extended across families, communities and professional settings (such as health and legal systems).
As such, the following policy recommendations are suggested for consideration:
1. Policy makers should acknowledge and recognise in drug and alcohol commissioning the key role that recovery organisations play in the initiation and sustaining of recovery journeys that benefit wider society and challenge stereotypes and stigma around addiction
2. Greater policy and funding commitment to recovery support services to ensure that those who initiate recovery journeys are supported to maximise their own wellbeing and their contributions to family and community
3. That greater funding is provided for alumni and aftercare organisations to enable the informal community support that is essential to build recovery capital and recovery communities
This story is only starting to be told.
We have much work to do – and we hope to do this through academic publications and presentations – to challenge the stereotypes of both the general public and our own professionals.
There is one core message that the data presented here in Australia and by FAVOR in the US
Addiction may well be a chronic, relapsing condition but people can and do recover.
They can change and that change is not only personal but social and societal.
The next step on this journey is to repeat and augment this work. At the date of publication this survey has already been approved and will be conducted in the UK and we we await the survey outcomes with great interest.
This survey has already followed in the footsteps of the FAVOR survey with almost no resources and supports and we should aim both to do this in more countries and to continue to repeat the surveying to allow us to map global changes and implications in recovery pathways (see final recommendations below).
LIFE IN RECOVERY SURVEY RECOMMENDATIONS
1. That the ‘Life in Recovery survey’ is undertaken in other countries to increase the comparability and so that a shared evidence base can be generated.
2. That repeat surveys are undertaken in Australia to assess change in the nature of the recovering population and in the journeys and stories they provide.
3. That the results from this survey are widely distributed and used to contribute to the policy debate about recovery in Australia.
4. That the results from the current survey are used for academic journal publications to augment the empirical evidence base around recovery.