Mechanisms and mediators of addiction recovery

Addiction recovery is a complex, dynamic and non-linear process of change on multiple life domains, and in substance use patterns in particular (Dekkers et al., 2020; White, 2007). While early definitions equated recovery with ‘remission’, ‘abstinence’ or absence of symptoms of dependence, later conceptualisations have also emphasised the importance of health, well-being, quality of life, citizenship and social participation, as illustrated in the Betty Ford Consensus Panel definition (Betty Ford Institute Consensus Panel, 2007, p. 222): ‘a voluntarily maintained lifestyle, characterized by sobriety, personal health, and citizenship’. Although abstinence may be an important feature, it is not a prerequisite for recovery (Laudet & White, 2010). The addiction recovery literature has grown quickly over the last few years, including a variety of recovery indicators, resources and instruments (Ashford et al., 2020; Best & Laudet, 2010; Best et al., 2021; Cano et al., 2017; Cloud & Granfield, 2008; Groshkova et al., 2013; Neale et al., 2016). Far less is known about how recovery takes place and which mechanisms and mediators are central to addiction recovery