REC-PATH : Recovery pathways and societal responses in the UK, Netherlands and Belgium : final report

It is now generally agreed that not only do most people eventually overcome substance use disorders, they do so through a gradual process of change that is referred to as a ‘recovery journey’. The aim of this study was to assess what the key factors are that are associated with this process and whether they differ according to gender and according to the context in which the journey is undertaken. The REC-PATH study was a collaboration between researchers in Belgium, the UK and the Netherlands who used multiple methods to address what support services and systems were commonly used in recovery and whether national policies were relevant in supporting and sustaining recovery change. Finally, we wanted to assess whether recovery pathways were different for men and women. While the results of the outcome component of the research, where more than 300 participants completed in-depth surveys on three occasions, separated by more than one year, did not show gender differences, there were some extremely positive results: - Relapse was unusual across the whole sample; - Relapse was unusual, especially for those who started the study with more than five years already in recovery; - Rates of meaningful activities and stable housing were high across the sample, while unmet needs were low particularly among those in stable recovery; - Participants whose recovery journeys included a combination of mutual aid and treatment were associated with better outcomes than participants whose recovery journeys only included specialist addiction treatment, or only included mutual aid. Qualitative interviews from the UK suggest that men’s recovery journeys are more dependent on careers and group factors while women rely more on primary relationships (partners, parents, and children in particular). The Photovoice study revealed the methodological potential of photovoice as a research method for exploring interconnected recovery challenges among women, as well as the destructive impact of negative social norms on women’s recovery experiences. National policies appeared to have less impact on recovery experiences as, across all three countries, bold recovery models had been poorly operationalised and the delegation of policy implementation to a local level meant weak implementation and limited evaluation