Purpose The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process. Design/methodology/approach The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery. It has been used in this series, as well as in the design of interventions that improve wellbeing and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model. Findings This paper shows that addiction recovery is a remarkable process that can be explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented. Originality/value Each account of recovery in this series is unique, and as yet, untold.

PurposeYoung people with co-occurring mental health concerns and substance use require support and treatment; however, little is known about the perceptions of what surmises recovery for young people experiencing these concerns. This study aims to identify young people’s perceptions and experiences of recovery in the context of co-occurring substance use and mental health concerns.Design/methodology/approachThis co-production study used a photovoice method to investigate recovery from the perspective of young people. The research team included a lived experience researcher who collaboratively developed the research approach and conducted data collection with traditional researchers. Interpretive phenomenological analysis was used for analysis.FindingsSeven young people participated in this study. Young people identify perceptions of recovery and their experience of pathways into recovery including themes on the connection between substance use and mental health concerns as well as challenges and supports for their recovery. This study has implications for future research and practice, including consideration of adverse childhood experiences, and the need for social and environmental connectedness was highlighted.Originality/valueThis study contributes new insights into perceptions of recovery from the voice of young people experiencing co-occurring mental health concerns and substance use. As a co-production project with a lived experience researcher on the research team, the findings reflect the unique perspectives and challenges young people face with recovery. This study contributes insights into photovoice approaches with young people, including an adapted version of one longer focus group and the use of photocards.

PurposePast traumatic experiences are common among older adults with substance use disorders. Services supporting this population must be sensitive and equipped to address possible past trauma and associated post-traumatic stress disorder (PTSD) amongst service users. This commentary aims to explore past traumatic experiences and associated PTSD among older adults with substance use disorders. The focus is on defining trauma and PTSD, discussing their manifestation in older populations and examining the links between trauma and substance use disorders within the older age group.Design/methodology/approachWe drew insights from authors’ lived experiences and experiences in practice within services supporting older people with substance use problems and trauma and findings from the CO-ACT study, exploring alcohol and mental health problems in older adults. This commentary is supplemented with findings and guidance from relevant research and key bodies involved with older substance users.FindingsThe analysis highlights the importance of services supporting older substance users to be sensitive to past trauma and equipped to address PTSD. The authors focus on the relevance of trauma-informed care and access to trauma-specific interventions in addressing PTSD within this demographic. We shed light on the specific challenges faced by care services in the United Kingdom, while emphasising that the recommendations presented are pertinent to other care systems.Originality/valueThis commentary responds to calls by people with lived experience aiming to inform research on substance use and mental health in older adults. By raising awareness of trauma amongst older substance users, the authors aim to contribute to a more comprehensive understanding of their unique needs. This paper provides insights into the manifestation of trauma and PTSD in older populations and offers recommendations to enhance care services supporting this vulnerable demographic.

PurposeIntegrated care approaches have been recommended for co-occurring substance use and mental health disorders. The purpose of this study is to explore and map the research literature regarding social work and its intersection with co-occurring substance use and mental health disorders.Design/methodology/approachAn iterative and systematic search of five electronic databases CINAHL, Scopus, PsycINFO, Social Science Database and Medline was conducted to identify studies published between 2002 and 2022. Two reviewers independently screened publications in two successive stages of title and abstract screening, followed by a full-text screening of eligible studies. Data from each included publication were screened and extracted using Covidence.FindingsA total of 38 eligible studies were included in the final scoping review. The included studies were conducted in eight different counties, including a range of study designs (e.g. cross-sectional, RCT, pilot studies). Only 8 of the 38 studies included people with co-occurring disorders as participants. Study settings were broad, for example, dual-diagnosis, military, homeless, substance use and community-based settings.Originality/valueA review of the literature surrounding social work practice and its intersection with co-occurring mental health and Alcohol and other drug was warranted to document the evidence on this largely unexplored area of research. This review found that there was a paucity of literature that focused specifically on the role of social work practice in relation to individuals with co-occurring disorders, with a limited number of studies focusing on dual diagnoses.

PurposeEvidence is lacking as to the superiority of dual-focused versus single-focused approaches in treating depression and alcohol use comorbidity. Different people may also value the different features of treatment options differently, necessitating a decision-support tool. This study aims to test the acceptability, feasibility, safety and potential usefulness of the Alcohol and Depression Decision-Aid for Psychological Treatments (ADDAPT).Design/methodology/approachADDAPT was developed according to International Patient Decision-Aid Standards and in consultation with potential end users. Adults with depression and alcohol use comorbidity, who were considering/recently considered psychological treatments, were recruited via online advertisements. After clicking on the study URL, participants accessed the ADDAPT e-book and completed validated and purpose-designed questionnaires.FindingsOf the 24 participants, most would recommend ADDAPT to others (79.2% agree) and endorsed it as easy-to-use (75%), useful in decision-making (79.2%), presenting balanced (87.5%), up-to-date (91.7%), easy-to-understand (79.2%) and trustworthy information (83.3%), which did not provoke anxiety (i.e. safety; 75%). Post-use, participants felt well prepared to decide on treatment (M = 3.48/5) and demonstrated good treatment knowledge (M = 65.83%). All but one participant indicated a treatment choice supported by best available evidence, and decisional conflict scores except for the uncertainty subscale were below the threshold for decisional delay (all M < 37.5/100).Originality/valueADDAPT is the first decision-aid of its kind, with pilot findings supporting its acceptability, feasibility, safety and potential usefulness for improving decision-making quality among people considering psychological treatment options for depression and alcohol use comorbidity.

PurposeThe purpose of this study is to examine the Values in Action (VIA) character strengths profile of people in addiction recovery, to identify which strengths are meaningfully represented in this population. This was compared with the generalised profile of a normative population to identify the differentiating features. Reasons for the profile variance and the significance this has for addiction recovery have also been explored.Design/methodology/approachAn independent group design was adopted using purposive sampling. This saw participants (n = 100) complete the VIA Inventory of Strengths-P assessment to establish a character strengths profile for people in addiction recovery. To identify the differences in this profile, a mean score and rank order comparison was conducted, using data taken from a normative population. Additional exploratory analysis was conducted to establish if there were any significant differences in the character strength profile of males and females.FindingsIn descending order, the top five ranked strengths were kindness, humour, honesty, fairness and teamwork. The lesser five strengths in the profile were spirituality, zest, perseverance, prudence and self-regulation. A distinguishing feature was the presence of humour as a top five strength for people in addiction recovery. The existence of teamwork also deviated from the generalised normative population. There were two strengths shown to have a meaningfully higher score for females, teamwork and love. This did not change the strengths present in the overall top five for males or females, however.Originality/valueThis study contributes useful knowledge to the understanding of character strengths in addiction recovery. To the best of the authors’ knowledge, this is the first time character strengths have been examined in a sample of people in addiction recovery.

News, guidance and resourcesCo-occurring substance misuse and mental health issues profiling tool Office of Health Improvement and Disparities, Public Health England https://fingertips.phe.org.uk/profile-group/mental-health/profile/drugsandmentalhealthDeveloped to support an intelligence-driven approach to understanding and meeting need.It collates and analyses a wide range of publicly available data around tobacco smoking, alcohol use and drug use, including data on prevalence, risk factors, treatment demand and treatment response.The tool also features indicators around mental health prevalence and services.Since December 2016, it has featured related indicators on mortality.The tool provides commissioners, service providers, clinicians, service users and their families with the means to benchmark their area against other areas.National mission on drug deaths: 20222026

PurposeIndividuals with dual diagnoses might experience significant clinical and social vulnerabilities during the pandemic and lockdown. This study aims to compare medication adherence, substance use, clinical stability and overall functioning before and during lockdown periods.Design/methodology/approachThis was a cross-sectional survey among patients registered in dual diagnosis clinic of an addiction psychiatry center in Northern India between March 2019 and February 2020. This study approached 250 patients for telephonic interviews. This study assessed adherence to medications with the brief adherence rating scale (BARS). Global functioning was measured by global assessment of functioning. Clinical interviews assessed substance use and the clinical status of psychiatric disorders.FindingsOne hundred fifty patients were recruited. The mean age of the sample was 35.8 years. The sample had a slight preponderance of alcohol dependence. Depressive disorder was the largest category of psychiatric diagnosis. Compared to prelockdown period, during the lockdown, there were an increased number of days of nonadherence (X2 17.61, p < 0.05), proportion of patients underdosing (X2 8.96, p = 0.003) and lower BARS scores (t = 10.52, df = 144, p < 0.0001). More patients were abstinent from substances during the lockdown (X2 49.02, p < 0.0001). Clinical stability of psychiatric disorders did not differ during the two-time points, but overall functioning decreased during the lockdown (t = 2.118, p = 0.036). This study observed a small positive correlation (r = 0.2, p = 0.02) between functioning and adherence levels.Originality/valueLockdown was associated with poor medication adherence, change in substance use patterns and functional impairment. In the future, treatment programs and policies must take preemptive steps to minimize the effects of restrictions.

The need for age-tailored, holistic and integrated support for older

PurposeThis paper aims to explore the transition from addiction to recovery. It is the third in a series of recovery stories that examine candid accounts of addiction and recovery. Shared components of recovery are considered, along with the change and growth needed to support the transition.Design/methodology/approachThe connectedness, hope, identity, meaning in life and empowerment (CHIME) framework comprises five elements important to recovery (connectedness, hope, identity, meaning in life and empowerment). It provides a standard to qualitatively study mental health recovery, having also been applied to addiction recovery. In this paper, an element for growth is included in the model (G-CHIME), to consider both recovery and sustained recovery. A first-hand account of addiction recovery is presented, followed by a semi-structured e-interview with the author of the account. This is structured on the G-CHIME model.FindingsThis paper shows that addiction recovery is a remarkable process that can be effectually explained using the G-CHIME model. The significance of each element in the model is apparent from the biography and e-interview presented.Originality/valueEach account of recovery in this series is unique, and as yet, untold.