From sobriety to quality of life: Revisiting recovery outcome measures

What’s included?

1. Introduction
2. Beyond abstinence: Why quality of life matters
3. Recovery capital
4. A new opportunity through the KTP

Addiction and recovery literature has typically focused on behavioural outcomes such as abstinence, reduced use, and the motivation to initiate and sustain change. While these outcomes matter, recovery is far more complex than the simple absence of addiction and its harmful consequences.  It is a long-term, effortful process that involves building a fulfilling life, maximising wellbeing, and forming connections with others and with society.  Crucially, we know that the shape and direction of this journey are personal choices, determined solely by the individual.

Recovery is about building a satisfying and meaningful life, as defined by the person themselves.

– UK Drug Policy Commission, 2008

Beyond abstinence: Why quality of life matters

An overemphasis on abstinence can be detrimental to individuals who have made significant progress in their relationships, health, and wellbeing but experience a lapse into previous behaviours. Anticipated and internalised stigma, shame, fear of judgment, and a sense of “failure” may discourage people from seeking help after a lapse, potentially delaying access to support when it is most needed.

If abstinence were not considered the primary benchmark of success, greater value could be placed on broader strengths and achievements. This approach would make continuing positive progress more meaningful than the prospect of reverting to old habits.

Recovery capital

The concept of “recovery capital” has advanced the addiction field by shifting the focus away from pathology and deficits toward a holistic, asset-based approach.  Recovery capital encompasses the internal and external resources that help individuals to build resilience and enhance wellbeing, social functioning, and life satisfaction. Together, these resources create a foundation for improved quality of life and serve as essential pillars for sustained recovery (Best and Hennessy, 2021).

Even during times of crisis, recovery capital provides resources and support that when effectively utilised, can help a person to regain stability and continue moving forward in their recovery journey, even following a stumble or lapse.

At Delamere, recent evaluation data from 158 guests demonstrates significant improvements in quality of life scores. On a five-point scale, scores rose from an average of 2.63 at admission to 4.24 at discharge. Guests who began with the lowest scores reported some of the most substantial gains by the end of treatment. Similar improvements were observed in measures of depression, anxiety, and cravings. These findings underscore that effective treatment supports outcomes that extend far beyond abstaining from substances. True recovery outcome measures should capture the dimensions of an improved life – one that feels manageable, balanced, and fulfilling.

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A new opportunity through the KTP

Although there is still no single agreed definition of recovery, the narrative is shifting. Stakeholders increasingly recognise recovery as multifaceted and deeply personal process. 

The next essential step is changing how we capture recovery data and monitor recovery progress in treatment settings. This Knowledge Transfer Partnership (KTP) offers a rare opportunity to do just that. 

First, it allows us to hear and learn what recovery outcomes are important for people with higher levels of social and financial capital. Historically, UK addiction and recovery research has concentrated on populations disproportionately affected by addiction-related harms, such as individuals experiencing homelessness, social exclusion, or involvement in the criminal justice system. While this focus is essential for addressing health inequalities, it has created a demographic bias within the evidence base, meaning that our understanding of addiction and recovery is incomplete, particularly for individuals who do not fit the typical profile of participants in addiction studies. The KTP provides space and opportunity to hear the voices of a group whose experiences, needs, and recovery trajectories have been underrepresented in academic literature.

Second, by expanding research metrics to include self-determined outcomes, we enable Delamere to collect data that truly reflects the diversity of its guests’ and alumni’s personal recovery experiences. By gathering and analysing outcomes throughout treatment and beyond, we can better understand how the Delamere Treatment Model supports sustained recovery and improved quality of life. Capturing, measuring, and celebrating a wide range of recovery outcomes raises expectations of what recovery – and recovery support – can deliver.

Citations

1. Best, D. and Hennessy, E.A. (2021). The science of recovery capital: where do we go from here? Addiction, 117(4), pp.1139–1145. https://doi.org/10.1111/add.15732
2. UK Drug Policy Commission (2008). A vision of recovery. pp.1–9.

Summary

Article Name

From sobriety to quality of life: Revisiting recovery outcome measures | Delamere

Description

Explore why recovery should be measured beyond abstinence, focusing on quality of life, recovery capital, & personalised outcomes that reflect true wellbeing.

Author

Emma Davidson

Publisher Name

Delamere Health Ltd

Publisher Logo

About the author: Emma Davidson

Emma is the Programme Impact Lead on the Knowledge Transfer Partnership (KTP) between Delamere and Manchester Metropolitan University. She is based in the School of Nursing and Public Health.