Prescription drug abuse is a pressing public health issue, and people who misuse prescription drugs are turning to online forums for help. Are such forums effective? We analyze the process of opioid withdrawal, recovery and relapse on Forum77, MedHelp.org's online health forum for substance abuse recovery. Applying Prochashka's Transtheoretical Model for behavior change, we develop a taxonomy describing phases of addiction expressed by Forum77 members. We examine activity and linguistic features across the phases USING, WITHDRAWING and RECOVERING. We train statistical classifiers to identify addiction phase, relapse and whether a user was RECOVERING at the time of her last post. Applying our classifiers to 2,848 users, we find that while almost 50% relapse, the prognosis for ending in RECOVERING is favorable. Supplementing our results with users' own accounts of their experiences, we discuss Forum77's efficacy and shortcomings, and implications for future technologies.

http://idl.cs.washington.edu/files/2015-Forum77-CSCW.pdf

Forum77: An Analysis of an Online Health Forum Dedicated to Addiction Recovery

Opioid Use Disorders.

Conceptualizing aetiology underpinning an individual’s substance use disorder (SUD) not only facilitates insight and understanding, but also serves to identify targets for treatment and aid practitioners in selecting the most appropriate interventions. There is now a wealth of literature on aetiology and treatment approaches, and in more recent years, also literature to support the concept of ‘recovery’ from a condition which was previously thought of as a chronic, relapsing condition. The burgeoning literature around research into recovery is revealing how recovery can best be defined and what factors might be associated with recovery from SUD. To add further to this growing body of literature, a new six-domain, explanatory biopsychosocial model of substance dependence and recovery, the Lifestyle Balance Model (LBM) is proposed. Based on research findings and theory reported in the literature, the LBM is a generic model depicting six domains of biopsychosocial functioning and includes within it the role of lifestyle. The LBM has been constructed as a domain model, allowing conceptualisation of the relationships between the six domain areas that perpetuate dependence and may also be associated with recovery from SUD, providing service users and clinicians with a tool for the delivery of case formulation and identification of target areas for intervention.

/pdf/the-role-of-lifestyle-in-perpetuating-substance-use-disorder-71079k4756.pdf

The role of lifestyle in perpetuating substance use disorder: the Lifestyle Balance Model

As the concept of recovery has expanded, and become embedded in drug and alcohol policy, so too has the proliferation of online recovery support. This article explores data from the UK Life in Recovery survey, focusing on online recovery methods categorized as online groups, websites, and smartphone applications. Although 301 people (39.30%) reported involvement with at least one online recovery method, chi-squared tests reveal significant associations between people in stable recovery (5 years or more) and the use of recovery applications (Cramer’s V = .114), as well as between people in full-time employment and the use of online recovery websites or recovery applications. Having dependent children was not associated with use of any online recovery method, yet gender was (Cramer’s V = .088). This study extends the relatively limited literature and knowledge base of online recovery methods. Although the evidence points to higher engagement of recovery websites and apps for people in stable recovery, encouraging online recovery methods for individuals in early recovery may support recovery efforts when the risk of returning to substance misuse and active using social networks remains high. Further research should investigate the mechanisms of recovery change, with a focus on gender differences.

/pdf/participation-with-online-recovery-specific-groups-findings-22e1gqa2zd.pdf

Participation with online recovery specific groups - findings from the UK Life in Recovery survey 2015

This textbook surveys the current knowledge on substance use disorders (SUD), summarizing scientific evidence from numerous fields. It uses a biopsychosocial framework to integrate the many factors that contribute to addictions, from genetic predispositions, neurological responses caused by drugs, co-occurring psychiatric disorders, personality traits, and developmental conditions to cultural influences. Real-life vignettes and first-person accounts build understanding of the lived experience of addiction. The currently accepted practices for diagnosis and treatment are presented, including the role of 12-step programmes and other mutual-assistance groups. The text also investigates the research methods that form the foundation of evidence-based knowledge. The main body text is augmented by study guideposts such as learning objectives, review exercises, highlighted key terms, and chapter summaries, which enable more efficient comprehension and retention of the book's material.

A. Thomas McLellan

Papers

What Is Recovery? Revisiting the Betty Ford Institute Consensus Panel Definition