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      The Case for Considering Quality of Life in Addiction Research and Clinical Practice

      research-article
      , Ph.D.
      Addiction Science & Clinical Practice
      National Institute on Drug Abuse

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          Abstract

          Substance use disorders are increasingly viewed as chronic conditions, and addiction treatment services are beginning to adopt models that were developed to address other chronic conditions. These models address the impact of disease and services on the patient’s overall well-being. From this perspective, treatment for addiction aims for the broad goal of recovery, which is defined as abstinence plus improved quality of life. However, the addiction field has come late to the chronic disease perspective, and the concept of quality of life in addiction is relatively undeveloped. This article reviews the evidence for the relevance of quality of life in substance use disorder treatment and recovery and discusses the importance of incorporating quality-of-life indices into research and services.

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          Most cited references73

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          Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.

          The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses. JAMA. 2000;284:1689-1695.
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            Conceptualizing recovery capital: expansion of a theoretical construct.

            In order to capture key personal and social resources individuals are able to access in their efforts to overcome substance misuse, we introduced the construct of recovery capital into the literature. The purpose of this paper is to further explore the construct and include discussions of implications unexplored in our previous writings. In this paper we reveal the relationship between access to large amounts of recovery capital and substance misuse maintenance and introduce the concept of negative recovery capital. In doing so, we examine the relationships between negative recovery capital and gender, age, health, mental health, and incarceration.
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              What is recovery? A working definition from the Betty Ford Institute.

              (2007)
              There is an unknown but very large number of individuals who have experienced and successfully resolved dependence on alcohol or other drugs. These individuals refer to their new sober and productive lifestyle as "recovery." Although widely used, the lack of a standard definition for this term has hindered public understanding and research on the topic that might foster more and better recovery-oriented interventions. To this end, a group of interested researchers, treatment providers, recovery advocates, and policymakers was convened by the Betty Ford Institute to develop an initial definition of recovery as a starting point for better communication, research, and public understanding. Recovery is defined in this article as a voluntarily maintained lifestyle composed characterized by sobriety, personal health, and citizenship. This article presents the operational definitions, rationales, and research implications for each of the three elements of this definition.
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                Author and article information

                Journal
                Addict Sci Clin Pract
                101316917
                Addiction Science & Clinical Practice
                National Institute on Drug Abuse
                1940-0632
                1940-0640
                July 2011
                : 6
                : 1
                : 44-55
                Affiliations
                Center for the Study of Addictions and Recovery, National Development and Research Institutes, New York, New York
                Author notes
                CORRESPONDENCE: Alexandre Laudet, Center for the Study of Addictions and Recovery, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th floor, New York, NY 10010; e-mail: alexandrelaudet@ 123456gmail.com .
                Article
                ascp-06-1-44
                10.1136/bmj.b2495
                3188817
                22003421
                155489bb-7abc-4a8d-aa5e-35eaa57c4f88
                Copyright @ 2011
                History
                Categories
                Clinical Perspectives

                Health & Social care
                Health & Social care

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