Posts by Dace Svikis, PhD, and Kenneth Kendler, MD

Summary: Individuals with a history of substance use disorder might be eligible to participate in a brief online survey about personality, mental health, and substance use. Those who complete the survey and provide a DNA sample (in the form of saliva) will be compensated for their time and effort

People seeking help for the resolution of alcohol and other drug (AOD) problems in the United States encounter not comprehensive systems of care but silos of care based on single pathway models of addiction with narrow menus of derived services, each highly critical of competing silos. Far too often, people with the most severe, complex, and enduring AOD problems traverse multiple silos without finding a sustainable recovery solution. Below are some reflections on why these single pathway approaches to addiction and recovery are so troublesome and a few thoughts on how we may escape entrapment in such ideological prisons.

Since the early promulgation of addiction as a brain disease, I have warned that such a model could increase rather than decrease addiction-related stigma if not also accompanied by a parallel understanding of the neurobiology of addiction recovery. To that end, I joined several colleagues in calling for a recovery research agenda that includes a focus on the degree to which brain functioning is restored during the recovery process. In the intervening years, significant research has illuminated such healing processes and their implications for recovery management. The most significant of this work has been done on alcohol use disorders. The extent to which these findings are applicable to other substance use disorders remains unclear.

Addiction recovery is best viewed as a process rather than an event, but the transition into recovery can sometimes be more a cataclysm than a product of incremental steps—more a lightning strike than a process of maturational learning—and the factors that sustain recovery over time may be quite different than those that trigger recovery initiation. Where recovery stability is achieved in gradual stages and within later stages of enhanced global health and functioning in recovery, there are can be surges in growth that exert profound effects on personal identity and character and one’s relationship with the world.