Robert D. Ashford

Collegiate Recovery Programs: The Integrated Behavioral Health Model

ABSTRACT Campus-based recovery programs have been shown to support students in recovery from substance use disorders, as well as mental health disorders. However, this support has been historically delivered in isolation. This study highlights preliminary outcomes from a novel collegiate recovery program, one that uses a model of recovery with integrated support services for students in recovery from substance use or mental health disorders, or co-occurring behavioral health disorders. Similar to traditional collegiate recovery programs, beneficial services of the integrated program were most often related to peer-based services. Outcomes were also similar, with students in recovery having higher than average Grade Point Average (M = 3.68, SD = .34) and lengths of recovery time (M = 3.69, SD = 2.87 [years]).

Can Twitter be used to predict county excessive alcohol consumption rates

Objectives The current study analyzes a large set of Twitter data from 1,384 US counties to determine whether excessive alcohol consumption rates can be predicted by the words being posted from each county. Methods Data from over 138 million county-level tweets were analyzed using predictive modeling, differential language analysis, and mediating language analysis. Results Twitter language data captures cross-sectional patterns of excessive alcohol consumption beyond that of sociodemographic factors (e.g. age, gender, race, income, education), and can be used to accurately predict rates of excessive alcohol consumption. Additionally, mediation analysis found that Twitter topics (e.g. ‘ready gettin leave’) can explain much of the variance associated between socioeconomics and excessive alcohol consumption. Conclusions Twitter data can be used to predict public health concerns such as excessive drinking. Using mediation analysis in conjunction with predictive modeling allows for a high portion of the variance associated with socioeconomic status to be explained.

The Language of Substance Use and Recovery: Novel Use of the Go/No–Go Association Task to Measure Implicit Bias

ABSTRACT Previous research has found initial evidence that word choice impacts the perception and treatment of those with behavioral health disorders through explicit bias (i.e., stigma). A more robust picture of behavioral health disorder stigma should incorporate both explicit and implicit bias, rather than relying on only one form. The current study uses the Go/No–Go Association Task to calculate a d′ (sensitivity) indexed score of automatic attitudes (i.e., implicit associations) to two terms, “addict” and “person with substance use disorder.” Participants have significantly more negative automatic attitudes (i.e., implicit bias) toward the term “addict” in isolation as well as when compared to “person with a substance use disorder.” Consistent with previous research on explicit bias, implicit bias does exist for terms commonly used in the behavioral health field. “Addict” should not be used in professional or lay settings. Additionally, these results constitute the second pilot study employed the Go/No–Go Association Task in this manner, suggesting it is a viable option for continued linguistic stigma related research.

What we know about students in recovery: meta-synthesis of collegiate recovery programs, 2000-2017

Abstract As a relatively new field of practice, collegiate recovery programs (CRP), have used a practice-informed approach as a means of establishing best practices and pedagogy. While research on collegiate recovery programs and populations of students in recovery is growing, much of the qualitative studies have yet to be synthesized into a useful organizing matrix. This study utilizes meta-synthesis design to explore the leading qualitative research on student experiences in collegiate recovery. From this synthesis, researchers identified six metaphors from ten included studies from 2000–2017. The six metaphors of social connectivity, recovery supports, drop-in recovery centers, internalized feelings, coping mechanisms, and conflict of recovery/student status, support much of the preexisting practices and provide a critical framework for future program design, service delivery, and research.

Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field

ABSTRACT The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations—Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences among those involved in the substance-use disorder and recovery profession using an embedded design and grounded theory approach. Findings suggest that generational differences do exist across the three generations in regard to ideologies, value of formal and informal knowledge, training, and education. Results from the current study provide a further understanding of how we may bridge perceived contentious ideologies and knowledge gaps between generations to better develop current and future professionals within the field.

Peer-delivered harm reduction and recovery support services: initial evaluation from a hybrid recovery community drop-in center and syringe exchange program

BackgroundRecovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effective in improving SUD outcomes, as well as improving the engagement and effectiveness of harm reduction programs.MethodsThis study provides an initial evaluation of a hybrid recovery community organization providing PRSS as well as peer-based harm reduction services via a syringe exchange program. Administrative data collected during normal operations of the Missouri Network for Opiate Reform and Recovery were analyzed using Pearson chi-square tests and Monte Carlo chi-square tests.ResultsIntravenous substance-using participants (Nu2009=u2009417) had an average of 2.14 engagements (SDu2009=u20092.59) with the program. Over the evaluation period, a range of 5345–8995 sterile syringes were provided, with a range of 600–1530 used syringes collected. Participant housing status, criminal justice status, and previous health diagnosis were all significantly related to whether they had multiple engagements.ConclusionsResults suggest that recovery community organizations are well situated and staffed to also provide harm reduction services, such as syringe exchange programs. Given the relationship between engagement and participant housing, criminal justice status, and previous health diagnosis, recommendations for service delivery include additional education and outreach for homeless, justice-involved, LatinX, and LGBTQ+ identifying individuals.

Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias

BACKGROUNDnThe general public, treatment professionals, and healthcare professionals have been found to exhibit an explicit negative bias towards substance use and individuals with a substance use disorder (SUD). Terms such as substance abuser and opioid addict have shown to elicit greater negative explicit bias. However, other common terms have yet to be empirically studied.nnnMETHODSn1,288 participants were recruited from ResearchMatch. Participants were assigned into one of seven groups with different hypothesized stigmatizing and non-stigmatizing terms. Participants completed a Go/No Association Task (GNAT) and vignette-based social distance scale. Repeated-measures ANOVAs were used to analyze the GNAT results, and one-way ANOVAs were used to analyze vignette results.nnnRESULTSnThe terms substance abuser, addict, alcoholic, and opioid addict, were strongly associated with the negative and significantly different from the positive counterterms. Relapse and Recurrence of Use were strongly associated with the negative; however, the strength of the recurrence of use positive association was higher and significantly different from the relapse positive association. Pharmacotherapy was strongly associated with the positive and significantly different than medication-assisted treatment. Both medication-assisted recovery and long-term recovery were strongly associated with the positive, and significantly different from the negative association.nnnCONCLUSIONSnResults support calls to cease use of the terms addict, alcoholic, opioid addict, and substance abuser. Additionally, it is suggested that recurrence of use and pharmacotherapy be used for their overall positive benefits. Both medication-assisted recovery and long-term recovery are positive terms and can be used when applicable without promoting stigma.

Systemic barriers in substance use disorder treatment: A prospective qualitative study of professionals in the field

BACKGROUNDnThe US is in the midst of one of the largest public health crises in recent history with over 63,000 drug poisoning deaths in 2016 and a projected annual economic cost of over

Collegiate recovery programs and disordered eating: exploring subclinical behaviors among students in recovery

420 billion. With the rise of deaths and economic burden related to substance use, it is paramount that systemic barriers within the treatment industry be identified and resolved.nnnMETHODSnData were collected from US substance use treatment professionals (Nu202f=u202f182) in the fall of 2016. Thematic analysis with axial coding was used on anonymized responses to an online open-ended survey. Additional ad hoc testing for variance (education, generation, regional location, and employment) was completed using Monte Carlo chi-square analyses.nnnRESULTSn7 major themes emerged: 1) additional training, education, and use of evidence-based practices, 2) expansion of treatment services, 3) increased resources, 4) stigma reduction, 5) increased collaboration and leadership, 6) reductions in regulations, requirements, and incentives, and 7) expansion of recovery support services. Participant response yielded a significant relationship between employment type (pu202f=u202f0.002) and regional location (pu202f=u202f0.046).nnnCONCLUSIONSnSystemic barriers in the treatment field are prevalent from the perspective of professionals engaged in the field. While previously identified barriers are still present, newly reported barriers include: 1) lack of treatment services (e.g., capacity), 2) lack of technological resources (e.g., technological support tools), 3) lack of recovery support services (e.g., recovery housing), 4) lack of collaboration and leadership (e.g., communication and partnership), and 5) increasing unethical practices in the field (e.g., incentive-based patient brokering).

“Abusing Addiction”: Our Language Still Isn’t Good Enough

ABSTRACT The co-occurring prevalence of disordered eating (DE) with substance use disorders is estimated to be high among college students. Collegiate recovery programs (CRPs), primarily used for the support of students with mental health disorders and substance use disorders, are well positioned to potentially provide support for students with DE behaviors. The current study identifies the prevalence of subclinical DE behaviors among college students currently participating in a collegiate recovery program at a U.S. institution. 61 recovering students (Age: M = 29 years, SD = 8.35, 59% male) completed a digital survey inquiring about subclinical DE behaviors using 9 Likert-type scaled questions. Composite subclinical DE scores were significantly different between student genders, as well as full-time and part-time students. Female and full-time students were more likely to experience subclinical DE behaviors than male and part-time students. As subclinical DE behaviors are present among students engaged in CRPs at a high rate, and though behaviors are most pronounced among female students, they are also are present in males. A majority of students engaged in the CRP feel that the CRP can support mental health and DE recovery in addition to serving those in recovery from substance use disorders.