The impact of COVID, lockdown and subsequent easing on recovery in an ongoing international study of people in recovery from drug addiction

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Evidence suggests that addiction recovery is a complex and long-term journey generally estimated to last approximately five years after completing a detoxification from the addictive substance. In the first year, the likelihood that the person will relapse is around 50-70% and that gradually diminishes so that, after five years of continuous sobriety, the likelihood of relapsing to substance use drops to around 14%. The recognition that there is a 'recovery pathway' beyond specialist addiction treatment has resulted in the emergence of a science and practice of supporting recovery by assessing what factors support people to achieve this goal and the barriers they are likely to encounter. For instance, we know that access to recovery housing, to peer support and to twelve-step mutual aid groups (Narcotics Anonymous and Alcoholics Anonymous) have a positive impact, but that other things, like ongoing mental health problems or involvement with the criminal justice system, are likely to have the opposite effect and increase the likelihood of relapse. This study builds on an ongoing research study that has assessed pathways to addiction recovery in one country with established recovery models (the UK) and two countries who have only recently developed recovery pathways and models (Belgium and the Netherlands). This original study assessed pathways to recovery and what support systems and services participants had used to support their recovery journeys, with a particular focus on how these varied between men and women. In the original study, there was an initial screening questionnaire followed by two waves of in-depth questionnaires that allowed us to chart changes over time in wellbeing and functioning, with a subset of people in each of the three countries also completing in-depth interviews about their experiences during their recovery journeys. That study has allowed two important things to emerge - the first is an international team who have worked closely together to develop a knowledge and expertise and, secondly, a strong and trusting relationship with many of the people in recovery who participated in the earlier waves of the study. The current proposal aims to build on that research and in particular to assess what impact the fear of COVID (or actually contracting COVID) has had on this vulnerable population and how it has affected their recovery journeys and wellbeing. Again, there will be an emphasis on the differences between men and women but this time there will also be a focus on ongoing recovery support and social support. The current study will allow us to assess the impact that COVID has on the wellbeing of a vulnerable and complex group and to assess what the risk factors are for people to relapse or in other ways suffer the adverse effects of COVID.