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

有证据表明，成瘾恢复是一个复杂而长期的过程，通常估计在完成对成瘾物质的解毒后持续大约五年。在第一年，这个人复吸的可能性在50-70%左右，然后逐渐减少，因此，在连续戒毒5年后，复吸的可能性降至14%左右。认识到除了专业的成瘾治疗之外，还有一条“康复之路”，这导致了一门支持康复的科学和实践的出现，通过评估哪些因素有助于人们实现这一目标，以及他们可能遇到的障碍。例如，我们知道获得康复住房、同伴支持和十二步互助会（匿名戒毒会和匿名戒酒会）有积极的影响，但其他事情，如持续的精神健康问题或与刑事司法系统的关系，可能会产生相反的效果，增加复发的可能性。这项研究建立在一项正在进行的研究的基础上，该研究评估了一个国家（英国）和两个国家（比利时和荷兰）的成瘾恢复途径，其中一个国家已经建立了恢复模式，另一个国家最近才建立了恢复途径和模式。这项最初的研究评估了恢复的途径，以及参与者使用了哪些支持系统和服务来支持他们的恢复旅程，并特别关注了这些在男性和女性之间的差异。在最初的研究中，有一个初步的筛选问卷，然后是两波深度问卷，使我们能够绘制出幸福感和功能随时间的变化，三个国家中的每个国家的一部分人也完成了关于他们在康复过程中的经历的深度访谈。这项研究带来了两件重要的事情——首先是一个国际团队，他们紧密合作，发展了知识和专业知识；其次，与许多参与早期研究的康复人员建立了牢固而信任的关系。目前的提案旨在以这项研究为基础，特别是评估对COVID（或实际感染COVID）的恐惧对这一弱势群体的影响，以及它如何影响他们的康复之旅和福祉。再次强调男性和女性之间的差异，但这一次也将关注持续的康复支持和社会支持。目前的研究将使我们能够评估COVID对脆弱和复杂群体的健康的影响，并评估人们复发或以其他方式遭受COVID不利影响的风险因素。

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.