Pathways to success in early recovery from Opioid Use Disorder: Comparing the change process and contextual factors of recovery between individuals using and not using medications

Abstract

Promoting recovery among individuals with Opioid Use Disorder (OUD) is urgent given the increasing morbidity and mortality associated with opioid use. However, recovery is a complex change process with multidimensional contextual variables involved (health, community integration) and multiple pathways. The current study sought to compare the change process and the contextual variables of recovery between two groups categorized by their chosen pathways of recovery: medication (methadone, buprenorphine, naltrexone) and no medication. The current study investigated these constructs among individuals who demonstrate initial success in the early stages of recovery from Opiate Use Disorder (OUD), such that they have achieved at least one month and less than six months of essential abstinence (i.e., abstinence with the possibility of a slip). Participants were recruited from community treatment agencies. Those participants deemed eligible completed a self-report survey assessing sociodemographics, other background variables, the change process variables of interest (stage of change, behavioral processes, confidence, temptation), and the contextual variables of interest (health pathology, quality of life, social recovery capital, consequences). To conduct the tests of the primary aims, a special case of MANOVA was used: Profile Analysis. Additionally, a subsample of participants completed interviews from which qualitative data were collected. The primary quantitative analyses revealed that there were no significant differences between individuals who chose to take medications compared to those who did not across indicators of engagement in the change process or the experience of the multidimensional contextual recovery variables. Both groups revealed profiles of individuals engaged in the change process with contextual recovery factors characteristic of early recovery. Qualitative analyses revealed themes that helped to contextualize the quantitative findings. Overall, this study suggests that individuals taking medications can be engaged in the change process, dispelling some of the myths associated with recovery medication use.