Addiction care needs a strategy for rigorous measurement and rapid progress

Measuring success through recovery capital indicators will boost care engagement, align with community priorities, and transform more lives

The addiction and overdose crisis in the United States is raging. COVID is exacerbating the underlying drivers of addiction. And despite the extraordinary efforts of great people and organizations, the problem persists.

Why?

The renowned Harvard Business School professor, Michael Porter, proclaimed:

“IF WE CAN’T MEASURE SUCCESS ROBUSTLY AND RIGOROUSLY, IT’S VERY HARD TO MAKE THE MOST RAPID PROGRESS.”

In the addiction and behavioral health arena, we aren’t measuring success. We’re plagued with measures of failure, such as: number of overdoses, DUI’s, number of prescriptions, alcohol-related traffic accidents, etc.

Policy is created and resources are allocated with these metrics in mind — either directly or indirectly. Instead, we should be designing solutions for the measures that ensure these events are not the leading indicators.

To get where we are today to that future is a big leap. But if we never take the first step, we’ll never get there.

The more I ponder this quandary, the more I believe the first step is to adopt a recovery capital-centered strategy.

What is a recovery capital strategy?

In a nutshell, systems, workflows, and interventions should all operate to build, strengthen, or maintain recovery capital.

Recovery capital encompasses all the tangible and intangible elements that either hinder or help our wellbeing. In other words, the social, economic, and environmental determinants of our health.

Since these elements or determinants include our general health, social connections, values, employment, to name a few, we are now centering our focus on the underlying drivers of addiction.

When we place those drivers at the center of our work, we start to move further from triage and chaos to act and adapt.

This is not to say that many organizations do not help those they serve get employment or housing, connect to positive social supports, and even educate toward self-discovery. It’s just that we’re not measuring those activities in most robust and meaningful way. Counting whether someone shows up to a mutual aid group is one thing, whether that action had any impact is another. The counting is important for reinforcing new, positive habits. We just need to drop below the surface a bit to understand whether the new habit has any meaning.

The right recovery capital strategy and tools for capturing and measuring this data are necessary.

There’s obviously a lot more to that very simplistic framing. That’s why I dove a little deeper and wrote a short eBook that includes access to an audio book version.

Beyond Sobriety: The Role of Recovery Capital in Successful Addiction and Behavioral Healthcare.

Here’s the introduction:

There’s an urgent need to focus on the social, economic, and environmental determinants of health. Conditions like addiction are rooted in these determinants, yet our care strategies position sobriety as the goal or a key indicator of success.

Continuing down this path will further alienate addiction and behavioral healthcare from upstream solutions, community- based opportunities, and outcomes- or impact-based payment models.

I’ve been in remission from addiction since 2005. I measure my recovery capital monthly. As you can see above, my recovery capital has been up and down in 2020. Despite the challenges of the year, the mindful practice of engaging my recovery capital has kept me solutions-focused, taking inventory of my whole-wellbeing, and immersed in my purpose.

What follows is designed to provide insight into how individual observations of recovery capital can strengthen engagement with those you serve, make your organization more data-driven, and ultimately transform more lives.

One of Commonly Well’s tools for building and designing better solutions is the Recovery Capital Index (RCI). Certainly we are interested in the adoption of recovery capital as a measure. Even more, we believe that the RCI can serve as a standard, quantified, and validated measure that will allow systems to communicate and deliver success in a common language.

I hope you’ll take a 20–30 minutes to read or listen to “Beyond Sobriety.” If you’re short on time, get the audio version for your phone and listen while you drive or go for a walk (like any other podcast).

It you are not already thinking about or using recovery capital in your data and outcomes strategy then maybe this will get you a step closer.

The term “recovery” can be ambiguous and have a separate definition for each person — and that’s okay. Recovery capital, on the other hand, can provide a framework of agreed upon elements that sustain and promote not just addiction recovery but general wellbeing.

Recovery Capital can apply to anyone at any stage in their experience with addiction. The more you apply recovery capital measures, the more you can personalize care but also get ahead of issues that exacerbate addiction at individual and community-wide levels.