Recovery Capital is the third leg of the addiction solution stool

Issue #1 — The Index

In a commentary written by Josh Nussbaum, CEO and co-Founder of Halcyon Health, he identified measurement as the third leg of the solutions stool for addiction in the U.S. Nussbaum wrote that we must measure “disease progression, treatment efficacy, and long-term outcomes.”

READ: One-size-fits-all addiction treatment must be replaced – MedCity News

“SUCH AN INSTRUMENT WOULD LEAD TO A VIRTUOUS CYCLE, POSITIVELY IMPACTING DOWNSTREAM EFFECTS QUALITY OF CARE, COST AND BETTER TREATMENT MODALITIES AND THERAPEUTICS.”

 Such a measurement also has the potential for upstream disruption. Yes, we need to improve the quality of care and advance the types of care for the millions getting care, but millions more are destined to experience the hell of addiction if we don’t have a connected upstream or prevention strategy.

Recovery capital is the measurement framework that can drive solutions on both sides of the coin. Clinical measures are necessary in the right time and place, but recovery measures provide a broader view of a person’s life. It captures the determinants of a person’s health and wellbeing. Some of those determinants include basic needs like food, shelter, and safety, but go further into one’s sense of purpose, social connections, education, and employment.

Nussbaum further writes:

“BY REORGANIZING THE CARE DELIVERY ECOSYSTEM AROUND EACH INDIVIDUAL’S NEEDS, DISTRIBUTED CATEGORICALLY, THE RESULT IS INCREASED EMPHASIS ON CARE ROUTING; NON-CLINICAL SUPPORT; AND TOOLS THAT OFFER HIGH LEVELS OF PERSONALIZATION.”

Recovery capital as a framework for measurement provides a number of promises for practitioners, advocates, and policymakers.

Practitioners need a wider view of their patient’s lives. In a purely clinical mode, the narrowness of the intervention is like shooting a rifle when what’s needed is a highly focused shotgun. And by expanding scope of care, the value of care increases, which, as Nussbaum points out, gets us closer to value-based or outcomes-based care.

Advocates need recovery data to support their powerful recovery stories. One story is one story. And we cannot say “recovery works” without having strong supporting data.

Policymakers have been fumbling for decades because they continue to focus on a trending substance. Every decade is another round of whack-a-mole. The 2010’s were opioids. Before that it was meth, then heroin, then cocaine. We need policies that fix the reason people turn to those substances. Recovery capital tells more of the complex social, cultural, behavioral, and environmental story that will drive better policies and systems change.

Nussbaum summarizes the current state of recovery capital well – linking to the predictive promise of the Recovery Capital Index.

“WHILE THE PREDICTIVE ABILITY OF ASSESSING AN INDIVIDUAL’S RECOVERY CAPITAL HOLDS GREAT PROMISE, IMPLEMENTATION TO DATE HAS BEEN SCARCE. ESTABLISHING FOCUS ON DEVELOPING THE RIGHT TOOLS, DELIVERED BY THE RIGHT PEOPLE, CONSISTENTLY OVER THE RIGHT TIMES CAN LOWER COSTS, INCREASE ACCESS AND IMPROVE OUTCOMES.”