What is successful recovery? More than 10,000 people worldwide sign on to participate in addiction research

“So here I am, days shy of my one-year soberversary, to tell you that it is possible. And life is so much better on the other side.” — Alissa

“I can stop drinking. I know, I’ve done it many times. But to live a sober life, to really live instead of merely existing, I will need to change fundamental aspects of my persona.” — David

As of September, more than 10,000 people representing all 50 states, about 60 countries, and six continents had joined a network of people in recovery from alcohol, tobacco, and drugs.

They are part of a thriving community on a shared journey toward recovery, and they have accessed resources, inspired others working to overcome addiction, and participated in research as part of the International Quit & Recovery Registry. Sponsored by the Fralin Biomedical Research Institute at VTC, it is a tool created to advance scientific understanding of success in recovery.

“When I came to Roanoke in 2011, I realized that we don't study recovery very systematically in addiction science,” said Warren Bickel, one of the institute’s founding faculty members. “So with the institute’s support, I developed a registry of people in recovery. We asked anybody who has quit anything to give us a valid email address, give us information about their drug and substance use history and their treatment history.”

A growing challenge

Bickel, who also is director of the institute’s Addiction Recovery Research Center and Center for Human Behaviors Research, said there is a pressing need to better understand addiction. Alcohol-related deaths have doubled since 2010. Tobacco use is the leading preventable cause of death in the United States. And accidental drug overdose is a leading cause of death among those under age 45, according to the National Center for Drug Abuse Statistics.

“We are facing unprecedented challenges to human health and well-being,” Bickel said. “The problem of addiction alone is unprecedented — more people are addicted at this time in our country than any time in its history.”

Addiction also has been relatively insensitive to clinical interventions. Among those who receive evidence-based treatment, 70 percent fail. “How would you feel if a doctor told you there was only a 30 percent chance your loved one’s treatment would be successful?” Bickel said. “That's unacceptable. Moreover, there has been no significant change in how we treat people since about 2003.” 

The research

Twelve years since its inception in September 2011, the registry has become a powerful tool. People can register anonymously and are regularly invited to participate in research, which is conducted virtually. Among discoveries based on research using the recovery network, scientists have found that

• Family history of addiction is a risk factor for substance use disorders, and it is associated with other behavioral markers of addiction.
• Confidence in the ability to abstain from substance use can help predict treatment outcomes and risk of relapse.
• The degree to which someone in recovery values immediate, smaller rewards compared with larger but delayed rewards can help identify the perceived risk of relapse.

Much of Bickel’s research examines how people think about the future, and the registry has provided valuable insights. “You have these people who've been focused on the short-term for a long time,” Bickel said. “If that process of having the short-term view is inimical to the problem of addiction, we should see it resolve in addiction recovery. And indeed, that's the way it works.” 

Current research trains participants to identify, reflect on, and value future events. “If you value the future more, you have a greater quality of life in recovery than someone who has a shorter temporal view,” Bickel said. Without that longer time horizon, individuals are less likely to stay in remission.

The robust enrollment also has created the opportunity for a currently active, long-term study of how often people in recovery from addiction, including alcohol use disorder, consume or used to consume alcohol. The study, which includes quarterly surveys of participants, also looks at how quality of life, employment, family relationships, housing, pain, and decisions change over time while in recovery. 

Through their science, and the registry, researchers also plan to continue to share stories of success, like Natalie’s: “After a long history of binge drinking, I got a DUI in 2017. One drink was never enough. I am a registered nurse. I lost my license for a year; I could not work. My whole identity was as an RN. It was a very humbling experience. … I now have 4.5 years sober, and I can confidently say I will not drink, my relationships are better, I sleep better, I lost about 30 pounds and I have more money at the end of the month. The benefits are awesome.”

Researchers invite people in recovery to join the international registry to advance research in evidence-based treatment and recovery.