Book Review: Tackling Addiction: Pathways to Recovery Edited by Rowdy Yates & Margaret S. Malloch

Reveiwed by By Dr Amul Patel, Specialty Registrar (ST5) in Addictions Psychiatry, Royal Edinburgh Hospital

‘Recovery’ is currently a topical and debated subject in the field of addiction. The Scottish Government has embraced recovery in its latest drug strategy: The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem. We may also see a similar move in the UK’s drug policy following recent change of government. This book’s stated aim is to contribute to the ongoing debate on recovery with an intention to inform the way forward for policy and practice in this area.

This is an edited book authored by experienced academics, researchers, professionals, clinicians, and service users with a broad range of expertise in addiction, criminal justice, psychology, psychiatry, service development and management, and sociology. It is a compilation of themes which emerged from a seminar series at the University of Stirling which brought together experts to examine various approaches to recovery and consider the relationship of these approaches to the broader policy context. Although the content of the book has a Scottish flavour, the themes discussed are relevant to the UK. The book is relevant for practitioners, researchers, policy makers and students in the fields of addiction, social care, psychology, and criminal justice.

The concept of recovery may have different connotations for the public, professionals and policy makers. The book begins with a discussion of various definitions of recovery and emphasises the importance of individual meaning and the holistic process. It moves on to describe a brief history of recovery, the new recovery movement and the emerging evidence base for the approach. It describes a recovery model by William White in the United States who has suggested three critical elements: sobriety, improvement in global health, and citizenship. The model acknowledges the place of treatment in the early phase of the recovery journey but emphasises much more the social location of the process. It underscores the need for a paradigm shift from an acute care model to the long-term approach.

The middle section of the book explores themes on recovery within projects, women and recovery, and the therapeutic community as a recovery-oriented treatment pathway. The chapters on recoveryoriented integrated systems in North West England and the Ley community, an addiction therapeutic community in Oxfordshire, give a useful insight in to how such systems can be commissioned and provided. The later chapters highlight implications for practitioners and also discuss the concept of recovery in the context of UK drug policies and criminal justice system. The book argues that in recent years, evidence has been used selectively to explain drug use as a crime problem rather than public health problem. It also examines the extent to which drug treatment and testing orders contribute towards promoting recovery. The longest chapter of the book explores the experiences of individuals ‘in recovery’, which I found fascinating. It instils optimism that individuals do recover from chronic and relapsing nature of addiction. This, along with its inclusion of hard-to-come-by information on women in recovery, makes the book unique.

Though the book covers disparate themes, its repeated emphasis on the definition of recovery is evident throughout. It is concise and does not intend to be comprehensive. It provides a starting point on the subject of recovery in addiction. It is easy to read but the style and content of chapters vary according to the theme and the background of the author. The discussion on the limitations of the recovery approach is sketchy and it does not appear to adequately acknowledge the process of recovery in non-abstinence based models.

The book does appear to succeed in its critique of current UK drug policies and criminal justice system which are described as somewhat less than favourable to the recovery oriented approach. It contrasts policies based on the public health (harm reduction) perspective with the person-centred approach of the recovery model and succeeds in stimulating thoughts on that subject. It is useful in understanding the recovery standpoint but the reader would have been benefi tted by case examples from professionals’ perspectives depicting how the process of recovery could be facilitated at grassroot level and how service users could be helped to be ‘on top’ of the process.

The book aspires researchers to be creative in finding academically credible ways of studying pathways and models of recovery, as described by one of its authors: ‘We are riding on a wave of enthusiasm and optimism at present – it is essential that this is translated into meaningful change and evidence’.

Tackling Addiction: Pathways to Recovery - Edited by Rowdy Yates & Margaret S. Malloch, Jessica Kingsley Publishers, 2010. £22.99 (pb). 192pp. ISBN: 9781849050173