Happiness with recovery from alcohol and substance use disorders predits abstinence and treatment retention

Abstract

Purpose: Although research has primarily focused on the role of indicators of poor functioning in treatment outcomes for alcohol and other substance use disorders (SUDs), a growing body of positive psychology research explores the importance of indicators of wellbeing for SUD recovery. We conducted a secondary analysis of data from an intervention study to clarify the association between wellbeing indicators and treatment outcomes. Methods: We recruited participants (N=81; M=39 years old, 53% female, 26% BIPOC, 46% indicating alcohol as primary addiction) from three treatment centers in the Upper Midwest in 2020-2021. We used baseline survey data to examine the association between wellbeing indicators (assessed M=62 [SD=57] days after intake at host treatment center) and two treatment outcomes: abstinence (yes/no) and treatment retention (leaving on good terms/leaving for other reasons). Wellbeing indicators included positive affect, serenity, flourishing, happiness with recovery, satisfaction with life, trait gratitude, commitment to sobriety, quality of life, and confidence staying sober. We calculated point biserial correlations between wellbeing indicators and binary outcomes. Logistic regression models examined the relationship between each wellbeing indicator significant in correlation analyses with treatment outcomes while controlling for urges to use, recruitment site, and days of sobriety. Results: Serenity (OR=1.386) and happiness with recovery (OR=1.625) were associated with abstinence; and positive affect (OR=1.121), flourishing (OR=1.119), and happiness with recovery (OR=1.501) were associated with leaving treatment on good terms, controlling for covariates (p<.05). Flourishing (OR=1.115) was marginally associated with abstinence and serenity (OR=1.234) was marginally associated with leaving on good terms at p<.10. Conclusions: People who are happy with their recovery are more likely to remain sober and leave treatment on good terms. Assessed via a single-item measure we developed ( “Overall, I am happy with my recovery”), results show promise for a novel, simple assessment approach to measuring wellbeing in recovery and a potential target for intervention: increase happiness with recovery. Future studies should explore the relationship between wellbeing indicators, especially happiness with recovery, and treatment outcomes using larger samples and among subpopulations of people in recovery from SUD.