Editorial: Understanding recovery capital for addiction recovery in adolescence and young adulthood

In 2017, the Recovery Capital for Adolescents Model (RCAM) was proposed to highlight needs of adolescents in recovery (1), building on the seminal work of William Cloud and Robert Granfield (2). Research since the RCAM was proposed has begun to examine to what extent it provides a meaningful way to understand adolescent recovery. Nearly 10 years later, this topic renews attention on adolescent recovery capital, as well as on recovery capital among young adults, whose needs are developmentally distinct.

This topic generated seven new articles which will expand the way we consider these unique populations and their quest for recovery as embedded within family, peer, and community systems. In addition to a systematic review of recovery high schools (RHS) and collegiate recovery programs (CRPs), the primary research articles examine youth experience in recovery clubhouses, family's and peers’ perception of substance use among youth in recovery, students in CRPs, and treatment for youth opioid use disorder. Importantly, unlike the original adult sample in Granfield and Cloud's development of recovery capital, each manuscript offers a distinct examination of adolescent and young adult subpopulations, or of how recovery supports may best meet their developmental and recovery needs. These articles provide novel approaches, thoughtfully situate their findings, and detail clear implications for both future research and practice.

Kosgolla et al. examined the intersection of social and community recovery capital among a sample of over 151,000 Illinois youth. Notably, they utilized both youth self-report measures of perceived family and peer disapproval of substances, alongside the recovery ecosystem index (REI), a measure of community-level resources. Their findings suggest that both family and peer disapproval are more strongly associated with youth recovery status than the larger community recovery ecosystem, with families providing stronger influence. Future research that considers both self-report and the broader ecosystem could help establish longitudinal associations between substance use initiation, treatment, and recovery, offering a fruitful path toward understanding adolescent recovery trajectories as context-dependent. Additionally, their work indicates that we may need clearer markers of an REI that is attuned to youth needs.

Jurinsky et al. also used the REI, combined with data from 416 students across 20 RHS to examine the interrelated domains of recovery capital for these youth and how these might influence substance use outcomes. They found that, as expected, higher recovery capital was associated with lower substance use. Yet, a higher REI score was associated with higher substance use. Although several explanations are possible, one key implication is that, alongside youth-specific models of recovery capital, there may also be a need for a youth-specific REI that better captures developmentally-relevant recovery supports (e.g., local RHSs or young person's 12-Step meetings).

Avilla Rodriguez et al. qualitatively examined how the Recovery Clubhouse model may build recovery capital for youth in Georgia. Using matched interviews with seven youth and their caregiver, they discovered that Clubhouses served multiple supportive functions, with different emphasis placed on specific factors by the youth and caregivers. Most prominent seemed to be the opportunities the Clubhouses offered for free, sober activities and to help with skill-building (youth) while their parents also discussed new, positive social groups for their child. The article presents a theory-driven approach to understanding pathways by which community programming like Clubhouses may work in different contexts. Additionally, it highlights the necessity of capturing both parent and youth voice in understanding how our community programs can support youth recovery through building new recovery capital factors.

Broman et al. examined associations between recovery capital and key recovery outcomes among a sample of 86 college students in self-reported recovery at a large, urban, and primarily commuter campus. They found that students with higher recovery capital also reported higher financial well-being, relationship quality, and fewer mental health challenges. The model explained a high degree of variability in recovery capital, as measured by the Multidimensional Inventory of Recovery Capital [MIRC; (3)]. These findings lend preliminary support for using the MIRC with other young adults. The authors also identified several sociodemographic characteristics and factors (e.g., sexual orientation, mental health symptoms, socioeconomic status) that may warrant further examination in larger samples.

Francis and colleagues examined to what extent a recovery identity—a sense of self in relation to recovery—buffered the effect of trauma symptoms on recovery capital among a sample of 168 students in a CRP. Although trauma symptoms were associated with lower recovery capital, this association was not observed among students with a strong recovery identity, suggesting a protective effect. As CRPs aim to foster new social networks and recovery-oriented identities, future studies should examine how recovery identity develops over time and influences other recovery outcomes.

Taylor et al. presented preliminary findings from a pilot trial implementing the Youth Opioid Recovery Support (YORS), a multi-component behavioral treatment approach for youth with opioid use disorder (OUD). Despite the small sample, they demonstrated preliminary evidence that this wrap-around approach to addressing OUD has the potential to provide strong support for these vulnerable youth by improving medication adherence and reducing return to use.

Hennessy et al. systematically identified and synthesized via systematic review 25 controlled trials of students in RHS and CRPs. They found that while these programs demonstrated positive outcomes for their participants, there is an urgent need for more rigorously designed research to examine whether and how these programs address student needs. As well, studies evaluating these programs should begin to examine to what extent they are developing positive, alternative social networks for their participants.

Collectively, these articles show that youth and young adult recovery is shaped by intersecting relational, identity-based, programmatic, and community contexts. Family, peers, recovery identity, and recovery supportive programs appear especially influential, while findings using the REI suggest current community measures may inadequately capture youth specific recovery ecosystems. Future longitudinal and rigorous research should clarify mechanisms, outcomes, and attend to creating and validating developmentally-responsive measures and supports.

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Footnotes

Edited and Reviewed by: Tammy Chung, Rutgers, The State University of New Jersey, United States