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Abstract

In recent years, recovery has increasingly been used as an organizing framework for addiction policies and services. This reconceptualization of addiction policy and service delivery has implications for how addiction treatment services are organized, funded, and delivered and warrants consideration of the role of people in long-term recovery from alcohol and drug problems as policy decision-makers and addiction service providers.,This study synthesizes the work conducted in two separate but complimentary projects: (1) The National Drug Abuse Treatment System Survey (NDATSS) State Case Studies and (2) the Addiction Recovery Stakeholder Project. From July 2016 to February 2018, 86 semi-structured qualitative interviews were conducted with 107 policy stakeholders representing the addiction service delivery system, including government agency administrators, policy advocates, service providers, insurance providers, community-based organization leaders, and addiction trainers and researchers, among others.,This study explores four facets of recovery-oriented policy reform and service delivery transformation. First, policy stakeholders in the addiction service delivery system define addiction recovery and elaborate its underlying values and principles. Stakeholders describe the utility and limitations of various addiction recovery definitions and the importance of self-directed and community-driven processes of defining recovery and elaborating its values and principles. Second, stakeholders conceptualize a recovery-oriented service delivery system. Stakeholders differentiate between the elements of a typical versus recovery-oriented system of care and describe the necessary elements for recovery-oriented systems transformation. Third, stakeholders identify the types of recovery support services that should be administered in a recovery-oriented service delivery system and consider the ideal characteristics for a service provider and setting. Stakeholders discuss the value of service provider lived experience and the policy considerations for engaging a peer workforce in the current service delivery system. Finally, I contextualize the adoption of recovery-oriented reforms to the current policy environment. Stakeholders discuss how recovery-oriented policy transformations are impacting—and have been impacted by—health policy reforms, including the Affordable Care act, and efforts to address the national opioid epidemic.

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