The 2025 Addiction Recovery Science Conference

Tom Horvath, Ph.D.

The second National Conference on Addiction Recovery Science was held online 4/23-24, 2025. The closing panel presentation was “Recovery Science: What Do We Know, and What Do We Need to Know?” The panel consisted of internationally recognized experts on this topic: David Best, Andrew Finch, Christine Grella, Keith Humphreys, and Sarah Zemore. The panel was skillfully moderated by Amy Mericle and Lourah Kelly.

Here are my takeaways from the Addiction Recovery Science Conference:

There was general support from the panel for the following ideas:

Severe addictive problems are chronic disorders, but with many variations.

Services for these problems need to be enduring.

There is overwhelming evidence that AA (Alcoholic Anonymous) works (for those who will attend).

There is now a range of other mutual help groups to attend, including SMART Recovery, LifeRing, Women for Sobriety, and others. Individuals seeking mutual help groups are increasingly seeking out these alternative groups. There is now evidence that these groups are effective, but further investigation is needed.

Professionals should support mutual help attendance (which can be enduring because they are free).

Recovery housing can be a crucial support. The National Association for Recovery Residences is raising standards in that field.

The addiction recovery field is shifting from an emphasis on deficit reduction (a problem focus) to existential growth (a solution focus).

For individuals with severe addictive problems, abstinence is a strong predictor of well-being.

It is easier to predict that a negative “turning point” will result in a return to problems, than to predict that a positive turning point will lead to greater success. We are still learning about positive turning points.

We need multiple kinds of studies about the process of change. We especially need longitudinal studies, that follow people for decades, to learn about the long-term trajectories of addictive problems, and the kinds of positive turning points that we might promote. Ideally such studies would start in the teen or pre-teen years.

“Recovery capital” is the term now widely used to describe the resources someone has available to address an addictive problem and build a better life. Resources can include personal ones (e.g., health, skills, employment, self-confidence), social ones (e.g., family support, a supportive social network), and community ones (e.g., easy access to services of various kinds, a community that supports the change process, a criminal justice system that is recovery oriented).

Rather than labeling someone as resistant to change we could start by examining the genuine problems they are facing, and how improved recovery capital could make a positive difference. For instance, do they need housing, food, or childcare?

Longitudinal studies could identify the kinds of recovery capital that are most important at different times or for different types of people.

We can continue to refine our descriptions of the process of change and what success looks like (“what is recovery?”). We also need greater agreement about how we measure the process of change and success. Scientific progress typically advances slowly on these issues, as scientists debate the possibilities and collect and analyze evidence. Nevertheless, clarity about what is being measured and how to measure it is essential for progress in any field of science. Fortunately, progress is occurring.

One easily remembered view of success in recovery is CHIME: Connectedness, Hope & Optimism, Identity, Meaning, and Empowerment.

The term recovery may also need expansion because for some it is a process of change, for others a state of success that they have finally arrived at, and for others an identity (“I’m in recovery,” which they may or may not want). Further, is one “in recovery” for the remainder of their lives?  Does that identify (or should it) become less significant over time (and possibly go away)?

We need to recognize that cultural and societal factors (the “social determinants of health”) may be as or more important than treatment or other typical recovery supports. We need to continue to improve these factors, and not focus on treatment studies only.

The challenges around MOUD (medications for opiate use disorder) remain. For instance, NA (Narcotics Anonymous) may be less than friendly to those on MOUD (often driving them away), but studies suggest that individuals on MOUD who also attend NA do better. MOUD also leads to longer stays in recovery housing. Longer stays are associated with better outcomes. Fitting medication use into the existing “recovery system” remains a challenge.

Commentary:

This conference is focused on severe addictive problems. For individuals lower on the severity spectrum, many of the ideas presented might not be highly relevant. Such individuals might not even use the term “recovery.”

Ironically, individuals with severe problems are the “tip of the iceberg.” They are the most visible, but most addictive problems are moderate, mild, or sub-clinical (at “sub-clinical” problems exist, but are not large enough to merit a diagnosis). If you could defrost an iceberg, you would gain more by defrosting what is below water than above.

Nevertheless, “recovery science” is more likely to gain research dollars than something like “habit change.” Individuals with severe addictive problems are worthy of investigating and helping. With luck what we learn with them will also come to be applied at lower levels of severity.

Liked this recap of this year’s Addiction Recovery Science Conference? You might also be interested in: Annual SMART Recovery Conference Recap 2025.