Yes, recovery from addiction is a life-long process, and too much attention to the treatment component tends to overlook or downplay that reality.  Approaching the task as an ongoing process that is continuing recovery is proving far more effective.      Ernest Kurtz, Ph.D. 

Thank you very much for the comments so far. It's ironic that many of the concepts of Recovery Management have a long historical perspective and are used, informally in 12-Step groups; so there is a precedent for it. While Recovery Management can include formal treatment, the emphasis is on addiction as an on-going, life-long process. Dr. Kurtz’s use of the word “process” is important in this context. It helps in seeing it as a system of that includes many different resources that are needed for a given individual to become abstinent, sober and continue to improve as their recovery improves.

Recovery changes the emphasis from treating acute pathology to helping the addicted person and those affected by him or her heal and manage problems related to alcohol and other drugs (as well as behavioral addictions) A person’s needs will change over time and through Recovery Management positive changes in their lives can change accordingly. In addition, the people close to them can change as well (i.e. through Al-Anon, etc.).

You might be interested in the sites for the Recovery Initiative and the Recovery to Practice (RTP) Initiative. The links are below. 

http://naadac.org/recovery

http://www.samhsa.gov/recoverytopractice/index.aspx

There is no substitute for daily, incremental change when it comes to recovery from addiction. If we consider that chronic abuse of substances creates a trauma in the brain then we must realize that while trauma can be arrested and reduced to a non-problematic stage, the trauma itself cannot be erased from the brain. Hence, in times of severe stress or when I simply have not been focusing daily on my recovery, I may relapse for no reason apparent to the outside world, but in my brain such a relapse makes sense, because that is how I respond, it's my habit.

This is why a daily program of recovery that works for the individual and includes regular self examination of our day-to-day behavior is crucial, and to my knowledge the only approach that has long term, lasting effects. 

In the United States, recovery management is not only a promising approach, but an important part of the Affordable Care Act's healthcare delivery for addicts of all types. This is consistent with the ACA's emphasis on treating the whole patient and not just the disease. No therapeutic treatment certainly will be independent from this approach. And most community-based approaches to dealing with recovering addicts are heavily involved in recovery management as well. As a result of the ACA, some 25-30 million patients diagnosed with addiction will be entering the primary healthcare system over the next few years, so this is going to be an important thing to get right.

The responses went far beyond what I expected. By that I mean everyone had a slightly different approach, but expressed what we all seem to know; using many examples of the benefits, One reason I summarized the discussion in this way is due to Daniel's comment. I am not a fan of President Obama's health plan, but there are a few good points. The one Daniel pointed out is something I did not consider. That brought this discussion to a somewhat different level and taught me quite a bit.

I think as a profession, we will be discussing Recovery Management for quite some time. For me, it is intuitively the correct way to go and something I thought about for some time. I wish I could say I had an impact on bringing it to academic and clinical attention, but I didn't. The prolific writer and addiction professional, Bill White, and others, gets that honor. I do admit that when it comes to this topic, I can be a bit biased and generalize more than science allows. However, members of AA, NA, and other 12-Step groups showed me the benefits of recovery long before empirical evidence started to emerge. 

I appreciate all your input and hope we can work together as medical, psychological, and addiction professionals along with systems thinkers to bring the kind of interventions addiction deserves. 

Our Virtual Hospital for Addiction project applies mobile technology to recovery management, which is a continuous process.  We analyze a plethora of incoming data from ambulatory (non-hospitalized) patients in recovery, and allow healthcare providers to manage their patients "remotely" -- getting alerts when either non-medical intervention (a nudge of some kind) or medical intervention (in the worst case, a potential overdose) is required.  We apply strong predictive analytics to all sorts of data coming in (geolocation activity, compliance with calendared activities, communication levels, media usage on the smartphone, electronic transactions, social networking activity, and even vital signs - right now just continuous heart rate) at an aggregate and individual level.  We are "data agnostic" in that our system learns over time what perturbations in the data are predictive of an adverse event.  Our belief, and hope, is that we can leverage technology to support continuous recovery management by healthcare providers - thereby keeping as many substance use disorder patients in remission (or at least in outpatient care) and away from the ED/detox/rehab.  Our system even goes so far as to suggest the optimal intervention strategy when a "perturbation" occurs (although for regulatory reasons we can't actually display that to healthcare providers, unfortunately.)

In addition to anecdotal 12-step data cited here, the data from the Physicians' Treatment Network (PTN) shows that addicted physicians who receive extended (90 day) residential treatment, followed by FOUR YEARS of intensive Recovery Management (approach varies from state to state) achieve remission rates substantially higher than non-physician patients.  In one study, 70% of physicians (with opioid substance use disorder) in a PTN remained in remission for the duration of their Recovery Management (over 4 years), compared to 8% of non-physician patients without intensive Recovery Management during the same period.  

Unfortunately, the Recovery Management used by PTNs is very expensive and literally done by hand (people with pens and paper and phones monitoring the patients in recovery).  It is financially unrealistic for most patients to receive the intensive Recovery Management that seems to keep SUD in remission for many.  Our hope is that good technology driven by data from smartphones (now ubiquitous; unheard of just a decade ago) can bring the same intensive Recovery Management to all patients at a low cost.  

Not just the ACA, but the Parity Act (Mental Health Parity and Addiction Act of 2008), as well as pressure by insurers and nation-state payors like Medicare Canada and the NHS in the UK are FORCING a paradigm shift to recovery management and away from "episodic" residential treatment (which is a very expensive revolving door).  Substance use disorder is an epidemic that threatens to swamp global healthcare resources unless there is a dramatic increase in efficacy of treatment.  In my opinion, Recovery Management offers much more efficacy (esp. in terms of cost/benefit) and we need innovations that make *intensive* recovery management an affordable Tx for all SUD patients.