To accurately advance addiction recovery science requires expanding the research agenda to examine recovery in emerging adulthood, the implementation of recovery-support institutions, the role of researchers with lived experience and exploring recovery pathways among justice-involved populations. White and Kelly 1 present a timely and compelling argument for establishing a dedicated addiction recovery research agenda, identifying 12 domains that could substantially advance understanding of long-term remission and sustained recovery. Their proposal reflects an important evolution within addiction science—from a primary focus on the etiology, prevention, and treatment of substance use disorders toward understanding how recovery unfolds across the life course and social environments. The breadth and scale of the agenda is a major strength. However, as recovery science continues to mature, several areas merit more emphasis. Specifically, the following four domains: (1) recovery during emerging adulthood; (2) the application of implementation science to recovery support institutions; (3) workforce development, including the role of researchers and scientists with lived experience; and (4) recovery among incarcerated and justice-involved populations. First, recovery during emerging adulthood remains under examined despite the developmental importance of this life stage. Most addiction research—including studies of recovery trajectories—has focused on individuals entering treatment in midlife. Yet substance use disorders often begin before age 25 2, making the transition to adulthood a critical window for intervention. Colleges and universities enroll more than 20 million students in the United States 3 and, therefore, represent important settings for recovery support, but most emerging adults are not enrolled in higher education and remain largely absent from recovery research and service design. Understanding how recovery unfolds for young adults navigating early employment, unstable housing or justice involvement is, therefore, equally important. Over the past decade, collegiate recovery programs have expanded rapidly and now represent one of the most visible forms of recovery-oriented infrastructure for emerging adults 4, 5. However, the evidence base remains limited regarding which program elements support academic persistence, relapse prevention and long-term recovery 6—and how similar supports might be adapted for emerging adults outside higher education. Second, advancing the recovery agenda will require stronger integration of implementation science. White and Kelly 1 highlight the emergence of new recovery support institutions—including recovery community centers, recovery residences and recovery-focused educational programs—but relatively little research has examined how these models can be effectively implemented, sustained and scaled. Implementation science frameworks (i.e. Reach, Effectiveness, Adoption, Implementation, Maintenance RE-AIM; Consolidated Framework for Implementation Research CFIR; and Exploration, Preparation, Implementation, Sustainment EPIS) can help address questions about organizational readiness, leadership engagement, financing and adaptation across settings 7, 8. Without such research, promising recovery-support innovations may remain localized rather than achieving broader population impact. Third, the recovery research workforce warrants further attention. White and Kelly 1 emphasize the importance of incorporating individuals with lived experience into recovery research processes. I would argue that tokenistic or cursory involvement is insufficient to meaningfully advance recovery research. In recent years, there has been growing recognition that academic researchers who bring lived experience of addiction and recovery can contribute unique forms of expertise to study design, interpretation and translation 9-11. Expanding training pathways for scientists with lived experience—including doctoral and post-doctoral opportunities—could strengthen the relevance and credibility of recovery research. At the same time, academic environments must address persistent stigma that may discourage researchers from openly disclosing lived experience, limiting the field's ability to fully benefit from these perspectives. Finally, recovery among justice-involved populations represents the most notable omission in the research agenda proposed by White and Kelly 1. Substance use disorders are highly prevalent among incarcerated individuals 12, yet correctional systems have historically prioritized punishment, institutional safety and risk management over recovery-oriented care. As a result, one of the largest concentrations of people with untreated substance use disorders remains largely outside the scope of recovery research. Periods of incarceration should be recognized as critical intervention points for initiating recovery, particularly when paired with education, peer support and structured re-entry services. A stronger research focus on recovery pathways among justice-involved populations—including prison-based recovery programs, recovery housing and community re-entry initiatives—could generate urgently needed evidence on how recovery can be supported among one of the most underserved populations affected by addiction. The research agenda proposed by White and Kelly 1 marks an important step toward advancing a science of addiction recovery, but it remains incomplete. Progress will require greater attention to developmental contexts, the implementation of recovery-support institutions, the composition of the recovery research workforce and populations that remain largely absent from recovery research. Without addressing these gaps, recovery science risks documenting recovery without generating the evidence needed to expand it. A more comprehensive agenda should, therefore, focus not only on understanding how recovery occurs, but on informing the policies, systems and institutions capable of making recovery more accessible across diverse settings and populations. Noel Vest: Conceptualization; writing—original draft preparation; writing—review and editing. Dr. Vest was supported by the National Institute on Drug Abuse under award numbers K01DA053391 and L30DA056944. None. N/A.
Noel Vest (Mon,) studied this question.