An Examination of the Social and Community Context of Substance Use Disorder Recovery Support Services in Rutherford County, Tennessee

Abstract

Substance use disorder causes significant morbidity and mortality in the United States. An estimated 20.1 million persons age 12 or older had a diagnosis of substance use disorder in 2016. Approximately 95,000 lives are lost due to alcohol-related causes yearly. A public health emergency was declared in 2017 due to increasing opioid overdoses. In 2018 in Rutherford County, Tennessee, overdoses resulted in 89 deaths or 27.6 per 100,000 persons. Many barriers prevent access to treatment services resulting in less than 20% of adults with substance use disorder receiving treatment. Recovery support services are needed to build recovery capital to promote and sustain recovery. Mutual aid and 12-step programs are peer recovery support services available at no cost to participants. Faith-based organizations often provide meeting space for these groups. The purpose of this project is to examine these services including the capacity of a recovery congregation program and program accessibility by population demographics. Enhancing interorganizational network capacity to increase the transfer of resources is a strategy to improve social programs. For a certified recovery congregation program, community capacity is necessary to achieve the certification best practices including providing visible outreach, disseminating recovery information, and hosting or referring individuals to recovery support groups. A social network analysis including 12 community partners examined the capacity of a recovery congregation program. Sociograms provided visual diagrams of the network’s collaboration frequency and collaboration level. Areas for capacity building were identified including unreciprocated relationships. Increasing capacity by leveraging collaborating cliques and dyads was one of the strategies identified to increase the density of the network. A one-year follow-up is needed to examine change in capacity over time. A spatial study utilizing geographic information system (GIS) mapping and logistic regression examined accessibility of mutual aid groups by census tract population demographics. In Rutherford County, an uneven distribution was identified with services located in census tracts of smaller square mileage with higher population density. GIS maps provided a visual of location of the services with overlays of poverty level and population density. More research is needed to better understand the accessibility of these important peer recovery support services.