The Collegiate Recovery Research Collaborative (CRRC) is a diverse group of academics and practitioners who have lived experience of recovery or who identify as allies, and addresses the lack of diverse, transdisciplinary research communities in addiction recovery. This article describes the process the CRRC used to facilitate a recent retreat focused on collegiate recovery research as a novel, replicable framework for identifying exploratory research ideas within the recovery community. This article also summarizes the insights and ideas derived from the retreat as the product of a collaborative and intentionally-fostered intellectual exercise, and identifies actionable next steps in collegiate recovery research.

OBJECTIVE:We investigated offspring alcohol use outcomes as a function of unremitted and remitted parental alcohol use disorder (AUD). METHOD:Self-report data of participants in the Collaborative Study on the Genetics of Alcoholism (COGA) were used. Offspring (n = 2,244, mean age 16.3 years at baseline, 26.9 years at follow-up, 50.8% female) were linked to parental data. Time-varying associations of parental AUD and remission with offspring age at first drink, years from first drink to AUD onset, and years from AUD onset to first remission were tested in Cox models adjusted for polygenic risk for problematic alcohol use (PGSPAU). Analyses were stratified by genetically inferred continental groups of European Americans (EA; 65.9%) and African Americans (AA; 34.1%) because of sociocultural factors that can contribute to differences in alcohol use and problems. RESULTS:In EA, maternal remission was associated with increased risk for offspring AUD; neither maternal nor paternal remission was associated with other outcomes. In AA, maternal and paternal remission were associated with an increased likelihood of early drinking; the association with maternal drinking varied as a function of whom offspring lived with during adolescence. Paternal, but not maternal, remission was associated with a heightened risk for AUD onset. Parental status had no association with offspring remission in EA or AA. CONCLUSIONS:Evidence that parental remission can help mitigate the risk associated with parental AUD and increase the likelihood of remission in affected offspring was limited and mixed based on continental group and sex. These nuanced outcomes highlight the complex interplay of parental AUD status and offspring's alcohol-related behaviors.

Recent conceptualizations frame addiction recovery as a complex process involving changes across behavioral, physical, psychological, and social domains. These broad conceptualizations can be difficult to apply directly to research, making detailed models of individual dimensions necessary to guide empirical work and subsequent clinical interventions. We used Kelly and Hoeppner's biaxial formulation of recovery as a basis for a detailed examination of social processes in recovery using social network approaches. We delineated how appraisal of situational risks and social network resources result in coping actions, and how repeated iterations of this process change a person's social recovery capital over time. In addition, we incorporated the experience of interpersonal trauma and structural oppression and demonstrated how the model accommodates the complex issues often encountered during recovery. We present a measurable framework that can guide empirical testing of how social processes and social recovery capital change over time during recovery. The model presented here illuminates key factors in the recovery process that have the potential to support trauma- and social-network-informed interventions. We call for research that empirically tests this model in ways that will result in practical, trauma-informed social network interventions for people in recovery.

Alcohol use is influenced by genetic and environmental factors. We examined the interactive effects between genome-wide polygenic risk scores for alcohol use (alc-PRS) and social support in relation to alcohol use among European American (EA) and African American (AA) adults across sex and developmental stages (emerging adulthood, young adulthood, and middle adulthood). Data were drawn from 4,011 EA and 1,274 AA adults from the Collaborative Study on the Genetics of Alcoholism who were between ages 18-65 and had ever used alcohol. Participants completed the Semi-Structured Assessment for the Genetics of Alcoholism and provided saliva or blood samples for genotyping. Results indicated that social support from friends, but not family, moderated the association between alc-PRS and alcohol use among EAs and AAs (only in middle adulthood for AAs); alc-PRS was associated with higher levels of alcohol use when friend support was low, but not when friend support was high. Associations were similar across sex but differed across developmental stages. Findings support the important role of social support from friends in buffering genetic risk for alcohol use among EA and AA adults and highlight the need to consider developmental changes in the role of social support in relation to alcohol use.

Abstract This chapter shares how a group of social work researchers used radical imagination to create a space of joyful resistance to the dominant narrative of the social work research process that perpetuates White supremacy and oppression. It explores three questions: What type of research do the researchers want to do? How do they conduct trauma-informed, socially just (TISJ) research? Who do they need to be in order to carry out TISJ research? It shares how this group used multiple practices as conduits for radical imagination and invites readers to engage in their own radically imaginative work to transform social work research and themselves. It offers ways of “staying in the mess” without clear answers and of becoming “social work philosophers” who use philosophical activism to challenge injustice, the results of which may be the start of a praxis to reclaim our humanity and an invitation to join a “soul-cial” work movement.

Abstract This chapter shares how a group of social work researchers used radical imagination to create a space of joyful resistance to the dominant narrative of the social work research process that perpetuates White supremacy and oppression. It explores three questions: What type of research do the researchers want to do? How do they conduct trauma-informed, socially just (TISJ) research? Who do they need to be in order to carry out TISJ research? It shares how this group used multiple practices as conduits for radical imagination and invites readers to engage in their own radically imaginative work to transform social work research and themselves. It offers ways of “staying in the mess” without clear answers and of becoming “social work philosophers” who use philosophical activism to challenge injustice, the results of which may be the start of a praxis to reclaim our humanity and an invitation to join a “soul-cial” work movement.

BACKGROUND:In the United States, ~50% of individuals who meet criteria for alcohol use disorder (AUD) during their lifetimes do not remit. We previously reported that a polygenic score for AUD (PGSAUD ) was positively associated with AUD severity as measured by DSM-5 lifetime criterion count, and AUD severity was negatively associated with remission. Thus, we hypothesized that PGSAUD would be negatively associated with remission. METHODS:Individuals of European (EA) and African ancestry (AA) from the Collaborative Study on the Genetics of Alcoholism (COGA) who met lifetime criteria for AUD, and two EA cohorts ascertained for studies of liver diseases and substance use disorders from the Indiana Biobank were included. In COGA, 12-month remission was defined as any period of ≥12 consecutive months without meeting AUD criteria except craving and was further categorized as abstinent and non-abstinent. In the Indiana Biobank, remission was defined based on ICD codes and could not be further distinguished as abstinent or non-abstinent. Sex and age were included as covariates. COGA analyses included additional adjustment for AUD severity, family history of remission, and AUD treatment history. RESULTS:In COGA EA, PGSAUD was negatively associated with 12-month and non-abstinent remission (p ≤ 0.013, βs between -0.15 and -0.10) after adjusting for all covariates. In contrast to the COGA findings, PGSAUD was positively associated with remission (p = 0.004, β = 0.28) in the Indiana Biobank liver diseases cohort but not in the Indiana Biobank substance use disorder cohort (p = 0.17, β = 0.15). CONCLUSIONS:PGSAUD was negatively associated with 12-month and non-abstinent remission in COGA EA, independent of behavioral measures of AUD severity and family history of remission. The discrepant results in COGA and the Indiana Biobank could reflect different ascertainment strategies: the Indiana Biobank participants were older and had higher rates of liver disease, suggesting that these individuals remitted due to alcohol-related health conditions that manifested in later life.

BACKGROUND:Endorsement of specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) alcohol use disorder (AUD) criteria have been shown to change significantly over time in men in their thirties who have persistent or recurrent AUD. However, few studies have documented whether the endorsement of AUD items changes over time in younger individuals or in women. We evaluated changes in the endorsement of AUD criteria in 377 men and women with persistent or recurrent AUD during their twenties.METHODS:Information on AUD-item endorsement over time was available for 223 men and 154 women aged 20-25 with persistent or recurrent AUD in at least three interviews in the Collaborative Study on the Genetics of Alcoholism. The statistical significance of endorsement changes over time was evaluated using the related-sample Cochran's Q test for the full sample and for men and women separately. Additional analyses evaluated sex differences in the patterns of change.RESULTS:In the full sample, the predominant pattern was for a significant increase in the rates of endorsement for six of the seven alcohol dependence criteria but not in the four abuse criteria. A similar pattern was seen within men, but women had significant changes in only three of the seven dependence criteria.CONCLUSIONS:Endorsement of the seven alcohol dependence criteria among individuals with persistent or recurrent AUD in their twenties generally increased, but few changes were observed in the rates of endorsement of the four abuse criteria. These results are discussed in terms of how they reflect on the nature of AUD and the DSM criteria.

Short Summary: The SRC-IPA, a new 10-item measure of Social Recovery Capital derived from the widely-used Important People and Activities instrument, has good model fit and acceptable reliability and validity. The SRC-IPA opens up avenues for improving our understanding of social recovery capital without mounting new data collection. Aim This study presents a measure of Social Recovery Capital (SRC) derived from the Important People and Activities instrument (IPA). Methods The sample comprised young adults who participated in the Collaborative Study on the Genetics of Alcoholism, a high-risk family study of alcohol use disorder (N = 2472). Exploratory and confirmatory factor analysis identified influential items and factor structure, adjusting for family relatedness. The final scale was tested for reliability and validity. Results Factor analysis retained 10 items loading on three factors (Network Abstinence Behaviors, Basic Network Structure and Network Importance) that together explained 42% of the variance in SRC. The total model showed adequate fit (Comparative Fit Index = 0.95; Tucker Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Squared Residual = 0.05) and acceptable reliability (alpha = 0.60; McDonald's omega = 0.73) and correlated with validation measures mostly in the weak to moderate range. Due to variable factor scores for reliability and validity, we only recommend using the total score. Conclusion The SRC-IPA is a novel measure of SRC derived from the IPA that captures social network data and has applications in research and clinical work. Secondary data analyses using the SRC-IPA in studies that collected the IPA can further demonstrate the interaction of SRC with a wide variety of clinical indicators and demographic characteristics, making it a valuable addition to other measures of SRC.

Substance use disorders (SUDs) incur serious social and personal costs. The risk for SUDs is complex, with risk factors ranging from social conditions to individual genetic variation. We examined whether models that include a clinical/environmental risk index (CERI) and polygenic scores (PGS) are able to identify individuals at increased risk of SUD in young adulthood across four longitudinal cohorts for a combined sample of N = 15,134. Our analyses included participants of European (NEUR = 12,659) and African (NAFR = 2475) ancestries. SUD outcomes included: (1) alcohol dependence, (2) nicotine dependence; (3) drug dependence, and (4) any substance dependence. In the models containing the PGS and CERI, the CERI was associated with all three outcomes (ORs = 01.37-1.67). PGS for problematic alcohol use, externalizing, and smoking quantity were associated with alcohol dependence, drug dependence, and nicotine dependence, respectively (OR = 1.11-1.33). PGS for problematic alcohol use and externalizing were also associated with any substance dependence (ORs = 1.09-1.18). The full model explained 6-13% of the variance in SUDs. Those in the top 10% of CERI and PGS had relative risk ratios of 3.86-8.04 for each SUD relative to the bottom 90%. Overall, the combined measures of clinical, environmental, and genetic risk demonstrated modest ability to distinguish between affected and unaffected individuals in young adulthood. PGS were significant but added little in addition to the clinical/environmental risk index. Results from our analysis demonstrate there is still considerable work to be done before tools such as these are ready for clinical applications.

BACKGROUND Early identification of individuals at high risk for alcohol use disorder (AUD) coupled with prompt interventions could reduce the incidence of AUD. In this study, we investigated whether Polygenic Risk Scores (PRS) can be used to evaluate the risk for AUD and AUD severity (as measured by the number of DSM-5 AUD diagnostic criteria met) and compared their performance with a measure of family history of AUD. METHODS We studied individuals of European ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA). DSM-5 diagnostic criteria were available for 7203 individuals, of whom 3451 met criteria for DSM-IV alcohol dependence or DSM-5 AUD and 1616 were alcohol-exposed controls aged ≥21 years with no history of AUD or drug dependence. Further, 4842 individuals had a positive first-degree family history of AUD (FH+), 2722 had an unknown family history (FH?), and 336 had a negative family history (FH-). PRS were derived from a meta-analysis of a genome-wide association study of AUD from the Million Veteran Program and scores from the problem subscale of the Alcohol Use Disorders Identification Test in the UK Biobank. We used mixed models to test the association between PRS and risk for AUD and AUD severity. RESULTS AUD cases had higher PRS than controls with PRS increasing as the number of DSM-5 diagnostic criteria increased (p-values ≤ 1.85E-05 ) in the full COGA sample, the FH+ subsample, and the FH? subsample. Individuals in the top decile of PRS had odds ratios (OR) for developing AUD of 1.96 (95% CI: 1.54 to 2.51, p-value = 7.57E-08 ) and 1.86 (95% CI: 1.35 to 2.56, p-value = 1.32E-04 ) in the full sample and the FH+ subsample, respectively. These values are comparable to previously reported ORs for a first-degree family history (1.91 to 2.38) estimated from national surveys. PRS were also significantly associated with the DSM-5 AUD diagnostic criterion count in the full sample, the FH+ subsample, and the FH? subsample (p-values ≤6.7E-11 ). PRS remained significantly associated with AUD and AUD severity after accounting for a family history of AUD (p-values ≤6.8E-10 ). CONCLUSIONS Both PRS and family history were associated with AUD and AUD severity, indicating that these risk measures assess distinct aspects of liability to AUD traits.

Importance: Substance use disorders (SUDs) incur serious social and personal costs. Screening techniques that identify persons at risk before problems develop can improve prevention efforts. Objective: To examine whether models that include polygenic scores (PGS) and a clinical/ environmental/risk index (CERI) are able to identify individuals as having a lifetime SUD. Design: We tested the predictive power of PGS and CERI for lifetime diagnosis of DSM-IV substance dependence using four longitudinal cohorts. Setting: The study included four samples: 1) the National Longitudinal Study of Adolescent to Adult Health (Add Health); 2) the Avon Longitudinal Study of Parents and Children (ALSPAC); 3) the Collaborative Study on the Genetics of Alcoholism (COGA); and 4) the Finnish Twin Cohort Study (FinnTwin12) for a combined sample of N = 15,134. Participants: Participants in Add Health (NEUR = 4,855; NAFR = 1,605) and COGA (NEUR = 1,878; NAFR = 870) included individuals of both European and African ancestries. Participants in ALSPAC (NEUR = 4,733) and FinnTwin12 (NEUR = 1,193) were limited to individuals of European ancestries. Exposures: A clinical/environmental risk index (CERI) composed of ten items and PGS for phenotypes with strong genetic overlap with SUDs (drinks per week, problematic alcohol use, externalizing problems, major depressive disorder, and schizophrenia). Main Outcomes: Meeting lifetime criteria for DSM-IV: 1) alcohol dependence, 2) drug dependence, and 3) any substance dependence (alcohol, other drug, or nicotine). Results: In the models containing the five PGS and CERI, the CERI was associated with all three outcomes (ORs = 1.35 - 1.64). PGS for problematic alcohol use was associated with alcohol dependence (OR = 1.14), PGS for externalizing was associated with drug dependence (OR = 1.14) and both were associated with any substance dependence (ORs = 1.11 - 1.19). Including the five PGS, CERI, and covariates explained 6% - 13% of the variance in SUDs. Those in the top 10% of CERI and PGS had relative risk ratios of 3.82 - 9.13 for each SUD relative to the bottom 90%. Conclusions and Relevance: Measures of clinical, environmental, and genetic, risk demonstrate modest ability to distinguish between affected and unaffected individuals for alcohol, drug, and any substance use disorders in young adulthood. These tools will continue to advance as we identify additional risk factors that can be incorporated into clinical practice and deliver on the goal of precision medicine.

The present paper highlights how alcohol use disorder (AUD) conceptualizations and resulting diagnostic criteria have evolved over time in correspondence with interconnected sociopolitical influences in the United States. We highlight four illustrative examples of how DSM-defined alcoholism, abuse/dependence, and AUD have been influenced by sociopolitical factors. In doing so, we emphasize the importance of recognizing and understanding such sociopolitical factors in the application of AUD diagnoses. Last, we offer a roadmap to direct the process of future efforts toward the improved diagnosis of AUD, with an emphasis on pursuing falsifiability, acknowledging researchers’ assumptions about human behavior, and collaborating across subfields. Such efforts that center the numerous mechanisms and functions of behavior, rather than signs or symptoms, have the potential to minimize sociopolitical influences in the development of diagnostic criteria and maximize the treatment utility of diagnoses.