Beyond Treatment: Building Systemic Capital for Recovery

ABSTRACT

Treatment is essential to addressing substance use disorders, but access to treatment alone does not determine whether recovery can be initiated and sustained. People enter treatment with very different levels of personal, social and material resources, and these inequalities continue to shape recovery long after formal treatment begins or ends.

This presentation examines recovery through the lens of recovery capital: the personal, social, community and structural resources that support change over time. Drawing on evidence from recovery science and public health, it considers how housing, employment, education, relationships, health, social protection and community participation can either strengthen or constrain an individual's capacity to sustain recovery.

The presentation argues that translating evidence into effective substance use disorder care requires us to look beyond the treatment system itself. Equal access to treatment does not necessarily create equal opportunities for recovery. A recovery oriented system must therefore consider not only what treatment an individual receives, but also whether the wider conditions required to support recovery are available to them.

The presentation concludes by proposing a stronger focus on recovery equity and systemic capital. If treatment creates an opportunity for recovery, recovery capital helps people use that opportunity, while systemic capital shapes whether the wider environment supports, undermines or sustains recovery over time. Building effective systems of care therefore requires recovery to be understood not simply as an individual clinical outcome, but as a dynamic process supported across health, housing, education, employment and community systems.

Keywords: recovery; recovery capital; systemic capital; recovery equity; substance use disorder; systems of care