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Patient Journey Map: Substance Use Disorder Treatment and Recovery Experiences

Updated: Oct 16, 2022

The Addiction Policy Forum's report Patient Journey Map: Substance Use Disorder Treatment and Recovery Experiences was developed through the input of patients in treatment and recovery from substance use disorders. The map underscores the obstacles and positive points patients encounter across seven distinct phases, from onset to finding long-term, stable recovery.

The qualitative study included 60 Life Course History interviews of individuals in recovery from a substance use disorder (SUD) from 22 states and Canada.

Key Takeaways

  1. Average age of first use is 14 years old, with the earliest initiation at 5 years old and the oldest at 19 years old.

  2. 1 out of 4 patients struggle with polysubstance use disorder and 98% report using multiple substances during active addiction.

  3. 85% patients report a family history of SUD, with an average of two previous generations with SUD history.

  4. 90% experienced adverse childhood events (ACEs). Of those with childhood traumatic events, the average ACEs score was 4.3, with 47% of patients reporting an ACEs score of 5 or higher.

  5. Significant barriers were encountered as patients try to find help, including high levels of stigma; the complexity of navigating the substance use disorders care system; wait times; the high costs of treatment; red tape payer policies such as fail first and prior authorization; and transportation difficulties.

  6. Multiple services are utilized, not a single intervention. On average, patients utilized four different services for treatment and recovery support, not a single treatment or intervention. Patient feedback also shows the need for layered interventions across three critical domains: 1) biological, or physical health, 2) psychological, and 3) social.

  7. Engaging in treatment and lifestyle modifications are concurrent, not sequential, in finding stable recovery. Lifestyle changes are cited by patients to be as critical to success as treatment and recovery services.

The Addiction Policy Forum was named one of the winners of the National Institute on Drug Abuse “Mapping Patient Journeys in Drug Addiction Treatment Challenge”; funds from this prize were used to support the development of this report.


Jessica Hulsey

Executive Director

Addiction Policy Forum

Kayla Zawislak, MSW, CADC

Director of Patient Engagement

Addiction Policy Forum


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