Development and roll-out of ‘SURE’ to measure recovery from alcohol/drug dependence

‘Recovery’ is central to addiction treatment policy and practice, and increasingly services are being asked to demonstrate that they are enabling people ‘to recover’. Despite this, there has been no consensus on what recovery means or how to assess it.

To address this issue, researchers at the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre developed and tested a new tool for measuring addiction recovery - the Substance Use Recovery Evaluator (SURE). It has 21 questions and measures five key dimensions of recovery: 1. alcohol and other drug use; 2. self-care; 3. relationships; 4. material resources; and 5. outlook on life.

Development with people using alcohol and other drugs

Whereas most addiction treatment outcome measures are developed by researchers and clinicians, SURE was developed in collaboration with people using alcohol and other drugs (see 1 & 2). This has made SURE unique in the addictions field. People who use substances report that the dimensions of recovery assessed are important to them and they enjoy and benefit from completing the measure.

SURE is used by patients, clinicians, commissioners, industry representatives and researchers internationally, including Australia, Canada, Japan, New Zealand, Norway, Portugal, South Africa, the UK and the US. Norwegian, Spanish, Danish, French, Argentinian Spanish and Brazilian Portuguese versions are also available.

Achieving consensus on recovery

The development of SURE has contributed to an emerging international consensus on what ‘recovery’ is and how it should be assessed. SURE gives people experiencing problems with alcohol and other drugs a mechanism for voicing their experiences and identifying goals that are personally important. This, in turn, enables clinicians to adapt their practice. As a validated measure, commissioners, service providers and researchers are also using SURE to evaluate recovery-oriented interventions.

In response to service user demand, a free ‘SURE Recovery’ app was created in 2018 (downloaded >1,000 times since October 2019). The app includes the SURE measure, information on harm reduction and whole person care (sleep, diet, exercise, etc.) and optional research questions.

This allows the research team to engage with treatment and non-treatment populations, yielding future potential for real-time monitoring of recovery processes, user involvement in the development of new interventions, and analyses to identify who is benefiting (or not) from specific therapies. Read about the development of the app in this blog marking two years since its launch for International Recovery Day in 2021. 



Involving Patients in Research | Industry Collaboration | Improving Access and Uptake