This is an American term that in a Scottish context has no fixed meaning. A ‘system of care’ usually refers to the services and wider support with which a person with a substance use problem might be engaged.
There is divergence in definitions in terms of which services might be included in a system of care. For example, would services available to people whether they have a substance use problem or not be included e.g. homelessness and housing services, social security or employability services?
There is also a question as to the extent to which a wide range of services often acting inde- pendently can be regarded as a system especially if a person has to navigate between and around those services independently. There are also different views about how much control anyone has in designing, managing and maintaining that ‘system’.
There are, of course, also different views as to a definition of recovery means (see recovery; see abstinence) and therefore what recovery-oriented means; does that mean that the care system forces people to an outcome, encourages a particular outcome or simply that a specif- ic outcome is simply possible within the system?
There is dispute over the extent to which services can and do support or promote recovery. There is a view that recovery necessarily happens outwith the treatment or care system. This view may preclude the existence or possibility of developing a ROSC.