Emerging adults’ treatment outcomes in relation to 12-step mutual-help attendance and active involvement

Abstract

Background Participation in Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) during and following treatment has been found to confer recovery-related benefit among adults and adolescents, but little is known about emerging adults (18–24yrs). This transitional life-stage is distinctive for greater distress, higher density of psychopathology, and poorer treatment and continuing care compliance. Greater knowledge would inform the utility of treatment referrals to 12-step organizations for this age-group. Methods Emerging adults (N=303; 18–24yrs; 26% female; 95% White; 51% comorbid [SCID-derived] axis I disorders) enrolled in a naturalistic study of residential treatment effectiveness assessed at intake, 3, 6, and 12 months on 12-step attendance and involvement and treatment outcomes (Percent Days Abstinent [PDA]; Percent Days Heavy Drinking [PDHD]). Lagged hierarchical linear models (HLMs) tested whether attendance and involvement conferred recovery benefits, controlling for a variety of confounds. Results The percentage attending 12-step meetings prior to treatment (36%) rose sharply at 3months (89%), was maintained at 6 months (82%), but declined at 12 months (76%). Average attendance peaked at about 3 times per week at 3 months dropping to just over once per week at 12 months. Initially high, but similarly diminishing, levels of active 12-step involvement were also observed. Lagged HLMs found beneficial effects for attendance, but stronger effects, which increased over time, for active involvement. Several active 12-step involvement indices were associated individually with outcome benefits. Conclusions Ubiquitous 12-step organizations may provide a supportive recovery context for this high-risk population at a developmental stage where non-using/sober peers are at a premium.

US Social Work Students' Attitudes Shift Favorably Towards a Harm Reduction Approach to Alcohol and Other Drugs Practice: The Effectiveness of Consequence Analysis

“…Given the overwhelming evidence that addiction is a chronic relapsing condition (McLellan, Lewis, O'Brien, & Kleber, 2000), an abstinence-only approach is not responsive to the needs of all people with AOD problems. Though there is evidence to support the effectiveness of this approach to helping people increase abstinence and reduce drinking-related problems (Kelly, Stout, & Slaymaker, 2013;Magura, Cleland, & Tonigan, 2013), a core principle which the US research-based guide to principles of drug addiction treatment (National Institute on Drug Abuse [NIDA], 2012) stresses is that no single treatment is appropriate for all. Thus, it is imperative to investigate whether a broader philosophical perspective on substance use might enable us to modify negative attitudes to bolster the effectiveness of SW practice.…”

Self-Help Groups for Alcohol Dependency: A Scoping Review

“…Finally, Kelly, Stout, and Slaymaker (2013) found that in a sample of 303 'emerging adults' (aged between 18-24) the greatest predictor of alcohol abstinence was active involvement at AA in the form of active verbal participation during meetings (F = 7.85; p < 0.002) and considering oneself a member of the group (f = 9.17; p < 0.005). Furthermore, Kelly et al (2013) found that meeting with others outside the group (F = 6.58 p < 0.01) and working the twelve steps (F = 5.40; p < 0.02) were the greatest predictors of reduced heavy days drinking.…”

Is residential treatment effective for opioid use disorders? A longitudinal comparison of treatment outcomes among opioid dependent, opioid misusing, and non-opioid using emerging adults with substance use disorder

“…Motivational enhancement, cognitive-behavioral and family-based therapeutic approaches were used to facilitate problem recognition, treatment engagement, and recovery. Participants remained in treatment for an average of 25.5±5.7 days (range 4–35 days) and 83.9% were discharged with staff approval (Kelly et al, 2013), indicating a high rate of treatment completion. Opioid detoxification was conducted primarily with buprenorphine.…”

“…Residential programs generally offer the potential for opioid detoxification, coping skills development, and facilitated involvement in the 12-step recovery community (Borkman et al,, 2007; Kelly et al, 2013). Relapse is very common among the opioid-dependent after abstinence-based inpatient treatment, leading to a perceived lack of efficacy of residential treatment (Smyth et al, 2010).…”

“…Yet, some studies have demonstrated promising long-term outcomes after residential treatment for opioid dependence (Gossop et al, 1989). In a naturalistic study of 28-day residential treatment for 18–25 year olds with mixed substance use disorders, nearly 89% of emerging adults were attending AA/NA three months later, and 12-step involvement was associated independently with increasingly greater abstinence in the year following treatment (Kelly et al, 2013). These data about outcomes for emerging adults after residential treatment is compelling, but we are aware of no studies comparing residential treatment outcomes based on opioid use status among emerging adults.…”