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

Drug Alcohol Depend. 2013 Apr 1;129(1-2):151-7. doi: 10.1016/j.drugalcdep.2012.10.005. Epub 2012 Oct 31.

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 (18-24 years). 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; 18-24 years; 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 3 months (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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Alcoholics Anonymous*
  • Alcoholism / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Male
  • Motivation
  • Neuropsychological Tests
  • Patient Compliance*
  • Prognosis
  • Psychiatric Status Rating Scales
  • Residential Treatment
  • Self-Help Groups / statistics & numerical data*
  • Socioeconomic Factors
  • Substance-Related Disorders / rehabilitation*
  • Surveys and Questionnaires
  • Temperance
  • Treatment Outcome
  • Young Adult