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Hayes BB. Annual use and perceived need for mental health and substance treatment among people in remission from substance use disorders in the United States. Drug Alcohol Depend 2023; 249:110820. [PMID: 37329728 DOI: 10.1016/j.drugalcdep.2023.110820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Receiving specialty substance treatment or general mental health treatment during remission from substance use disorders (SUD) may reduce odds of SUD recurrence, but little is known about prevalence of treatment or perceptions of treatment need among remitted people in the United States. SAMPLE Participants in the National Survey on Drug Use and Health, years 2018-2020, were considered remitted if they ever had an SUD (i.e., self-reported history of "problems with alcohol or drugs", or lifetime history of treatment for SUD) but did not meet DSM-IV criteria for substance abuse or dependence during the prior year (n = 9,295). ANALYSES Annual prevalence was estimated for any SUD treatment (e.g., mutual-help groups), any mental health (MH) treatment (e.g., private therapy), self-reported perceived need for SUD treatment, and self-reported unmet need for MH treatment. Generalized linear models examined effects of socio-demographics, mental illness, past-year substance use, and self-identified recovery status on outcomes. FINDINGS MH treatment was more common than SUD treatment (27.2% [25.6%, 28.8%] v. 7.8% [7.0%, 8.6%], respectively). Unmet need for mental health treatment was reported by 9.8% [8.8%, 10.9%], but only 0.9% [0.6%, 1.2%] perceived need for substance treatment. Age, sex, marital status, education, health insurance, mental illness, and prior year alcohol use were among the factors associated with variation in outcomes. CONCLUSION Most people who maintained clinical remission from substance use disorders in the U.S. during the prior year did so without treatment. Remitted people report substantial unmet need for mental health treatment, but not specialized substance use treatment.
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Affiliation(s)
- Bridget B Hayes
- Department of Psychology, Cornell University, United States; Substance Abuse and Mental Health Services Administration, United States.
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2
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Beasley CR, LaBelle O, Vest N, Olson B, Skinner MD, Ferrari JR, Jason LA. The Involvement in Alcoholics Anonymous Scale - Short Form: Factor Structure & Validation. Subst Use Misuse 2022; 58:119-128. [PMID: 36474456 PMCID: PMC9951623 DOI: 10.1080/10826084.2022.2149245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: The aim of this research was to examine the psychometrics of a short form version of the multidimensional Involvement in Alcoholics Anonymous scale (IAA-SF) by assessing the factor structure, internal consistency, and predictive validity. While there are several existing measures of involvement in Alcoholics Anonymous, many are either unidimensional or are limited in their ability to gather variation in the level of involvement in the different dimensions of 12-step programs. Objective: To achieve our aim, we used exploratory and principal axis factor analysis, correlation, and logistic regression with two unique and diverse samples. Longitudinal data were collected from a northern Illinois sample of 110 post-treatment adults, and cross-sectional data were from a random sample of 296 recovery home residents in the United States. Results: Results from the first sample suggested three exploratory factors (Principles Involvement, Social Involvement, and Spiritual Involvement) that were concordant with the proposed conceptualization and were then confirmed in the second sample. A 2nd order factor of global involvement was also found. All subscales demonstrated good to excellent internal consistency and were moderately associated with AA affiliation. Global and social involvement predicted greater odds of abstinence 2 years later, but principles and spiritual involvement did not. Conclusion: Overall results suggest the IAA- SF is a valid and reliable 12-item instrument for assessing involvement in the AA program, and the differential prediction suggests potential utility for a multidimensional approach to 12-step involvement.
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Affiliation(s)
- Christopher R. Beasley
- School of Interdisciplinary Arts & Sciences, University of Washington Tacoma, Tacoma, Washington, USA
| | - Onawa LaBelle
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Noel Vest
- Stanford School of Medicine, Stanford University, Stanford, California, USA
| | - Bradley Olson
- Psychology, National Louis University, Chicago, Illinois, USA
| | - Michael D. Skinner
- School of Interdisciplinary Arts & Sciences, University of Washington Tacoma, Tacoma, Washington, USA
| | | | - Leonard A. Jason
- DePaul University Center for Community Research, Chicago, Illinois, USA
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Palzes VA, Kline-Simon AH, Satre DD, Sterling S, Weisner C, Chi FW. Predictors of early and sustained cessation of heavy drinking over 5 years among adult primary care patients. Addiction 2022; 117:82-95. [PMID: 34159681 PMCID: PMC8664973 DOI: 10.1111/add.15612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/11/2021] [Accepted: 06/09/2021] [Indexed: 01/03/2023]
Abstract
AIMS To identify factors asociated with early and sustained cessation of heavy drinking. DESIGN Retrospective cohort study over 5 years. SETTING Kaiser Permanente Northern California, United States. PARTICIPANTS Adults reporting heavy drinking during primary care-based alcohol screening between 1 June 2013 and 31 May 2014. The sample (n = 85 434) was 40.7% female and 33.8% non-white; mean age was 50.3 years (standard deviation = 18.1). MEASUREMENTS Following US guidelines, early and sustained cessation of heavy drinking was defined as reporting lower-risk drinking or abstinence at 1 year and to 5 years after achieving early cessation, respectively. Associations between patient characteristics and service use and cessation outcomes were examined using logistic regression with inverse probability weights addressing attrition. FINDINGS Nearly two-thirds of participants achieved early cessation of heavy drinking. Women [odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.35, 1.44], middle-age (35-64 years: ORs = 1.16-1.19), non-white race/ethnicity (ORs = 1.03-1.57), medical conditions (OR = 1.05, 95% CI = 1.04, 1.06), psychiatric (OR = 1.10, 95% CI = 1.06, 1.15) and drug use disorders (OR = 1.35, 95% CI = 1.17, 1.56) and addiction treatment (OR = 1.19, 95% CI = 1.09, 1.30) were associated with higher odds of early cessation, while older age (≥ 65 years: OR = 0.91, 95% CI = 0.86, 0.96), smoking (OR = 0.81, 95% CI = 0.77, 0.84), higher index drinking levels (exceeding both daily and weekly limits: OR = 0.30, 95% CI = 0.29, 0.32) and psychiatric treatment (OR = 0.91, 95% CI = 0.84, 0.99) were associated with lower odds. Among those who achieved early cessation (n = 19 200), 60.0% sustained cessation. Associations between patient factors and sustained cessation paralleled those observed in analyses of early cessation. Additionally, routine primary care (OR = 1.57, 95% CI = 1.44, 1.71) and addiction treatment post-1 year (OR = 1.41, 95% CI = 1.19, 1.66) were associated with higher odds of sustained cessation. Lower-risk drinking versus abstinence at 1 year was associated with lower odds of sustained cessation (OR = 0.62, 95% CI = 0.57, 0.66). CONCLUSIONS Nearly two-thirds of a large, diverse sample of patients who reported heavy drinking in a Californian health-care system achieved early and sustained cessation of heavy drinking. Vulnerable subgroups (i.e. non-white patients and those with psychiatric disorders), patients who received routine primary care and those who received addiction treatment were more likely to sustain cessation of heavy drinking than other participants.
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Affiliation(s)
- Vanessa A Palzes
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Stenersen MR, Thomas K, Struble C, Moore KE, Burke C, McKee S. The impact of self-help groups on successful substance use treatment completion for opioid use: An intersectional analysis of race/ethnicity and sex. J Subst Abuse Treat 2021; 136:108662. [PMID: 34840040 PMCID: PMC8940633 DOI: 10.1016/j.jsat.2021.108662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 10/04/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Race/ethnicity and sex disparities in substance use and substance use treatment completion are well documented in the literature. Previous literature has shown that participation in self-help groups is associated with higher rates of substance use treatment completion. While most of this research has focused on the completion of treatment for alcohol and stimulant use, research examining this relationship using an intersectional approach for individuals in treatment for opioid use is limited. METHODS Thus, the current study utilized responses from the Treatment Episodes Data Set-Discharges, 2015-2017 to examine disparities in the relationship between participation in self-help groups and substance use treatment completion for individuals undergoing treatment for opioid use based on sex, race, and ethnicity. RESULTS Results revealed a positive association between participation in self-help groups and treatment completion among those in treatment for opioid use across race, ethnicity, and sex. Further, the study found several differences in this association based on one's race, ethnicity, and sex. When compared to men of other races/ethnicities, the association between self-help group participation and treatment completion was highest among Black men. CONCLUSIONS The results of the current study extend the knowledge-base about self-help participation's role in promoting successful substance use treatment completion to individuals in treatment for opioid use. Results also highlight the need to examine treatment outcomes with an intersectional lens.
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Affiliation(s)
| | - Kathryn Thomas
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
| | - Cara Struble
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
| | - Kelly E Moore
- Department of Psychology, East Tennessee States University, Johnson City, TN 37614, USA.
| | - Catherine Burke
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
| | - Sherry McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
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Williams IL. An Apologetic Interpretation of Alcoholics Anonymous (AA): Timeless Wisdom, Outdated Language. Subst Use Misuse 2021; 56:1079-1094. [PMID: 33970771 DOI: 10.1080/10826084.2021.1892134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Twelve Steps of Alcoholics Anonymous (AA) has proven to be an effective aid in recovery for many people with alcohol use disorder. While constructive criticisms of AA can be beneficial to the organization, other criticisms have merely served as rhetorical devices intent on discrediting the 12-step approach. OBJECTIVES This paper examines six prominent critiques of AA, paying special attention to the premises, tone, and factual basis of the statements. Interpretations grounded in AA literature are offered to address claims or critiques around prominent themes, which are organized into two main classes: purported causes of alcoholism and factors maintaining alcoholism. RESULTS Findings reveal tenuous statements in the AA literature that appear contradictory and thereby invite a misreading. These statements, some of which misrepresent the tenets of AA and its founders, underscore certain vocal criticisms that are not entirely unfounded. While many pages of the AA literature are imbued with timeless wisdom, even the most apologetic interpretations-distilled into benefit-of-the-doubt renderings-largely falter in defending the nature of the language that originated in the early 1900s at odds with 21st century understandings of alcohol use disorder. Conclusions/Importance: The AA literature essentially presents a valid target for critics, fueling resistance to this free community-based resource that may prevent people who could benefit from AA from seeking the help of the 12-steps.
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Tsutsumi S, Timko C, Zemore SE. Ambivalent attendees: Transitions in group affiliation among those who choose a 12-step alternative for addiction. Addict Behav 2020; 102:106143. [PMID: 31855782 PMCID: PMC7043797 DOI: 10.1016/j.addbeh.2019.106143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 09/12/2019] [Accepted: 09/20/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mutual-help alternatives for addiction are numerous, and research attests to the benefits of involvement in such alternatives. Yet, virtually nothing is known about affiliation patterns over time among 12-step alternatives. We investigated the patterns, correlates, and outcomes of transitions in affiliation (including changing groups and dropping out) within alternatives for alcohol problems. METHODS We analyzed data from the Peer ALternatives for Addiction (PAL) Study, a longitudinal study comparing the nature and effectiveness of 12-step groups, WFS, LifeRing, and SMART (N = 647). First, using all data, we compared affiliation patterns over time across 12-step and 12-step alternative members at baseline. Second, analyzing exclusively 12-step alternative members at baseline, we compared baseline characteristics and 6-month outcomes of those who changed and dropped out of (vs. retained) their primary groups at 6 months. RESULTS While drop-out rates were low, and similar, across groups, members of the alternatives were more likely (vs. 12-step) to change groups at 6 months, and transitioned predominantly to 12-step. Further, among the 12-step alternatives, both changing groups and dropping out was associated with lower group cohesion and satisfaction. Meanwhile, in multivariate analyses of 6-month outcomes, changing (vs. retaining) groups robustly predicted lower cohesion, higher negative affect, and lower quality of life, whereas dropping out was associated with lower odds of alcohol abstinence. CONCLUSIONS While dropping out is known to be risky, changing groups is more common among the 12-step alternatives, and connotes risk of future problems that may be partially explained by dissatisfaction with the new group (usually 12-step).
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Affiliation(s)
- Shiori Tsutsumi
- Department of Social and Human Sciences, School of Environment and Society, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8552, Japan.
| | - Christine Timko
- Department of Veterans Affairs, Health Services Research & Development, 795 Willow Rd., Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA.
| | - Sarah E Zemore
- Alcohol Research Group, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
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7
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Jacobs L. Women’s spiritually mediated stories about recovery from Alcohol Use Disorder: A brief report. JOURNAL OF PSYCHOLOGY IN AFRICA 2018. [DOI: 10.1080/14330237.2018.1523338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Liezille Jacobs
- Psychology Department, Rhodes University, Grahamstown, South Africa
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8
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Proeschold-Bell RJ, Evon DM, Makarushka C, Wong JB, Datta SK, Yao J, Patkar AA, Mannelli P, Hodge T, Naggie S, Wilder JM, Fried MW, Niedzwiecki D, Muir AJ. The Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention: Study protocol of a multi-center randomized controlled trial. Contemp Clin Trials 2018; 72:73-85. [PMID: 30006024 PMCID: PMC6711183 DOI: 10.1016/j.cct.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/25/2018] [Accepted: 07/09/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Among patients with hepatitis C virus (HCV) infection, alcohol synergistically increases the risk of cirrhosis, hepatocellular carcinoma, and death. Randomized controlled trials of integrated models of HCV-alcohol treatment have been recommended but only performed in patients with severe alcohol use disorders. OBJECTIVES This pragmatic randomized controlled trial seeks to compare clinical effectiveness and cost-effectiveness of integrated alcohol treatment compared to enhanced treatment as usual (TAU) on alcohol consumption and economic outcomes among patients ever infected with HCV. METHODS Patients recruited from three liver centers who had current or prior chronic HCV and qualifying alcohol screener scores were randomly assigned to enhanced TAU or the Hepatitis C-Alcohol Reduction Treatment (Hep ART) intervention. All patients received enhanced TAU, consisting of a patient-administered alcohol screener and care from medical providers who were trained in Screening, Brief Intervention and Referral to Treatment (SBIRT), including brief motivational interviewing counseling. The Hep ART intervention combined enhanced TAU with up to six months of integrated co-located individual and/or group therapy that provided motivational, cognitive, and behavioral strategies to reduce alcohol consumption. The Timeline Followback (TLFB) Method was used to evaluate alcohol use at baseline, 3, 6, and 12 months. Primary outcomes are alcohol abstinence and fewer heavy drinking days, and for the cost-effectiveness analysis, measures included grams of alcohol consumed. DISCUSSION This study will determine whether Hep ART, a six-month integrated alcohol treatment, compared to enhanced TAU, is both clinically effective and cost-effective in patients with a history of comorbid HCV and alcohol use.
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Affiliation(s)
- Rae Jean Proeschold-Bell
- Duke Global Health Institute, Duke University, Box 90392, Durham, NC 27708-0392, USA; Duke Center for Health Policy & Inequalities Research, Duke University, Box 90392, Durham, NC 27708-0392, USA.
| | - Donna M Evon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, CB# 7584, Chapel Hill, NC 27599-7584, United States.
| | - Christina Makarushka
- Duke Center for Health Policy & Inequalities Research, Duke University, Box 90392, Durham, NC 27708-0392, USA.
| | - John B Wong
- Division of Clinical Decision Making, Tufts Medical Center, 800 Washington St #302, Boston, MA 02111, USA.
| | - Santanu K Datta
- Department of Medicine, Duke University, 411 West Chapel Hill St, Suite 500, Durham, NC 27701, USA.
| | - Jia Yao
- Duke Center for Health Policy & Inequalities Research, Duke University, Box 90392, Durham, NC 27708-0392, USA.
| | - Ashwin A Patkar
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Suite 165, Durham, NC 27705, United States; Department of Community and Family Medicine, Duke University Medical Center, 2213 Elba Street, Suite 165, Durham, NC 27705, United States.
| | - Paolo Mannelli
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Suite 165, Durham, NC 27705, United States.
| | - Terra Hodge
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, DUMC 3913, Durham, NC 27710, USA.
| | - Susanna Naggie
- Duke University School of Medicine, Infectious Diseases, Durham, NC 27710, USA; Duke Clinical Research Institute, 2400 Pratt Street, Rm. 0311, Terrace Level, Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA.
| | - Julius M Wilder
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, DUMC 3913, Durham, NC 27710, USA; Duke Clinical Research Institute, 2400 Pratt Street, Rm. 0311, Terrace Level, Durham, NC 27705, USA.
| | - Michael W Fried
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, CB# 7584, Chapel Hill, NC 27599-7584, United States.
| | - Donna Niedzwiecki
- Department of Biostatistics and Bioinformatics, Duke University, Box 2721, Durham, NC 27710, United States.
| | - Andrew J Muir
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, DUMC 3913, Durham, NC 27710, USA; Duke Clinical Research Institute, 2400 Pratt Street, Rm. 0311, Terrace Level, Durham, NC 27705, USA.
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Karriker-Jaffe KJ, Witbrodt J, Subbaraman MS, Kaskutas LA. What Happens After Treatment? Long-Term Effects of Continued Substance Use, Psychiatric Problems and Help-Seeking on Social Status of Alcohol-Dependent Individuals. Alcohol Alcohol 2018; 53:394-402. [PMID: 29617709 PMCID: PMC6016698 DOI: 10.1093/alcalc/agy025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 11/14/2022] Open
Abstract
PURPOSE We examined whether alcohol-dependent individuals with sustained substance use or psychiatric problems after completing treatment were more likely to experience low social status and whether continued help-seeking would improve outcomes. SHORT SUMMARY Ongoing alcohol, drug and psychiatric problems after completing treatment were associated with increased odds of low social status (unemployment, unstable housing and/or living in high-poverty neighborhood) over 7 years. The impact of drug problems declined over time, and there were small, delayed benefits of AA attendance on social status. METHOD Alcohol-dependent individuals sampled from public and private treatment programs (N = 491; 62% male) in Northern California were interviewed at treatment entry and 1, 3, 5 and 7 years later. Random effects models tested relationships between problem severity (alcohol, drug and psychiatric problems) and help-seeking (attending specialty alcohol/drug treatment and Alcoholics Anonymous, AA) with low social status (unemployment, unstable housing and/or living in a high-poverty neighborhood) over time. RESULTS The proportion of participants experiencing none of the indicators of low social status increased between baseline and the 1-year follow-up and remained stable thereafter. Higher alcohol problem scores and having any drug and/or psychiatric problems in the years after treatment were associated with increased odds of low social status over time. An interaction of drug problems with time indicated the impact of drug problems on social status declined over the 7-year period. Both treatment-seeking and AA attendance were associated with increased odds of low social status, although lagged models suggested there were small, delayed benefits of AA attendance on improved social status over time. CONCLUSION Specialty addiction treatment alone was not sufficient to have positive long-term impacts on social status and social integration of most alcohol-dependent people.
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Affiliation(s)
| | - Jane Witbrodt
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450 Emeryville, CA, USA
| | - Meenakshi S Subbaraman
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450 Emeryville, CA, USA
| | - Lee Ann Kaskutas
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450 Emeryville, CA, USA
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McGrath DS, Kim HS, Hodgins DC, Novitsky C, Tavares H. Who Are the Anonymous? Involvement and Predictors of Gamblers Anonymous Attendance Among Disordered Gamblers Presenting for Treatment. J Gambl Stud 2018; 34:1423-1434. [PMID: 29691703 DOI: 10.1007/s10899-018-9774-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Gamblers Anonymous is the most widely available form of support for disordered gambling. Although chapters exist worldwide, knowledge of how attendees interact with the program is limited. The present study aimed to investigate involvement in Gamblers Anonymous among attendees, motives for attendance, and overall satisfaction with the program. Furthermore, potential gambling-related predictors of attendance versus deciding not to attend Gamblers Anonymous were investigated. A treatment-seeking sample of disordered gamblers (N = 512) from São Paulo, Brazil completed a series of self-report measures including an author-compiled Gamblers Anonymous survey. From the sample, 141 gamblers reported attending Gamblers Anonymous over the previous 30 days. An examination of involvement, satisfaction, and motives for attending Gamblers Anonymous was conducted, followed by regression analyses to assess predictors of attendance and satisfaction with the program. The majority of attendees (80%) reported some satisfaction with the program. The most common motive for attending Gamblers Anonymous was related to relapse prevention. Regression analyses revealed that greater gambling severity and number of days gambled were associated with not attending Gamblers Anonymous while giving testimonials was strongly related (OR = 6.18) to satisfaction with the program. The findings of this study contribute to the literature on Gamblers Anonymous. In particular, that members derive great satisfaction from the program and see it as a way to strengthen their abstinence goals. However, despite high satisfaction, the results also suggest that most members were passively involved in the program. More research that assesses the effectiveness of Gamblers Anonymous as either a stand-alone or adjunct treatment is needed.
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Affiliation(s)
- Daniel S McGrath
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Christine Novitsky
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, Butantã, São Paulo, 03178-200, Brazil
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Abstract
Unhealthy alcohol use is common and routine screening is essential to identify patients and initiate appropriate treatment. At-risk or hazardous drinking is best managed with brief interventions, which can be performed by any provider and are designed to enhance patients' motivations and promote behavioral change. Alcohol withdrawal can be managed, preferably with benzodiazepines, using a symptom-triggered approach. Twelve-step programs and provider-driven behavioral therapies have robust data supporting their effectiveness and patients with alcohol use disorder should be referred for these services. Research now support the use of several FDA-approved medications that aid in promoting abstinence and reducing heavy drinking.
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Affiliation(s)
- Stephen Holt
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, 1450 Chapel Street, New Haven, CT 06511, USA.
| | - Jeanette Tetrault
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, 367 Cedar Street, New Haven, CT 06510, USA
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Peavy KM, Garrett S, Doyle S, Donovan D. A comparison of African American and Caucasian stimulant users in 12-step facilitation treatment. J Ethn Subst Abuse 2016; 16:380-399. [PMID: 27294812 DOI: 10.1080/15332640.2016.1185657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Engagement in 12-step meetings and activities has been shown to be a powerful aid to recovery from substance use disorders. However, only limited attention has been given to ethnic and racial differences in attitudes toward 12-step and involvement. This study utilized data from a large multisite trial testing the effectiveness of a 12-step facilitation therapy with stimulant-dependent treatment seekers. We compared baseline differences and treatment outcomes between African American and Caucasian participants. A select few baseline differences were found (i.e., African Americans reported higher levels of spirituality than Caucasians; African American participants indicated more perceived benefits of 12-step involvement; Caucasians were more likely to endorse future involvement in 12-step). There were no outcome differences (e.g., substance use outcomes, 12-step meeting attendance). The tested intervention produced similar outcomes for both groups, indicating that it may be useful across racial categories.
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Affiliation(s)
- K Michelle Peavy
- a Alcohol & Drug Abuse Institute , University of Washington , Seattle , Washington.,b Evergreen Treatment Services , Seattle , Washington
| | - Sharon Garrett
- a Alcohol & Drug Abuse Institute , University of Washington , Seattle , Washington
| | - Suzanne Doyle
- a Alcohol & Drug Abuse Institute , University of Washington , Seattle , Washington
| | - Dennis Donovan
- a Alcohol & Drug Abuse Institute , University of Washington , Seattle , Washington
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13
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Lima-Rodríguez JS, Guerra-Martín MD, Domínguez-Sánchez I, Lima-Serrano M. Alcoholic patients' response to their disease: perspective of patients and family. Rev Lat Am Enfermagem 2015; 23:1165-72. [PMID: 26626009 PMCID: PMC4664018 DOI: 10.1590/0104-1169.0516.2662] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 05/03/2015] [Indexed: 11/24/2022] Open
Abstract
Objective: to know the perspective of alcoholic patients and their families about the
behavioral characteristics of the disease, identifying the issues to modify the
addictive behavior and seek rehabilitation. Method: ethnographic research using interpretative anthropology, via participant
observation and a detailed interview with alcoholic patients and their families,
members of Alcoholics Anonymous (AA) and Alanon in Spain. Results: development of disease behavior in alcoholism is complex due to the issues of
interpreting the consumption model as a disease sign. Patients often remain long
periods in the pre-contemplation stage, delaying the search for assistance, which
often arrives without them accepting the role of patient. This constrains the
recovery and is related to the social thought on alcoholism and self-stigma on
alcoholics and their families, leading them to deny the disease, condition of the
patient, and help. The efforts of self-help groups and the involvement of health
professionals is essential for recovery. Conclusion: understanding how disease behavior develops, and the change process of addictive
behavior, it may be useful for patients, families and health professionals,
enabling them to act in a specific way at each stage.
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Affiliation(s)
| | - María Dolores Guerra-Martín
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Isabel Domínguez-Sánchez
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - Marta Lima-Serrano
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
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