Keith Humphreys1, Nicolas B Barreto2, Sheila M Alessi3, Kathleen M Carroll4, Paul Crits-Christoph5, Dennis M Donovan6, John F Kelly7, Richard S Schottenfeld8, Christine Timko9, Todd H Wagner10. 1. Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA. Electronic address: knh@stanford.edu. 2. Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA. 3. Department of Psychiatry, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030 USA. 4. Department of Psychiatry, Yale University, 300 George St., Suite 90, New Haven, CT, 06511 USA. 5. Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104 USA. 6. Alcohol and Drug Institute, 1107 NE 45th Street, University of Washington, Box 354805, Seattle, WA 98195 USA. 7. Recovery Research Institute, Center for Addiction Medicine, Harvard Medical School, 151 Merrimac Street 6th Floor, Boston MA 02114 USA. 8. Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA, 20060 USA. 9. Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA. 10. Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA.
Abstract
BACKGROUND: 12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorder patients. METHODS: Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models. All trials included a 12 step group facilitation condition and employed the Addiction Severity Index as a core measure. RESULTS: The ability of 12 step facilitation to increase mutual help group participation among drug use disorder patients was minimal, limiting ability to employ two-stage instrumental variable models that correct for selection bias. However, traditional fixed and random effect regression models found that greater 12 step mutual help group attendance by drug use disorder patients predicted reduced use of and problems with illicit drugs and also with alcohol. CONCLUSION: Facilitating significant and lasting involvement in 12 step groups may be more challenging for drug use disorder patients than for alcohol use disorder patients, which has important implications for clinical work and for effectiveness evaluations. Though selection bias could explain part of the results of traditional regression models, the finding that participation in 12 step mutual help groups predicts lower illicit drug and alcohol use and problems in a large, diverse, sample of drug use disorder patients is encouraging.
BACKGROUND: 12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorderpatients. METHODS: Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models. All trials included a 12 step group facilitation condition and employed the Addiction Severity Index as a core measure. RESULTS: The ability of 12 step facilitation to increase mutual help group participation among drug use disorderpatients was minimal, limiting ability to employ two-stage instrumental variable models that correct for selection bias. However, traditional fixed and random effect regression models found that greater 12 step mutual help group attendance by drug use disorderpatients predicted reduced use of and problems with illicit drugs and also with alcohol. CONCLUSION: Facilitating significant and lasting involvement in 12 step groups may be more challenging for drug use disorderpatients than for alcohol use disorderpatients, which has important implications for clinical work and for effectiveness evaluations. Though selection bias could explain part of the results of traditional regression models, the finding that participation in 12 step mutual help groups predicts lower illicit drug and alcohol use and problems in a large, diverse, sample of drug use disorderpatients is encouraging.
Authors: Roger D Weiss; Margaret L Griffin; Robert J Gallop; Lisa M Najavits; Arlene Frank; Paul Crits-Christoph; Michael E Thase; Jack Blaine; David R Gastfriend; Dennis Daley; Lester Luborsky Journal: Drug Alcohol Depend Date: 2005-02-14 Impact factor: 4.492
Authors: John F Kelly; Yifrah Kaminer; Christopher W Kahler; Bettina Hoeppner; Julie Yeterian; Julie V Cristello; Christine Timko Journal: Addiction Date: 2017-08-01 Impact factor: 6.526
Authors: Dennis M Donovan; Dennis C Daley; Gregory S Brigham; Candace C Hodgkins; Harold I Perl; Sharon B Garrett; Suzanne R Doyle; Anthony S Floyd; Patricia C Knox; Christopher Botero; Thomas M Kelly; Therese K Killeen; Carole Hayes; Nicole Kau'i Baumhofer; Nicole Kau'ibaumhofer; Cindy Seamans; Lucy Zammarelli Journal: J Subst Abuse Treat Date: 2012-05-31