The effect of 12-step self-help group attendance and participation on drug use outcomes among cocaine-dependent patients.
OBJECTIVE
Although cocaine-dependent patients are frequently referred to 12-step self-help groups, little research has examined the benefits of 12-step group attendance in this population. Moreover, the distinction between attending meetings and actively participating in 12-step activities has not typically been examined.


METHODS
In the National Institute on Drug Abuse Collaborative Cocaine Treatment Study, 487 cocaine-dependent outpatients were recruited at five sites for a randomized controlled trial of 24-week behavioral treatments. Study data were examined to see whether self-help attendance or active participation were related to subsequent drug use.


RESULTS
Twelve-step group attendance did not predict subsequent drug use. However, active 12-step participation in a given month predicted less cocaine use in the next month. Moreover, patients who increased their 12-step participation during the first 3 months of treatment had significantly less cocaine use and lower ASI Drug Use Composite scores in the subsequent 3 months. Finally, Individual Drug Counseling, based on a 12-step model, and increasing levels of 12-step participation each offered discrete benefits.


CONCLUSIONS
Results suggest that active 12-step participation by cocaine-dependent patients is more important than meeting attendance, and that a combination of Individual Drug Counseling and active 12-step participation is effective for these patients.
Weiss
Roger D
RD
Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA. rweiss@mclean.harvard.edu
Griffin
Margaret L
ML
Gallop
Robert J
RJ
Najavits
Lisa M
LM
Frank
Arlene
A
Crits-Christoph
Paul
P
Thase
Michael E
ME
Blaine
Jack
J
Gastfriend
David R
DR
Daley
Dennis
D
Luborsky
Lester
L
D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010358:Patient Participation; D012657:Self-Help Groups; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome