[Self-help programs in drug addiction therapy].
BACKGROUND
Treatment of drug addiction is complex; hence there is a debate in the field of what is the best approach. An honest desire to stop using drugs is the entry ticket into the self-help programmes Alcoholics Anonymous (AA) and Narcotics Anonymous (NA); these groups are a possible supplement to ordinary treatment. They employ the twelve-step programme and are found in most large cities in Norway and around the world. The usefulness of these groups has been disputed, and few Norwegian treatment facilities have developed a systematic cooperation with them. The purpose of this study was to examine whether the use of self-help groups is associated with higher rates of abstinence two years after participants started attending groups.


METHODS
114 patients, 59 with alcohol addiction and 55 with drug addiction, who started in self-help groups after a drug treatment, were approached two years later with a questionnaire. The response rate was 66%; 6 (5%) patients were dead.


RESULTS
Intention to treat analysis showed that 38% participated in self-help programmes two years after treatment. Of regular participants, 81% had been abstinent over the previous 6 months, compared with only 26% among non-participants. Logistic regression analysis showed odds ratio = 12.6, 95% CI (4.1-38.3), p < 0.001, for participation and abstinence.


CONCLUSIONS
The study has several methodological problems; particularly that correlation does not necessarily indicate causality. These problems are discussed here; the conclusion is that the probability of a positive effect is strong enough to recommend participation in self-help groups as a supplement to drug addiction treatment.
Kristensen
Øistein
Ø
Avdeling for rus- og avhengighetsbehandling, Sørlandet Sykehus HF, Serviceboks 416, 4604 Kristiansand. oistein.kristensen@sshf.no
Vederhus
John-Kåre
JK
D000328:Adult; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D010349:Patient Compliance; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome