'Tweaking 12-Step': the potential role of 12-Step self-help group involvement in methamphetamine recovery.
OBJECTIVE
To determine from a review of the available literature the extent to which involvement in 12-Step mutual support groups could play a role in the recovery process for individuals abusing or dependent on methamphetamine.


METHODS
Review of the literature on outcomes associated with 12-Step meeting attendance and involvement in 12-Step activities among substance abusers, particularly those who abuse stimulants.


RESULTS
There are few if any data available on methamphetamine abusers and their use of 12-Step approaches. Evidence derived from work with alcohol- and cocaine-dependent individuals indicates that involvement in 12-Step self-help groups, both attending meetings and engaging in 12-Step activities, is associated with reduced substance use and improved outcomes. Although involvement in 12-Step fellowship improves outcome, many individuals do not engage on their own in 12-Step activities, and there are high rates of dropout from such groups. There are a number of evidence-based therapies available to assist clinicians in facilitating 12-Step involvement; however, these have not been used with methamphetamine abusers. While there are some potential barriers to adopting manualized treatment interventions into clinical practice, the familiarity, in community-based practice, of the 12-Step approach may make this easier.


CONCLUSIONS
More actively integrating 12-Step approaches into the treatment process may provide low- or no-cost options for methamphetamine abusers and increase the capacity for providing treatment. Further research and evaluation are necessary to determine the extent to which methamphetamine abusers do engage in 12-Step self-help programs, whether they prefer more general (e.g. Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous) or drug-specific (e.g. Crystal Meth Anonymous) meetings, the rate of dropout and the outcomes associated with their involvement. Further, the efficacy of efforts to facilitate involvement of methamphetamine abusers in such 12-Step groups needs to be determined.
Donovan
Dennis M
DM
Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA 98105, USA. ddonovan@u.washington.edu
Wells
Elizabeth A
EA
D019969:Amphetamine-Related Disorders / Q000534:rehabilitation*; D000697:Central Nervous System Stimulants; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008694:Methamphetamine; D010349:Patient Compliance; D012657:Self-Help Groups / Q000458:organization & administration*
D000697:Central Nervous System Stimulants; D008694:Methamphetamine