Social recovery model: an 8-year investigation of adolescent 12-step group involvement following inpatient treatment.
BACKGROUND
Despite widespread use of 12-step treatment approaches and referrals to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) by youth providers, little is known about the significance of these organizations in youth addiction recovery. Furthermore, existing evidence is based mostly on short-term follow-up and is limited methodologically.


METHODS
Adolescent inpatients (n = 160; mean age = 16, 40% female) were followed at 6-months, and at 1, 2, 4, 6, and 8 years posttreatment. Time-lagged, generalized estimating equations modeled treatment outcome in relation to AA/NA attendance controlling for static and time-varying covariates. Robust regression (locally weighted scatterplot smoothing) explored dose-response thresholds of AA/NA attendance on outcome.


RESULTS
The AA/NA attendance was common and intensive early posttreatment, but declined sharply and steadily over the 8-year period. Patients with greater addiction severity and those who believed that they could not use substances in moderation were more likely to attend. Despite declining attendance, the effects related to AA/NA remained significant and consistent. Greater early participation was associated with better long-term outcomes.


CONCLUSIONS
Even though many youth discontinue AA/NA over time, attendees appear to benefit, and more severely substance-involved youth attend most. Successful early posttreatment engagement of youth in abstinence-supportive social contexts, such as AA/NA, may have long-term implications for alcohol and drug involvement into young adulthood.
Massachusetts General Hospital, Department of Psychiatry, Center for Addiction Medicine, 60 Staniford St., Suite 120, Boston, MA 02114, USA. jkelly11@partners.org
John F
JF
Kelly
Sandra A
SA
Brown
Ana
A
Abrantes
Christopher W
CW
Kahler
Mark
M
Myers
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010358:Patient Participation; D012720:Severity of Illness Index; D012944:Social Support; D013695:Temperance / Q000523:psychology; D016896:Treatment Outcome