title: Do Drug-Dependent Patients Attending Alcoholics Anonymous Rather than Narcotics Anonymous Do As Well? A Prospective, Lagged, Matching Analysis.
abstract: OBJECTIVE
  Alcoholics Anonymous (AA) is the most prevalent 12-step mutual-help organization (MHO), yet debate has persisted clinically regarding whether patients whose primary substance is not alcohol should be referred to AA. Narcotics Anonymous (NA) was created as a more specific fit to enhance recovery from drug addiction; however, compared with AA, NA meetings are not as ubiquitous. Little is known about the effects of a mismatch between individuals' primary substance and MHOs, and whether any incongruence might result in a lower likelihood of continuation and benefit. More research would inform clinical recommendations.
  
  
  METHODS
  Young adults (N = 279, M age 20.4, SD 1.6, 27% female; 95% White) in a treatment effectiveness study completed assessments at intake, and 3, 6, and 12 months post-treatment. A matching variable was created for 'primary drug' patients (i.e. those reporting cannabis, opiates or stimulants as primary substance; n = 198/279), reflecting the proportion of total 12-step meetings attended that were AA. Hierarchical linear models (HLMs) tested this variable's effects on future 12-step participation and percent days abstinent (PDA).
  
  
  RESULTS
  The majority of meetings attended by both alcohol and drug patients was AA. Drug patients attending proportionately more AA than NA meetings (i.e. mismatched) were no different than those who were better matched to NA with respect to future 12-step participation or PDA.
  
  
  CONCLUSIONS
  Drug patients may be at no greater risk of discontinuation or diminished recovery benefit from participation in AA relative to NA. Findings may boost clinical confidence in making AA referrals for drug patients when NA is less available.
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, USA jkelly11@mgh.harvard.edu.
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, USA.
authors.forename: M Claire
authors.initials: MC
authors.lastname: Greene
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, USA.
authors.forename: Brandon G
authors.initials: BG
authors.lastname: Bergman
mesh_terms: D064829:Alcohol Abstinence / Q000523:psychology / Q000706:statistics & numerical data; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000150:complications / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D055815:Young Adult