title: Predictors of 12-Step Attendance and Participation for Individuals With Stimulant Use Disorders.
abstract: Few studies have examined the effectiveness of 12-step peer recovery support programs with drug use disorders, especially stimulant use, and it is difficult to know how outcomes related to 12-step attendance and participation generalize to individuals with non-alcohol substance use disorders (SUDs).
  
  
  
  A clinical trial of 12-step facilitation (N=471) focusing on individuals with cocaine or methamphetamine use disorders allowed examination of four questions: Q1) To what extent do treatment-seeking stimulant users use 12-step programs and, which ones? Q2) Do factors previously found to predict 12-step participation among those with alcohol use disorders also predict participation among stimulant users? Q3) What specific baseline "12-step readiness" factors predict subsequent 12-step participation and attendance? And Q4) Does stimulant drug of choice differentially predict 12-step participation and attendance?
  
  
  
  The four outcomes variables, attendance, speaking, duties at 12-step meetings, and other peer recovery support activities, were not related to baseline demographic or substance problem history or severity. Drug of choice was associated with differential days of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) attendance among those who reported attending, and cocaine users reported more days of attending AA or NA at 1-, 3- and 6-month follow-ups than did methamphetamine users. Pre-randomization measures of perceived benefit of 12-step groups predicted 12-step attendance at 3- and 6-month follow-ups. Pre-randomization 12-step attendance significantly predicted number of other self-help activities at end-of-treatment, 3- and 6-month follow-ups. Pre-randomization perceived benefit and problem severity both predicted number of self-help activities at end-of-treatment and 3-month follow-up. Pre-randomization perceived barriers to 12-step groups were negatively associated with self-help activities at end-of-treatment and 3-month follow-up. Whether or not one participated in any duties was predicted at all time points by pre-randomization involvement in self-help activities.
  
  
  
  The primary finding of this study is one of continuity: prior attendance and active involvement with 12-step programs were the main signs pointing to future involvement. Limitations and recommendations are discussed.
authors.affiliation: University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific St., Seattle, WA 98105. Electronic address: hatchm@uw.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Hatch-Maillette
authors.affiliation: University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Wells
authors.affiliation: University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Doyle
authors.affiliation: Adapt & SouthRiver Community Health Center, Roseburg, OR 97470.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Brigham
authors.affiliation: University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213.
authors.forename: Dennis
authors.initials: D
authors.lastname: Daley
authors.affiliation: San Francisco General Hospital, 1001 Potrero Ave., San Francisco, CA 98110.
authors.forename: Jessica
authors.initials: J
authors.lastname: DiCenzo
authors.affiliation: University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific St., Seattle, WA 98105.
authors.forename: Dennis
authors.initials: D
authors.lastname: Donovan
authors.affiliation: University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105.
authors.forename: Sharon
authors.initials: S
authors.lastname: Garrett
authors.affiliation: University of Miami Department of Public Health Sciences, Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136.
authors.forename: Viviana E
authors.initials: VE
authors.lastname: Horigian
authors.affiliation: Multnomah County Health Department, 426 SW Stark St, Portland, OR 97204.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Jenkins
authors.affiliation: Medical University of South Carolina Department of Psychiatry and Behavioral Sciences, 67 President St., Charleston, SC 29425.
authors.forename: Therese
authors.initials: T
authors.lastname: Killeen
authors.affiliation: University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, 2650 Yale Blvd SE, Albuquerque, NM 87106.
authors.forename: Mandy
authors.initials: M
authors.lastname: Owens
authors.affiliation: Independent Consultant, P.O. Box 169, Arroyo Seco, NM 87514.
authors.forename: Harold I
authors.initials: HI
authors.lastname: Perl
mesh_terms: D000436:Alcoholics Anonymous; D019969:Amphetamine-Related Disorders / Q000534:rehabilitation*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects; D010342:Patient Acceptance of Health Care; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine
keywords: 12-step; Attendance; Participation; Peer recovery; Predictors; Stimulant users