Twelve-step program attendance and polysubstance use: interplay of alcohol and illicit drug use.
Twelve-step program attendance and polysubstance use: interplay of alcohol and illicit drug use.
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DOI：
10.15288/jsad.2011.72.864
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发表时间：
2011-09
影响因子：
3.4
通讯作者：
J. Tonigan;Gregory K Beatty
中科院分区：
文献类型：
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作者：
J. Tonigan;Gregory K Beatty
目的 本研究的主要目的是通过确定 12 步计划附属机构中酒精和非法药物使用之间的时间关系，增进对 12 步计划功效的了解。方法 从药物滥用治疗和社区戒酒互诫协会中招募了 253 名早期 12 步会员，他们没有丰富的参加戒酒互诫协会 (AA) 的历史。大多数样本符合酒精依赖诊断标准，报告终生使用非法药物，并报告招募前 90 天内使用非法药物。知情同意后，参与者在入学时接受采访，并在一年内以 3 个月为增量进行采访。结果 初步分析表明，12 步出勤可以预测药物使用的减少，并且这种减少不受非法药物使用障碍诊断或酒精问题严重程度的影响。滞后的分层线性模型表明，非法药物的使用是后来饮酒的有力预测因素，尽管饮酒的频率和强度取决于参与者是否持续参与 12 步计划。持续参加 12 步计划的参与者中，饮酒并不能预测其后的非法药物使用情况。结论 研究结果表明，12 步参与可能可以作为药物滥用后的保护因素。尽管我们的结果表明，开始使用非法药物可能会破坏实现和维持戒酒的努力，但我们的研究结果并不表明，酒精的使用必然会导致十二步计划附属机构中不同物质的复发。
OBJECTIVE The primary aim of this study was to advance understanding of the efficacy of 12-step programs by determining the temporal relationships between alcohol and illicit drug use among 12- step program affiliates. METHOD A total of 253 early 12-step affiliates without extensive histories of Alcoholics Anonymous (AA) attendance were recruited from substance use treatment and community-based AA. A majority of the sample met criteria for a diagnosis of alcohol dependence, reported lifetime use of illicit drugs, and reported illicit drug use in the 90-day period before recruitment. After informed consent, participants were interviewed at intake and in 3-month increments for 1 year. RESULTS Preliminary analyses indicated that 12-step attendance was predictive of reductions in substance use and that such reductions were not moderated by illicit substance use disorder diagnosis or alcohol problem severity. Lagged hierarchical linear models indicated that illicit drug use was a robust predictor of later use of alcohol, although the frequency and intensity of drinking were contingent on whether participants sustained 12-step program affiliation. Alcohol use did not predict later illicit drug use among participants who sustained 12-step program participation. CONCLUSIONS Findings suggest that 12-step participation may serve as a protective factor after substance use occurs. Although our results suggest that the initiation of illicit drug use may undermine efforts to achieve and sustain abstinence from alcohol, our findings do not suggest that alcohol use necessarily mobilizes relapse across different substances among 12-step program affiliates.