Alcohol and drug treatment involvement, 12-step attendance and abstinence: 9-year cross-lagged analysis of adults in an integrated health plan

• Published in: Journal of substance abuse treatment 2014-04, Vol.46 (4), p.412-419
• Main Authors: Witbrodt, Jane, Ph.D, Ye, Yu, M.A, Bond, Jason, Ph.D, Chi, Felicia, M.P.H, Weisner, Constance, Ph.D., M.S.W, Mertens, Jennifer, Ph.D
• Format: Article
• Language: English
• Subjects: 12-Step attendance; Abstinence; Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol and drug treatment; Alcoholism - rehabilitation; Ambulatory Care - organization & administration; Biological and medical sciences; Causality; Delivery of Health Care, Integrated - organization & administration; Desintoxication. Drug withdrawal; Drug abuse; Drug addiction; Drug use; Female; Follow-Up Studies; Gender differences; Health care; Health insurance; Humans; Longitudinal data; Male; Managed care; Medical sciences; Mental health care; Middle Aged; Miscellaneous; Outpatient treatment; Path model; Patient Compliance - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Self-Help Groups; Substance abuse treatment; Substance-Related Disorders - rehabilitation; Time Factors; Treatment Outcome; Treatments; Twelve step model
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2013.10.015

Abstract This study explored causal relationships between post-treatment 12-step attendance and abstinence at multiple data waves and examined indirect paths leading from treatment initiation to abstinence 9-years later. Adults ( N = 1945) seeking help for alcohol or drug use disorders from integrated healthcare organization outpatient treatment programs were followed at 1-, 5-, 7- and 9-years. Path modeling with cross-lagged partial regression coefficients was used to test causal relationships. Cross-lagged paths indicated greater 12-step attendance during years 1 and 5 and were casually related to past-30-day abstinence at years 5 and 7 respectfully, suggesting 12-step attendance leads to abstinence (but not vice versa) well into the post-treatment period. Some gender differences were found in these relationships. Three significant time-lagged, indirect paths emerged linking treatment duration to year-9 abstinence. Conclusions are discussed in the context of other studies using longitudinal designs. For outpatient clients, results reinforce the value of lengthier treatment duration and 12-step attendance in year 1.