Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA.
Drug Alcohol Depend. 2010 Jul 1;110(1-2):117-25. doi: 10.1016/j.drugalcdep.2010.02.019. Epub 2010 Mar 24.
Despite advances in the development of treatments for adolescents with substance use disorders (SUD), relapse remains common following an index treatment episode. Community continuing care resources, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), have been shown to be helpful and cost-effective recovery resources among adults. However, little is known about the clinical utility and effectiveness of AA/NA for adolescents, despite widespread treatment referrals.
Adolescents (N=127; 24% female, 87% White, M age=16.7 years) enrolled in a naturalistic, prospective study of community outpatient treatment were assessed at intake, and 3 and 6 months later using a battery of standardized and validated measures.
Just over one-quarter of youth attended AA/NA meetings during the first 3 months, which was predicted by a goal of abstinence, prior AA/NA attendance, and prior SUD treatment experiences. Controlled multiple regression analyses revealed an independent effect of AA/NA on abstinence, in both contemporaneous and lagged models, which persisted over and above the effects of pre-treatment AA/NA attendance, prior treatment, self-efficacy, abstinence goal, and concomitant outpatient treatment.
Results suggest that, similar to findings comparing adult outpatients to inpatients, AA/NA participation is less common among less severe adolescent outpatients. Nonetheless, attendance appears to strengthen and extend the benefits of typical community outpatient treatment. Given the dramatic increase in rates of substance use among same-aged peers in the population at this life-stage, and the relative dearth of abstainers and recovery-specific supports, these resources may provide a concentrated cost-effective social recovery resource for young people.
尽管在治疗青少年物质使用障碍(SUD)方面取得了进展,但在索引治疗发作后,复发仍然很常见。酒精匿名(AA)和麻醉品匿名(NA)等社区持续护理资源已被证明是对成年人有帮助且具有成本效益的康复资源。然而,尽管广泛推荐了治疗,但青少年 AA/NA 的临床实用性和有效性知之甚少。
参加社区门诊治疗的自然前瞻性研究的青少年(N=127;24%为女性,87%为白人,M 年龄=16.7 岁)在入组时以及 3 个月和 6 个月后使用一系列标准化和经过验证的措施进行评估。
超过四分之一的青少年在头 3 个月内参加了 AA/NA 会议,这是由禁欲目标、以前的 AA/NA 出席情况以及以前的 SUD 治疗经验预测的。控制多元回归分析显示,AA/NA 对禁欲的影响具有独立性,无论是在同期还是滞后模型中,这一影响持续存在,超过了治疗前 AA/NA 出席情况、先前治疗、自我效能、禁欲目标和同时进行的门诊治疗的影响。
结果表明,与比较成人门诊患者和住院患者的研究结果相似,AA/NA 的参与在较轻的青少年门诊患者中较为常见。尽管如此,出席似乎加强并延长了典型社区门诊治疗的益处。鉴于在这个生命阶段,同年龄段人群中物质使用的比例急剧增加,以及缺乏禁欲者和特定于康复的支持,这些资源可能为年轻人提供集中的、具有成本效益的社交康复资源。