Kings College London, National Addiction Centre, Maudsley Hospital/Institute of Psychiatry, 4 Windsor Walk, London SE5 8BB, UK.
Drug Alcohol Depend. 2012 Nov 1;126(1-2):131-7. doi: 10.1016/j.drugalcdep.2012.05.004. Epub 2012 Jun 6.
Active engagement in 12-Step self-help groups (SHG) is associated with improvements in substance use outcomes during and after treatment, yet levels of participation in SHG meetings in the U.K. remain low.
An RCT investigating the impact of active referral to SHG, delivered by doctors or 12-Step peers during inpatient treatment on both inpatient and post-treatment meeting attendance was conducted. 151 inpatients with alcohol, opiate, crack-cocaine or benzodiazepine dependence undergoing detoxification, received one of two active referral interventions: 12-Step peer intervention (PI), doctor intervention (DI), or no intervention (NI). 83% of the sample was followed up, 2-3 months following discharge.
Active referral interventions significantly increased attendance at 12-Step meetings during inpatient treatment (88% versus 73%, p<.05). Rates of post-discharge meeting attendance were PI=64%, DI=48%, NI=33%, with those in the PI group significantly (OR=3.6; CI=1.3, 9.8) more likely to have attended. Inpatient meeting attenders were three times as likely to have attended meetings post-discharge (59% versus 20%, p<.01), and post-discharge meeting attenders reported significantly higher abstinence rates (60.8% versus 39.2%, p<.05) at follow-up. However, abstinence rates did not differ significantly across intervention groups (44% [PI], 41% [DI] and 36% [NI]).
Attendance at 12-Step SHGs is associated with greater rates of abstinence and active referral, especially by 12-Step peers, increases 12-Step SHG attendance rates. However, improved clinical outcomes among attendees might not occur until stronger recovery peer support networks are established. These results show promise for the benefit of incorporating Twelve Step Facilitation into U.K. treatment settings.
积极参与 12 步自助小组（SHG）与治疗期间和治疗后的物质使用结果改善相关，但在英国，SHG 会议的参与度仍然较低。
一项 RCT 研究了在住院治疗期间由医生或 12 步同伴主动转介到 SHG 对住院和治疗后会议出勤率的影响。151 名接受酒精、阿片类药物、可卡因或苯二氮䓬类药物依赖脱毒治疗的住院患者接受了两种主动转介干预措施之一：12 步同伴干预（PI）、医生干预（DI）或无干预（NI）。83%的样本接受了随访，在出院后 2-3 个月进行。
主动转介干预措施显著增加了住院期间参加 12 步会议的人数（88%比 73%，p<.05）。出院后会议出勤率分别为 PI=64%、DI=48%、NI=33%，PI 组的出勤率显著更高（OR=3.6；CI=1.3, 9.8）。住院期间参加会议的人出院后参加会议的可能性高三倍（59%比 20%，p<.01），出院后参加会议的人报告的戒断率显著更高（60.8%比 39.2%，p<.05）。然而，干预组之间的戒断率没有显著差异（PI 组为 44%，DI 组为 41%，NI 组为 36%）。
参加 12 步自助小组与更高的戒断率相关，尤其是通过 12 步同伴，增加 12 步自助小组的出勤率。然而，直到建立更强有力的康复同伴支持网络，参与者的临床结果才可能得到改善。这些结果表明，将十二步促进法纳入英国治疗环境可能会带来好处。
