Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, New Mexico 87106, USA.
J Stud Alcohol Drugs. 2013 Jul;74(4):514-20. doi: 10.15288/jsad.2013.74.514.
Strong opinions have been voiced about the "fit" between 12-step treatment, community-based 12-step practices, and American Indian beliefs and values. Little is known, however, about the relative benefit of 12-step programs for urban American Indians, although they are the most widely accessed type of treatment by American Indians. This study investigated rates of 12-step attendance, attrition, and substance use outcomes for American Indians for 9 months relative to non-Hispanic White participants.
This study compared urban American Indian (n = 63) and non-Hispanic White (n = 133) 12-step attendance, attrition, and substance use over 9 months. The sample was formed by merging data from two prospective single-group longitudinal studies investigating behavior change in community-based 12-step programs. Participants were interviewed at baseline and at 3-, 6-, and 9-month follow-ups. No intervention was provided. Participants were recruited from Alcoholics Anonymous meetings in the community and as they presented for outpatient substance use disorder treatment. Substance use and patterns of 12-step attendance were measured using the Form 90 calendar-based interview, and the General Alcoholics Anonymous Tools of Recovery was administered to assess the adoption of prescribed 12-step practices and beliefs.
Trajectories in 12-step meeting attendance over 9 months did not differ between American Indian and non-Hispanic White participants. However, American Indian participants discontinued 12-step attendance significantly less often than non-Hispanic White participants. Higher rates of 12-step attendance predicted increased alcohol abstinence and decreased drinking intensity for both American Indian and non-Hispanic White participants. Twelve-step attendance was unrelated to later illicit drug use for both American Indian and non-Hispanic White participants.
Community-based 12-step program attendance is associated with drinking reductions among urban American Indians.
对于 12 步治疗、基于社区的 12 步实践以及美国印第安人的信仰和价值观之间的“契合度”，人们表达了强烈的意见。然而，对于城市美国印第安人来说，12 步项目的相对益处知之甚少，尽管他们是美国印第安人最广泛接受的治疗类型。本研究调查了与非西班牙裔白人参与者相比，9 个月内美国印第安人参加 12 步治疗的比例、退出率和物质使用结果。
本研究比较了城市美国印第安人（n = 63）和非西班牙裔白人（n = 133）在 9 个月内的 12 步治疗出勤率、退出率和物质使用情况。该样本由合并两项针对基于社区的 12 步计划中行为变化的前瞻性单组纵向研究的数据形成。参与者在基线和 3、6 和 9 个月的随访中接受了访谈。没有提供干预措施。参与者是从社区的匿名戒酒会会议和门诊物质使用障碍治疗中招募的。使用基于表单 90 的日历访谈测量物质使用和 12 步治疗出勤率模式，使用一般匿名戒酒会工具评估规定的 12 步实践和信仰的采用情况。
9 个月内 12 步会议出勤率的轨迹在印第安人和非西班牙裔白人参与者之间没有差异。然而，美国印第安参与者停止参加 12 步治疗的频率明显低于非西班牙裔白人参与者。较高的 12 步治疗出勤率预测了印第安人和非西班牙裔白人参与者的酒精戒断和饮酒强度降低。对于印第安人和非西班牙裔白人参与者，12 步治疗出勤率与后来的非法药物使用无关。
基于社区的 12 步治疗计划的参与与城市美国印第安人的饮酒量减少有关。
