Bergman Brandon G, Hoeppner Bettina B, Nelson Lindsay M, Slaymaker Valerie, Kelly John F
Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Drug Alcohol Depend. 2015 Aug 1;153:207-14. doi: 10.1016/j.drugalcdep.2015.05.017. Epub 2015 May 27.
Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults' participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts.
Emerging adults (N=284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, substance use disorder (SUD) medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates.
Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups).
Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment.
专业的持续护理服务可提高成年人和青少年的康复率,不过对于初显期成年人(18至25岁),人们了解得较少。尽管有证据表明初显期成年人参与12步互助组织(MHO)有益,但尚不清楚这种参与是否能独立于专业持续护理服务之外带来益处。该领域更多的知识将为临床转诊和联系工作提供参考。
对初显期成年人(N = 284;74%为男性;95%为白种人)在住院治疗后的一年中进行评估,内容包括每周门诊次数、住院治疗天数及居住在清醒生活环境中的天数、物质使用障碍(SUD)药物使用情况、积极参与12步MHO的情况(例如,有担保人、完成步骤工作、与会议之外的成员联系)以及持续戒酒情况(二分法,是/否)。一个广义估计方程(GEE)模型测试了每项专业服务对戒酒的独特影响,在另一个GEE模型中,测试了12步MHO参与情况独立于个体协变量之外对戒酒的独特影响,该影响超出专业服务范畴。
除了SUD药物外,所有专业持续护理服务与个体因素之外的戒酒情况均显著相关。在更全面的模型中,相对于12步MHO活动为零的情况,如果患者参与一项活动,戒酒的几率是其1.3倍,如果参与五项活动,戒酒几率是其3.2倍(在所有随访中样本中活动的最低平均次数)。
积极参与12步MHO以及将患者与这些基于社区的资源相联系的康复支持性专业服务,可能会提高初显期成年人住院治疗后的康复效果。