Bergman Brandon G, Greene M Claire, Zemore Sarah E, Kelly John F
Recovery Research Institute, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Program on Forced Migration and Health, Columbia University Mailman School of Public Health, New York, New York, USA.
Alcohol Clin Exp Res (Hoboken). 2024 Mar;48(3):545-555. doi: 10.1111/acer.15268. Epub 2024 Jan 21.
Mutual-help organizations (MHOs) are effective community-based, recovery support options for individuals with alcohol and other drug use disorders (i.e., substance use disorder; SUD). Greater understanding of second-wave MHOs, such as SMART Recovery, can help build on existing research that has focused primarily on 12-step MHOs, such as Alcoholics Anonymous, to inform scientific, practice, and policy recommendations.
We conducted a secondary analysis of the National Recovery Study, a representative sample of US adults who resolved a substance use problem (N = 1984). Using survey-weighted estimates, we examined descriptive statistics for any lifetime, weekly lifetime, and past 90-day MHO attendance; we compared rates of 12-step and second-wave MHO attendance over time by descriptively examining distributions for calendar year of the first meeting attended. We also used two logistic regression models to examine demographic, substance use, clinical, and recovery-related correlates of weekly lifetime attendance separately for 12-step (n = 692) and second-wave MHOs (n = 32).
For any attendance, 41.4% attended a 12-step MHO and 2.9% a second-wave MHO; for weekly attendance, 31.9% attended a 12-step MHO, and 1.7% a second-wave MHO. Two-thirds (64%) of initial second-wave attendance occurred between 2006 and 2017 compared to 22% of initial 12-step attendance during this time frame. Significant correlates of weekly 12-step MHO attendance included histories of SUD treatment and arrest. Significant correlates of weekly second-wave MHO attendance included Black identity (vs. White) and history of SUD medication.
Attendance at second-wave MHOs is far less common than 12-step MHOs, but appears to be on the rise. Observed correlates of second-wave MHO attendance should be replicated in larger second-wave MHO samples before integrating these findings into best practices. Enhanced linkages from clinical and criminal justice settings to both second-wave and 12-step groups may help to "broaden the base" of MHOs.
互助组织（MHOs）是针对患有酒精及其他药物使用障碍（即物质使用障碍；SUD）的个人，基于社区的有效康复支持选项。对诸如SMART Recovery等第二代互助组织有更深入的了解，有助于在主要聚焦于诸如戒酒互助会等12步互助组织的现有研究基础上，为科学、实践及政策建议提供参考。
我们对全国康复研究进行了二次分析，该研究是对解决了物质使用问题的美国成年人的代表性样本（N = 1984）。使用调查加权估计，我们检查了任何终身、每周终身以及过去90天参加互助组织的描述性统计数据；通过描述性检查首次参加会议的日历年分布，我们比较了12步互助组织和第二代互助组织随时间的参与率。我们还使用了两个逻辑回归模型，分别针对12步互助组织（n = 692）和第二代互助组织（n = 32），研究每周终身参与的人口统计学、物质使用、临床及康复相关的关联因素。
对于任何参与情况，41.4%的人参加了12步互助组织，2.9%的人参加了第二代互助组织；对于每周参与情况，31.9%的人参加了12步互助组织，1.7%的人参加了第二代互助组织。三分之二（64%）的第二代互助组织首次参与发生在2006年至2017年之间，而在此时间范围内第一代12步互助组织首次参与的比例为22%。每周参加12步互助组织的显著关联因素包括物质使用障碍治疗史和被捕史。每周参加第二代互助组织的显著关联因素包括黑人身份（与白人相比）和物质使用障碍药物治疗史。
参加第二代互助组织的情况远不如12步互助组织常见，但似乎呈上升趋势。在将这些发现纳入最佳实践之前，应在更大的第二代互助组织样本中重复观察到的第二代互助组织参与的关联因素。加强临床和刑事司法环境与第二代和12步互助组织之间的联系，可能有助于“扩大”互助组织的“基础”。
