Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials.
Identifieur interne : 000186 ( Main/Exploration ); précédent : 000185; suivant : 000187Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials.
Auteurs : Keith Humphreys [États-Unis] ; Nicolas B. Barreto [États-Unis] ; Sheila M. Alessi [États-Unis] ; Kathleen M. Carroll [États-Unis] ; Paul Crits-Christoph [États-Unis] ; Dennis M. Donovan [États-Unis] ; John F. Kelly [États-Unis] ; Richard S. Schottenfeld [États-Unis] ; Christine Timko [États-Unis] ; Todd H. Wagner [États-Unis]Source :
- Drug and alcohol dependence [ 1879-0046 ] ; 2020.
Abstract
BACKGROUND
12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorder patients.
METHODS
Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models. All trials included a 12 step group facilitation condition and employed the Addiction Severity Index as a core measure.
RESULTS
The ability of 12 step facilitation to increase mutual help group participation among drug use disorder patients was minimal, limiting ability to employ two-stage instrumental variable models that correct for selection bias. However, traditional fixed and random effect regression models found that greater 12 step mutual help group attendance by drug use disorder patients predicted reduced use of and problems with illicit drugs and also with alcohol.
CONCLUSION
Facilitating significant and lasting involvement in 12 step groups may be more challenging for drug use disorder patients than for alcohol use disorder patients, which has important implications for clinical work and for effectiveness evaluations. Though selection bias could explain part of the results of traditional regression models, the finding that participation in 12 step mutual help groups predicts lower illicit drug and alcohol use and problems in a large, diverse, sample of drug use disorder patients is encouraging.
DOI: 10.1016/j.drugalcdep.2020.108213
PubMed: 32801112
PubMed Central: PMC7502458
Affiliations:
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Schottenfeld</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA, 20060 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Timko, Christine" sort="Timko, Christine" uniqKey="Timko C" first="Christine" last="Timko">Christine Timko</name><affiliation wicri:level="2"><nlm:affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Wagner, Todd H" sort="Wagner, Todd H" uniqKey="Wagner T" first="Todd H" last="Wagner">Todd H. 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Quarry Road, MC: 5717, Stanford, CA 94035 USA. Electronic address: knh@stanford.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Barreto, Nicolas B" sort="Barreto, Nicolas B" uniqKey="Barreto N" first="Nicolas B" last="Barreto">Nicolas B. Barreto</name><affiliation wicri:level="2"><nlm:affiliation>Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Alessi, Sheila M" sort="Alessi, Sheila M" uniqKey="Alessi S" first="Sheila M" last="Alessi">Sheila M. Alessi</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, UConn Health, 263 Farmington Avenue, Farmington, CT</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Carroll, Kathleen M" sort="Carroll, Kathleen M" uniqKey="Carroll K" first="Kathleen M" last="Carroll">Kathleen M. Carroll</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, Yale University, 300 George St., Suite 90, New Haven, CT, 06511 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Yale University, 300 George St., Suite 90, New Haven, CT</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Crits Christoph, Paul" sort="Crits Christoph, Paul" uniqKey="Crits Christoph P" first="Paul" last="Crits-Christoph">Paul Crits-Christoph</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Donovan, Dennis M" sort="Donovan, Dennis M" uniqKey="Donovan D" first="Dennis M" last="Donovan">Dennis M. Donovan</name><affiliation wicri:level="2"><nlm:affiliation>Alcohol and Drug Institute, 1107 NE 45th Street, University of Washington, Box 354805, Seattle, WA 98195 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Alcohol and Drug Institute, 1107 NE 45th Street, University of Washington, Box 354805, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Kelly, John F" sort="Kelly, John F" uniqKey="Kelly J" first="John F" last="Kelly">John F. Kelly</name><affiliation wicri:level="2"><nlm:affiliation>Recovery Research Institute, Center for Addiction Medicine, Harvard Medical School, 151 Merrimac Street 6th Floor, Boston MA 02114 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Recovery Research Institute, Center for Addiction Medicine, Harvard Medical School, 151 Merrimac Street 6th Floor</wicri:cityArea></affiliation></author><author><name sortKey="Schottenfeld, Richard S" sort="Schottenfeld, Richard S" uniqKey="Schottenfeld R" first="Richard S" last="Schottenfeld">Richard S. Schottenfeld</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA, 20060 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Timko, Christine" sort="Timko, Christine" uniqKey="Timko C" first="Christine" last="Timko">Christine Timko</name><affiliation wicri:level="2"><nlm:affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Wagner, Todd H" sort="Wagner, Todd H" uniqKey="Wagner T" first="Todd H" last="Wagner">Todd H. Wagner</name><affiliation wicri:level="2"><nlm:affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">Drug and alcohol dependence</title><idno type="eISSN">1879-0046</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorder patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models. All trials included a 12 step group facilitation condition and employed the Addiction Severity Index as a core measure.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The ability of 12 step facilitation to increase mutual help group participation among drug use disorder patients was minimal, limiting ability to employ two-stage instrumental variable models that correct for selection bias. However, traditional fixed and random effect regression models found that greater 12 step mutual help group attendance by drug use disorder patients predicted reduced use of and problems with illicit drugs and also with alcohol.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Facilitating significant and lasting involvement in 12 step groups may be more challenging for drug use disorder patients than for alcohol use disorder patients, which has important implications for clinical work and for effectiveness evaluations. Though selection bias could explain part of the results of traditional regression models, the finding that participation in 12 step mutual help groups predicts lower illicit drug and alcohol use and problems in a large, diverse, sample of drug use disorder patients is encouraging.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">32801112</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-0046</ISSN><JournalIssue CitedMedium="Internet"><Volume>215</Volume><PubDate><Year>2020</Year><Month>Oct</Month><Day>01</Day></PubDate></JournalIssue><Title>Drug and alcohol dependence</Title><ISOAbbreviation>Drug Alcohol Depend</ISOAbbreviation></Journal><ArticleTitle>Impact of 12 step mutual help groups on drug use disorder patients across six clinical trials.</ArticleTitle><Pagination><MedlinePgn>108213</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0376-8716(20)30378-1</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.drugalcdep.2020.108213</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">12 step mutual help groups are widely accessed by people with drug use disorder but infrequently subjected to rigorous evaluation. Pooling randomized trials containing a condition in which mutual help group attendance is actively facilitated presents an opportunity to assess the effectiveness of 12 step groups in large, diverse samples of drug use disorder patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Data from six federally-funded randomized trials were pooled (n = 1730) and subjected to two-stage instrumental variables modelling, and, fixed and random effects regression models. All trials included a 12 step group facilitation condition and employed the Addiction Severity Index as a core measure.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The ability of 12 step facilitation to increase mutual help group participation among drug use disorder patients was minimal, limiting ability to employ two-stage instrumental variable models that correct for selection bias. However, traditional fixed and random effect regression models found that greater 12 step mutual help group attendance by drug use disorder patients predicted reduced use of and problems with illicit drugs and also with alcohol.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Facilitating significant and lasting involvement in 12 step groups may be more challenging for drug use disorder patients than for alcohol use disorder patients, which has important implications for clinical work and for effectiveness evaluations. Though selection bias could explain part of the results of traditional regression models, the finding that participation in 12 step mutual help groups predicts lower illicit drug and alcohol use and problems in a large, diverse, sample of drug use disorder patients is encouraging.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Humphreys</LastName><ForeName>Keith</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA. Electronic address: knh@stanford.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barreto</LastName><ForeName>Nicolas B</ForeName><Initials>NB</Initials><AffiliationInfo><Affiliation>Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alessi</LastName><ForeName>Sheila M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carroll</LastName><ForeName>Kathleen M</ForeName><Initials>KM</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Yale University, 300 George St., Suite 90, New Haven, CT, 06511 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crits-Christoph</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Donovan</LastName><ForeName>Dennis M</ForeName><Initials>DM</Initials><AffiliationInfo><Affiliation>Alcohol and Drug Institute, 1107 NE 45th Street, University of Washington, Box 354805, Seattle, WA 98195 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kelly</LastName><ForeName>John F</ForeName><Initials>JF</Initials><AffiliationInfo><Affiliation>Recovery Research Institute, Center for Addiction Medicine, Harvard Medical School, 151 Merrimac Street 6th Floor, Boston MA 02114 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schottenfeld</LastName><ForeName>Richard S</ForeName><Initials>RS</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Howard University, 2041 Georgia Avenue, NW, WA, 20060 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Timko</LastName><ForeName>Christine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 N. Quarry Road, MC: 5717, Stanford, CA 94035 USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wagner</LastName><ForeName>Todd H</ForeName><Initials>TH</Initials><AffiliationInfo><Affiliation>Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA, 94025 USA; Department of Surgery, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305 USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>UG1 DA015815</GrantID><Acronym>DA</Acronym><Agency>NIDA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>Ireland</Country><MedlineTA>Drug Alcohol Depend</MedlineTA><NlmUniqueID>7513587</NlmUniqueID><ISSNLinking>0376-8716</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">12 steps</Keyword><Keyword MajorTopicYN="N">Continuing care</Keyword><Keyword MajorTopicYN="N">Mutual help groups</Keyword><Keyword MajorTopicYN="N">Opioid addiction</Keyword><Keyword MajorTopicYN="N">Recovery</Keyword><Keyword MajorTopicYN="N">Self-help</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="pmc-release"><Year>2021</Year><Month>10</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32801112</ArticleId><ArticleId IdType="pii">S0376-8716(20)30378-1</ArticleId><ArticleId IdType="doi">10.1016/j.drugalcdep.2020.108213</ArticleId><ArticleId IdType="pmc">PMC7502458</ArticleId><ArticleId IdType="mid">NIHMS1618868</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>J Subst Abuse Treat. 2013 Jan;44(1):103-14</Citation><ArticleIdList><ArticleId IdType="pubmed">22657748</ArticleId></ArticleIdList></Reference><Reference><Citation>Drug Alcohol Depend. 2005 Feb 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(État)</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Humphreys, Keith" sort="Humphreys, Keith" uniqKey="Humphreys K" first="Keith" last="Humphreys">Keith Humphreys</name></region><name sortKey="Alessi, Sheila M" sort="Alessi, Sheila M" uniqKey="Alessi S" first="Sheila M" last="Alessi">Sheila M. Alessi</name><name sortKey="Barreto, Nicolas B" sort="Barreto, Nicolas B" uniqKey="Barreto N" first="Nicolas B" last="Barreto">Nicolas B. Barreto</name><name sortKey="Carroll, Kathleen M" sort="Carroll, Kathleen M" uniqKey="Carroll K" first="Kathleen M" last="Carroll">Kathleen M. Carroll</name><name sortKey="Crits Christoph, Paul" sort="Crits Christoph, Paul" uniqKey="Crits Christoph P" first="Paul" last="Crits-Christoph">Paul Crits-Christoph</name><name sortKey="Donovan, Dennis M" sort="Donovan, Dennis M" uniqKey="Donovan D" first="Dennis M" last="Donovan">Dennis M. Donovan</name><name sortKey="Kelly, John F" sort="Kelly, John F" uniqKey="Kelly J" first="John F" last="Kelly">John F. Kelly</name><name sortKey="Schottenfeld, Richard S" sort="Schottenfeld, Richard S" uniqKey="Schottenfeld R" first="Richard S" last="Schottenfeld">Richard S. Schottenfeld</name><name sortKey="Timko, Christine" sort="Timko, Christine" uniqKey="Timko C" first="Christine" last="Timko">Christine Timko</name><name sortKey="Wagner, Todd H" sort="Wagner, Todd H" uniqKey="Wagner T" first="Todd H" last="Wagner">Todd H. Wagner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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