- 作者：Andrew Rosenblum ; Harlan Matusow ; Chunki Fong ; Howard Vogel ; Thomas Uttaro ; Thomas L. Moore ; Stephen Magura
- 关键词：Mutual aid ; 12-Step groups ; Recovery ; Dual diagnosis ; Co-occurring disorders
- 刊名：Drug and Alcohol Dependence
- 出版年：1 February, 2014
- 年：2014
- 卷：135
- 期：Complete
- 页码：78-87
- 全文大小：668 K
Background
Previous studies have indicated that persons with co-occurring mental health and substance use problems can benefit by attending dual-focus mutual aid groups. However, to date, a trial to test the efficacy of these groups has not been published.Method
This study randomly assigned 203 substance misusing clients attending a mental health or dual-diagnosis facility to either a dual-focus 12-step group (Double Trouble in Recovery; DTR) or a waiting list control group. Participants were followed for 3-6 months. The primary outcome was substance use (days used in the past 30 with saliva testing to detect under-reporting); secondary outcomes included psychiatric medication adherence, attendance at traditional (single-focus) 12-step meetings (e.g., AA/NA); and improvement in mental health and substance use problems (quality of life). Multilevel model (MLM) regression was used to analyze the nested effect of participants within 8 facilities (7 in New York City and 1 in Michigan). Regression imputation was used to adjust for drug use under-reporting.
Results
At follow-up 79% of the subjects were interviewed. In intent to treat analysis, DTR subjects compared with control subjects used alcohol (p = .03) and any substances (p = .02) on fewer days. DTR compared with control subjects were also more likely to rate themselves as experiencing better mental health and fewer substance use problems (p = .001). There were no effects for DTR on drug use only, medication adherence or NA/AA attendance.
Conclusion
Findings reported in previous studies on the association between exposure to DTR and reductions in substance use were partially supported in this efficacy trial.