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Study Finds Treatment, AA Participation Works Best

Neither Is Substitute for the Other, Authors Say

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Updated October 27, 2005

A research study indicates that people trying to quit drinking who become involved in both Alcoholics Anonymous and professional treatment program fare much better than those who only go to treatment or only go to AA.

A study in the October 2005 issue of Alcoholism: Clinical & Experimental Research tracks individuals for 16 years who have first acknowledged their alcohol-use problems and then chosen Alcoholics Anonymous, treatment, or both. Findings indicate that people who become involved in both AA and treatment fare better than those who obtain only treatment.

"We know that self-help groups, such as AA, contribute to better alcohol-related and psychosocial outcomes," said Rudolf H. Moos, senior research career scientist for the Department of Veterans Affairs Health Care System in Palo Alto, California, and corresponding author for the study. "For example, patients with alcohol use-disorders who participate in AA, and those who attend more meetings and/or participate for a longer time, are more likely to be abstinent and to maintain remission up to five years after an episode of professional treatment than patients who are not involved or less involved in such groups.

"Affiliation with AA also is associated with more self-efficacy and problem-solving coping skills, and better social functioning, which are linked to better alcohol-related outcomes."

"In the current study, we wanted to find out whether individuals who participated only in AA in the first year after initiating help-seeking (and did not obtain professional treatment) achieved outcomes comparable to those of individuals who participated in AA and also obtained professional treatment. We also wanted to find out whether individuals who participated in AA in the first year achieved better long-term outcomes."

Researchers surveyed 362 individuals (193 females, 169 males) who had initial contact with an alcoholism treatment system for their alcohol-use disorder. Study participants were asked about their subsequent participation in AA and/or treatment, as well as their alcohol-related functioning, at baseline (initial contact) and then again at one, three, eight and 16 years later.

Participation Is the Key

"One, individuals who enter AA relatively quickly after initiating help-seeking, either alone or in conjunction with treatment, are more likely to participate in AA in the subsequent 15 years and participate in AA more frequently and for a longer duration," said Moos. "Two, a longer duration of participation in AA is associated with a higher likelihood of continuing remission up to 15 years later.

"Three, individuals who obtain professional treatment and participate in AA in the first year after initiating help-seeking are more likely to achieve remission for up to 15 years later than are individuals who obtain professional treatment alone. Finally, individuals who have achieved remission but who discontinue participation in AA are at increased risk for relapse; individuals who have not stopped drinking and who discontinue participation in AA are more likely to continue drinking."

Better Long-Term Outcomes

"These findings are consistent with previous studies of AA," said William R. Miller, Distinguished Professor of psychology and psychiatry at the University of New Mexico. "As we already knew, drop-out from AA is high. Nevertheless, involvement in AA during, and in the few years after, treatment is associated with better long-term outcomes.

"An additional 10 to 20 percent were in remission, which is a large and clinically meaningful difference. Of those who do not attend AA during treatment, many don't [ever] go, and if they do, [their] delayed entry to AA is associated with less benefit. In sum, there are good reasons to encourage people to get involved with AA while they are still in treatment."

Self-Action Improves Recovery

"These findings emphasize that initial and subsequent episodes of participation in AA can have long-term effects on the likelihood of remission of alcohol-related problems," said Moos. "They also emphasize that counselors in information and referral centers and clinicians in substance use treatment settings should make every reasonable effort to enable individuals with alcohol-related problems to enter and continue to participate in self-help groups such as AA."

"Are these better outcomes due specifically to AA?" asked Miller. "We can't be sure. In general, the more actions people take toward their own recovery the better they do, whether it is attending treatment, going to AA, or faithfully taking medication. It is an impressively consistent finding, however, that people who go to AA during treatment have better outcomes.

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