Abstract
BackgroundSocial factors play a key role in addiction recovery. Research with adults indicates individuals with substance use disorder (SUD) benefit from mutual-help organizations (MHOs), such as Alcoholics Anonymous, via their ability to facilitate adaptive network changes. Given the lower prevalence of sobriety-conducive, and sobriety-supportive, social contexts in the general population during the life-stage of young adulthood, however, 12-step MHOs may play an even more crucial recovery-supportive social role for young adults, but have not been investigated. Greater knowledge could enhance understanding of recovery-related change and inform young adults’ continuing care recommendations.MethodsEmerging adults (N = 302; 18–24 yrs; 26% female; 95% White) enrolled in a study of residential treatment effectiveness were assessed at intake, 1, 3, 6, and 12 months on 12-step attendance, peer network variables (“high [relapse] risk” and “low [relapse] risk” friends), and treatment outcomes (Percent Days Abstinent; Percent Days Heavy Drinking). Hierarchical linear models tested for change in social risk over time and lagged mediational analyses tested whether 12-step attendance conferred recovery benefits via change in social risk.ResultsHigh-risk friends were common at treatment entry, but decreased during follow-up; low-risk friends increased. Contrary to predictions, while substantial recovery-supportive friend network changes were observed, this was unrelated to 12-step participation and, thus, not found to mediate its positive influence on outcome.ConclusionsYoung adult 12-step participation confers recovery benefit; yet, while encouraging social network change, 12-step MHOs may be less able to provide social network change directly for young adults, perhaps because similar-aged peers are less common in MHOs. Findings highlight the importance of both social networks and 12-step MHOs and raise further questions as to how young adults benefit from 12-step MHOs.
Highlights
From myriad theoretical standpoints social variables play a key role in the etiology and resolution of substance-related problems, and in relapse to substance use disorder (SUD) [1,2,3,4]
Research among adult SUD samples supports this clinical recommendation showing that participation in Alcoholics Anonymous (AA)/Narcotics Anonymous (NA) leads to better substance use outcomes, in large part, by facilitating recovery supportive social changes in the networks of attendees [21,22,23,24,25]
12-step attendance on substance use by social variables, we begin with analyses of the effects of 12-step attendance on substance use
Summary
From myriad theoretical standpoints social variables play a key role in the etiology and resolution of substance-related problems, and in relapse to substance use disorder (SUD) [1,2,3,4]. Research among adult SUD samples supports this clinical recommendation showing that participation in AA/NA leads to better substance use outcomes, in large part, by facilitating recovery supportive social changes in the networks of attendees [21,22,23,24,25]. Research with adults indicates individuals with substance use disorder (SUD) benefit from mutual-help organizations (MHOs), such as Alcoholics Anonymous, via their ability to facilitate adaptive network changes. Given the lower prevalence of sobriety-conducive, and sobriety-supportive, social contexts in the general population during the life-stage of young adulthood, 12-step MHOs may play an even more crucial recovery-supportive social role for young adults, but have not been investigated. Greater knowledge could enhance understanding of recovery-related change and inform young adults’ continuing care recommendations
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