Table 2.
Nineteen Studies That Investigate the Effects of AA/NA-Related Programming on Drug Use Outcomes
| Authors | Subjects | Method | Results |
|---|---|---|---|
| 1. AADAC and Harvey-Jansen (1995); Williams and Chang (2000) | N = 395, 12–17 years old, 63% M, high% W, most polydrug, alc most common, Alberta, Canada | SG; 83% outpt, skills and 12-step | At 3 months, 29% abstin, 19% abstin all 3 months, meetings not mentioned as being related to success |
| 2. AARC (1994); Williams and Chang (2000); www.aarc.ab.ca/qa.php, accessed June 25, 2009 | N = 56, 13–22 years old, 76% M, 87% W, most polydrug, mar most common, Alberta, Canada | SG; Day treatment, 12-step, milieu, family, peer | At 1 year, 65% completers abstin since the end of treatment, 33% of dropouts abstin since dropout; Web site reported evaluation of N = 100 graduates, 48 continuously sober |
| 3. Alford, Koehler, and Leonard (1991) | N = 157, 13–19 years old, 62% M, high% W, DOC = 53% mar, 31% alc, 7% hall., 3% stim (all F), Nebraska | SG; Inpt 12-step 45 days, individual 5 times per week, group 5 times week, daily presentations | At 2 years, 48% of prog. completers and 33% of noncompleters were abstin-minor lapse, 27% versus 23% adequate social function, 84% of high freq 12-step attend (1 + meeting/week) vs. 46% attend 1 meeting/3 months abstin-minor lapse |
| 4. Brown, D’Amico, and McCarthy (2001) | N = 162, 14–18 years old, 60% M, 81% W, 11% H, DOC = 56% stim, 32% mar, 2% alc, California | SG; Inpt 12-step, 4 weeks ave stay, intake to 4 years follow-up | At 4 years, overall 13% abstin and 15% minor lapse. From intake to 4 year use in last month: 91% to 66% alc, 85% to 77% cig, 84% to 44% mar, 85% to 20% stim, 32% to 16% oth |
| 5. Chi, Kaskutas, Sterling, Campbell, and Weisner (2009); Sterling, Chi, Campbell, and Weisner (2009) | N = 357, 13–18 years old 66% M, 50% W, 19% H, 16% B, all using at baseline but rates not reported, California | SG; Kaiser CD outpt programs, groups (1–3 times per week for 1 year), education, family, 12-step attendance expected | At 3 years, overall 30% absin (38% alc, 57% drugs). At 3 years, N = 68 attended any 12-step meetings in last 6 months. Attendance at 3 years (10 or more meetings last 6 months) 2.5 times more likely to be abstin alc or drugs. Potential mediation by social support and religiosity |
| 6. Garner, Godley, Funk, Dennis, and Godley (2007); Godley, Godley, Dennis, Funk, and Passetti (2006) | N = 183; 12–17 years old 71% M, 73% W, 18% B, DOC = 53% mar, 27% alc, 18% cocaine or other drug, Illinois | SG; Inpt program (at least 7 days; ave days = 52), 12-step groups, ind, group skills training, education, family groups | At 9 months, overall 24% were abstin. (28% vs. 19% when examining assignment or not to case management aftercare program, ACC; 31% vs. 26% alc) |
| 7. Godley, Godley, Dennis, Funk, and Passetti (2002); Godley, Godley, Dennis, Funk, and Passetti (2004) Godley, Godley, Dennis, Funk, and Passetti (2005) Godley, Kahn, Dennis, Godley, and Funk, 2005 | N = 552, 12–18 years old 82% M, 62% W, 29% B, DOC = 100% cannabis abuse or dependence (not currently very heavy use of other drugs, though 37% alc, 12% other drug), Illinois, Pennsylvania, Florida, Connecticut | RCT of Outpt, ind. MET, CBT, or Family support or MDFT, or teen community reinforcement, with 2+ days of outpt treatment; 12-step meeting participation was expected/examined | At 30 months, 30% were lowest trajectory subjects (less than 10 days use at 1 year, 14 days by 30 months). At 1 year, 26% of the variance of outcomes explained by recovery environment and social risk; high involvement in 12-step groups, low involvement in victimization or substance-involved activities, predictive of substance use |
| 8. Grella (2002); Hser et al. (2001) | N = 810 (358 residential, 270 short-term inpt, 182 outpt), 75% 15–16 years old, 70% M, 62% W, 22% B, 10% H, DOC = 66% mar, 37% alc, 10% stim, 62% comorbid diagnosis, Illinois, Oregon, Minnesota, Pennsylvania cities | SG; Inpt and outpt, daily groups, individual counseling, education, 12-step sessions | At 1 year, 36% residential, 22% short-term inpt, 30% outpt abstin. For comorbid youth 12-step participants were 3 times more likely to be abstin. Over full sample, longer time in treatment important |
| 9. Grenier (1985); Williams and Chang (2000) | N = 144 (117 treatment, 27 no treatment wait-list controls [actually 19 with no other treatment]), 9–21 years old, 60% M, mostly W, most polydrug, alc, then mar most common, Louisiana | QE; Inpt AA-family model, focus on first 5 steps; also education, group, individual, recreation, occupation | At a weighted ave of 9.8 months for controls and (maybe) 2 years for program, 66% treatment and 20 (14% is no other treatment)% control abstin |
| 10. Hoffmann and Kaplan (1991); Williams and Chang (2000); | N = 826, 15–17 years old 64% M, 90% W, most polydrug, mar most common, facilities distributed throughout United States. States not reported | SG; Inpt programs | At 1 year, 40% treatment completers abstin, regular attendance in support group predicts abstin |
| 11. Hsieh, Hoffmann, and Hollister (1998); Hsieh and Hollister (2004); Kelly and Myers (2007) | N = 2,317, 17–19 years old, 63% M, 90% W, 2% H, 2% B, type of drug abuse not reported, but 82% CATOR inpt for alc database in Minnesota, facilities distributed throughout the United States. States not reported | SG; 24 inpt programs; Comprehensive Assessment and Treatment Outcome Research (CATOR) database | At 1 year, 48% abstin last 6 months, best predictors of abstin attendance at AA/NA or other self-help support group, attendance at aftercare, and parental attendance at Alanon/Alateen |
| 12. Kelly, Brown, Abrantes, Kahler, and Myers (2008) | N = 139, 14–18 years old, 60% M, 75% W, 5% H, 5% B, DOC = 53% stim, 32% mar, 7% hall, 4% alc, California | SG; Inpt Minn. Model, 12-step meetings, samples at 2 facilities | Across 8 years, 50% days abstin, but not clear % totally abstin at 8 years. From intake to 8-year follow-up, 92% to 31% (65% down to 8%) rate of AA/NA any (weekly) attendance. Early (first 6 months) attendance predicts abstin but effect falls to almost 0 by 8 years, whereas attendance through 2 years maintains abstin |
| 13. Kelly, Myers, and Brown (2000, 2002, 2005); Kelly and Myers (2007) | N = 99, 14–18 years old, 40% M, 78% W, 16% H, DOC = 44% mar, 44% stim, 11% alc, 8% hall, 4% opiates, California | SG; Inpt Minn Model, 12-step meetings, overlapping samples at 2 facilities (2000, 2002 studies) | At 6 months, 30% abstin, 59% attending 12-step meetings, those abstin attended 2 times the number of meetings (28 vs. 12 on average, in previous 3 months). Motivation for abstin mediates relation of attendance and outcomes |
| 14. Kennedy and Minami (1993) | N = 91, 14–20 years old, 81% M, 92% W, DOC = 89% alc, 80% mar, off the coast of Maine | SG; Inpt 3-day detox, then wilderness location 22 days Outward Bound, challenging activities with AA/NA concepts | At 1 year, 47% maintained abstin, 38% attend AA/NA 1 + times per week, 4 times more likely to be abstin if attend AA/NA |
| 15. King, Chung, and Maisto (2009) | N = 142, 14–18 years old, 63% M, 89% W, 6% B, DOC = 80% mar, 47% alc, Pennsylvania | SG; Outpts at six sites, 12-step meetings, relapse prevention, group, family, individual | At 6 months postbaseline, an average 6 days mar (7 days at baseline), and one to two 12-step meetings, in last 30 days; meeting attendance predicted greater diff. abstin; abstin prev not reported |
| 16. Knapp, Templar, Cannon, and Dobson (1991); Williams and Chang (2000) | N = 94, 14–17 years old, 67% M, 84% W, 12% H, DOC = 34% alc/mar, 24% stim-mixed, 18% mar, 14% alc, California | SG; Inpt 30–40 days, AA/NA model, ind, group, family, education, recreation, life skills | At unknown follow-up point (had to be at least 1–2 months since intake), 33% alc/39% drug “currently” abstin |
| 17. Ralph and McMenamy (1996); Williams and Chang (2000) | N = 172 (108 completers, 65 noncompleters), 13–19 years old, 72% M, 91% W, DOC = not reported | SG; Inpt 45 days, emphasis on AA/NA groups; milieu and token economy; family aftercare | At about 1 year, 33% treatment completers abstin previous 10 months (57% “since discharge” with varying follow-up), aftercare (60% attended)and AA/NA (44% attended) predicted outcome |
| 18. Winters, Stinchfield, Latiner, and Lee, 2007; Winters, Stinchfield, Latiner, and Stone, 2008; Winters, et al. 2000 | N = 245 (179 treatment, 66 wait-list controls), 12–18 years old, 56% M, 85% W, DOC = 77% alc, 20% stim, 21% oth, Minnesota. (A small community non-drug abuse control group was involved but no data at 1-year for them; not included here.) | QE; Inpt and Outpt 12-step Minn. Model; intake to 1 year and 5.5 years follow-up | At 1 year, 45% abstin-minor lapses overall in treatment group, 53% completers, 15% non completers, 27% wait-list; at 5.5 years, 35% abstin-minor lapses (up to monthly use) among all in treatment, 5% wait list |
| 19. Yu, Buka, Fitzmaurics, and McCormick (2006); Deykin and Buka (1997) | N = 201 (43 LD, 158 no LD), 15–19 years old, 67% M, 87% W, DOC = 8% alc only, 10% drugs only, 82% both, Massachusetts | SG; seven in pt treatment centers, 12-step model, groups, graded level of responsibility | At 6 months post baseline 51% abstin overall (37% LD, 55% no LD), 42% LD, 53% no LD attends 12-step meetings at least 1 time per week |
NOTES: M = males; W= White ethnicity; H = Hispanic; B = Black; cig = cigarettes; alc = alcohol; mar = marijuana; stim = stimulants; hall = hallucinogens; DOC = drug of choice; LD = learning disability patients; inpt = inpatients; outpt = outpatients; ind = individual counseling; SG = single group design; QE = quasi-experimental design; RCT = randomized control trial; MET = motivation enhancement training; CBT = cognitive-behavioral therapy; MDFT = multidimensional family therapy; Minn Model = Minnesota Model; abstin = abstinent; ACC = assertive continuing care; diff abstin = difference in abstinence; ave = average.