The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63606

Lee Ann Kaskutas, DrPH¹, Robin Room, PhD², Jason Bond, PhD¹, Lyndsay Ammon¹, and Constance Weisner, DrPH, MSW³. (1) Alcohol Research Group, 2000 Hearst Ave., Suite 300, Berkeley, CA 94709-2167, (510) 642-1751, lkaskutas@arg.org, (2) Centre for Social Research in Alcohol and Drugs, Stockholm University, Sveaplan, Stockholm, S-10691, Sweden, (3) Department of Psychiatry, University of California, San Francisco, 401 Parnansus, San Francisco, CA 94143

Those with drinking or drug problems may have at least three potential careers: their drinking/drug use career, their career as a client of treatment, and very often their career in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Whether things go well with them in their drinking/drug use career may depend on the effects of their treatment experience, and on the effects of experience of AA/NA membership. These careers are explored here, using baseline and 1, 3 and 5 year follow-up data from clients recruited into the study as they entered public, private and HMO alcohol treatment in a northern California county (n=606). Most (82%) reported prior AA exposure at intake, and two-thirds had gone to at least one AA meeting in the year after. However, only 40% reported AA meeting attendance during the 5th year of follow-up, and there was considerable turnover in who was attending AA at the various follow-up points. While the normative AA model is continuous lifetime attendance as a condition of sobriety, the use of AA in a crisis period of life may also have a successful outcome. This paper describes different career trajectories in AA over the 5 years post-treatment, and examines the relationship between AA involvement and drinking/abstinence careers as well as alcohol-related problems across time. The concept of AA career as used here includes AA meeting attendance as well as reporting AA practices (reading literature, having a sponsor) and AA-oriented psychological states (having a spiritual awakening, feeling you are a member).

Learning Objectives:

At the end of this presentation, one will be able to:
• Describe the dominant patterns of AA involvement and AA disaffiliation between an initial baseline interview at treatment entry and follow-up interviews 1, 3, and 5 years later;
• Relate these AA careers to substance abuse-related outcomes including abstinence, moderate drinking, continuation of problem drinking, and cessation of social and other problems;
• Identify relevant measures of AA involvement.

Keywords: Substance Abuse Treatment, Alcohol Use