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

Abstract #66128

Harold Perl, Health Services Research Branch, Division of Clinical and Prevention Research, NIAAA, 6000 Executive Blvd, msc 7003, suite 505, Bethesda, MD 20892-7003, 301-443-0788, hperl@willco.niaaa.nih.gov and Lee Ann Kaskutas, DrPH, Alcohol Research Group, 2000 Hearst Ave., Suite 300, Berkeley, CA 94709-2167.

Mounting evidence suggests that Alcoholics Anonymous and Narcotics Anonymous can work, and work well, to potentiate treatment effects. The majority of substance abuse treatment programs in the U.S. encourage AA and NA involvement, both during treatment and as a form of aftercare. In addition, many problem drinkers and drug users make their way to AA and NA on their own, without ever attending formal treatment. Of special relevance given today's cost constraints, AA/NA participation is free. This session provides multiple perspectives on AA involvement over the short, intermediate and long-term, using data from three treatment samples and one untreated sample of problem drinkers in the general population. Measures of AA and NA involvement were similar across the four samples under study here. The value of AA and NA involvement is described for both the treated and untreated samples. Different patterns of utilization are identified, with careful attention to how study participants may have changed their level of AA and NA meeting attendance across the years, and whether involvement in other activities (beyond simple meeting attendance) signaled another type of AA/NA affiliation (rather than disaffiliation) over time. Results clarify the various AA careers that are associated with positive (and negative) outcomes such as ongoing abstinence or a return to non-problematic (or problematic) drinking. Taken together, this session will isolate the value of health and human service agencies that provide formal services to dependent and problem drinkers, it will identify the optimal levels of AA and NA meeting attendance during treatment, and it will suggest what may be the more important AA/NA activities over time.

Learning Objectives:

At the end of this session, one will be able to:
• Identify distinct patterns of AA involvement,
• Relate patterns of AA involvement to drinking outcomes,
• Relate patterns of AA involvement to predisposing factors, and to each other, (
• Describe and distinguish the distinct trajectories of AA attendance and practicing of prescribed AA-related behaviors among alcohol dependent individuals, (
• Apply evidence-based thresholds of AA attendance during treatment to predict posttreatment AA attendance, (
• Select and apply psychometrically evaluated measures of AA attendance and involvement,
• Describe the trajectory of consumption for problem and dependent drinkers and the factors related to improvement over time,
• Discuss the role of informal and formal services vis-à-vis long-term consumption,
• Understand new analytical techniques for examining longitudinal data, 1
• 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, 1
• Relate these AA careers to substance abuse-related outcomes including abstinence, moderate drinking, continuation of problem drinking, and cessation of social and other problems, and 1
• Identify relevant measures of AA involvement.

Keywords: Substance Abuse, Alcohol Use