Funding: NIAAA R01AA027920
Project PI: Sarah E. Zemore
Hazardous alcohol and drug use are leading causes of avoidable mortality. Alongside 12-step groups like Alcoholics Anonymous, numerous mutual help groups are now available to help individuals address alcohol and drug problems. These groups are appealing because they can be used before, during, after, and instead of formal treatment, thus extending the continuum of care. Yet, little is known about the many alternatives to 12- step groups, which may be particularly attractive to those who dislike the 12-step approach. The current study will provide much-needed information on the nature and effectiveness of secular 12-step alternatives, including Women for Sobriety, LifeRing, and SMART Recovery, in addressing alcohol problems.
Our previous NIAAA-funded R21 study was the first longitudinal, comparative study of 12-step groups and 12-step alternatives and surveyed U.S. adults with lifetime alcohol use disorders attending WFS, LifeRing, SMART, and 12-step groups. This project will capitalize on and extend our R21 data by adding 800 new cases collected using parallel protocols and measures, permitting us to combine data. Data will be collected at baseline via collaboration with mutual-help group directors and IntheRooms, an online meeting hub for those in recovery. Follow-ups will be collected at 6 and 12 months. Leveraging these well-powered data, the study will:
(1) Examine associations between both in-person and online involvement and substance use outcomes over time. The incorporation of online involvement is included because extremely little is known on this topic and because online resources have great potential where meeting access is limited.
(2) Compare mechanisms of action across mutual help groups, testing a novel theory of behavior change—the Affect, Cognition, Motivation, and social engagement in recovery (ACME) model—designed to predict sustained recovery. Tests will help determine whether 12-step alternatives have common or distinct mechanisms of action, and will inform interventions for SUDs broadly.
(3) Examine participant-level moderators of the benefits of mutual help involvement, informing treatment tailoring. In anticipation of this R01, R21 surveys included most key measures.
Results of this study, led by experts in mutual-help groups for addiction, will contribute substantially to understanding whether, when, and why mutual help alternatives are effective. Findings should inform court referrals and treatment planning and may enhance the growth of effective alternatives. Results may also help identify core drivers of recovery that can be targeted in diverse interventions for substance use disorders.
