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J Subst Abuse Treat. 2014 Apr;46(4):412-9. doi: 10.1016/j.jsat.2013.10.015. Epub 2013 Nov 12.

Alcohol and drug treatment involvement, 12-step attendance and abstinence: 9-year cross-lagged analysis of adults in an integrated health plan.

Author information

1
Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA. Electronic address: jwitbrodt@arg.org.
2
Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA. Electronic address: jbond@arg.org.
3
Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, USA.
4
Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, USA.
5
Kaiser Permanente Division of Research, 2000 Broadway, 3rd floor, Oakland, CA 94612, USA; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Box F-0984, San Francisco, CA 94143, USA.

Abstract

This study explored causal relationships between post-treatment 12-step attendance and abstinence at multiple data waves and examined indirect paths leading from treatment initiation to abstinence 9-years later. Adults (N = 1945) seeking help for alcohol or drug use disorders from integrated healthcare organization outpatient treatment programs were followed at 1-, 5-, 7- and 9-years. Path modeling with cross-lagged partial regression coefficients was used to test causal relationships. Cross-lagged paths indicated greater 12-step attendance during years 1 and 5 and were casually related to past-30-day abstinence at years 5 and 7 respectfully, suggesting 12-step attendance leads to abstinence (but not vice versa) well into the post-treatment period. Some gender differences were found in these relationships. Three significant time-lagged, indirect paths emerged linking treatment duration to year-9 abstinence. Conclusions are discussed in the context of other studies using longitudinal designs. For outpatient clients, results reinforce the value of lengthier treatment duration and 12-step attendance in year 1.

KEYWORDS:

12-Step attendance; Alcohol and drug treatment; Longitudinal data; Managed care; Path model

PMID:
24342024
PMCID:
PMC3943492
DOI:
10.1016/j.jsat.2013.10.015
[Indexed for MEDLINE]
Free PMC Article

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