APC: 12-step facilitation and self-help groups for addiction

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This document summarizes research on the effectiveness of 12-step facilitation and self-help groups for addiction. It begins by noting that addiction self-help organizations are an international phenomenon with various groups in different countries. The document then provides background information on Alcoholics Anonymous (AA), the prototypic self-help organization founded in the U.S. in 1935.<br /><br />The document presents research findings on the effectiveness of AA and 12-step groups. One study conducted among Veterans Affairs outpatients found that intensive referral to 12-step groups led to higher rates of group involvement and greater improvement in substance use disorder outcomes compared to standard referral. Another study found that network support approaches produced higher AA involvement and more abstaining days compared to case management.<br /><br />Additional research using instrumental variables analysis of over 2,300 alcohol use disorder patients in six trials found that AA was effective in five out of the six trials. The document also highlights the cost offset findings in the Veterans Health Administration, where implementing self-help programs based on 12-step principles resulted in reduced treatment costs.<br /><br />The document includes a Cochrane systematic review that summarizes the findings of 27 primary studies involving over 10,000 participants. The review concluded that AA and professionally-delivered 12-step facilitation interventions are at least as effective as other treatments for alcohol-related outcomes and are more effective for promoting complete abstinence. It also notes that implementing AA and 12-step facilitation can result in substantial healthcare cost savings.<br /><br />The document discusses the mediators of the benefits of 12-step groups, including increased self-efficacy, strengthened commitment to abstinence, more active coping, enhanced social support, and replacement of substance-using friends with abstinent friends.<br /><br />The document also discusses the benefits of in-treatment preparation for AA, the ineffectiveness of normal referral processes, and the potential benefits of self-help referral in non-specialty settings. It also briefly mentions non-12 step mutual help organizations and the need for more research on and support for these alternatives.<br /><br />In conclusion, the document highlights the significant impact and cost-effectiveness of 12-step facilitation and self-help groups for addiction. It emphasizes the need for investment in both 12-step and non-12 step mutual-help supportive infrastructure to improve public health and reduce healthcare costs.

Keywords

12-step facilitation

self-help groups

addiction

Alcoholics Anonymous

substance use disorder outcomes

network support approaches

treatment costs

Cochrane systematic review

self-efficacy

abstinence commitment

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