This ancillary investigation of data from National Drug Abuse Treatment Clinical Trials Network protocol CTN-0031 (“Stimulant Abuser Groups to Engage in 12-Step (STAGE-12)“), by Pacific Northwest Node members Elizabeth Wells, Dennis Donovan, Suzanne Doyle, Sharon Garrett, Michelle Ingalsbe, Mary Hatch-Maillette, and colleagues examined whether level of exposure to the STAGE-12 intervention, a 12-step facilitative therapy, is related to treatment outcome.
The original study compared STAGE-12 combined with treatment-as-usual (TAU) to TAU alone; however, these analyses include only those randomized to STAGE-12 (n=234).
“High-exposure” patients (n=158; attended at least 2 of 3 individual and 3 of 5 group sessions in the STAGE-12 intervention), compared to those with less exposure, demonstrated:
- Higher odds of self-reported abstinence from, and lower rates of, stimulant and non-stimulant drug use;
- Lower probabilities of stimulant-positive urine screens;
- More days of attending and lower odds of not attending 12-Step meetings;
- Greater likelihood of reporting no drug problems;
- More days of duties at meetings;
- More types of 12-Step activities.
Many of these differences declined over time, but several were still significant by the last follow-up (180 days following randomization).
Conclusions: Although outpatient substance use disorder treatment is thought to be characterized by high drop-out rates and low rates of treatment completion, exposure to STAGE-12 was relatively high for this 8-session intervention. Those achieving high exposure to STAGE-12 demonstrated more positive outcomes, though the design of this secondary analysis cannot demonstrate a causal relationship there. However, it does demonstrate that it is feasible to interest people entering intensive outpatient treatment in a 12-Step oriented intervention and that individuals who agree to participate can be retained at relatively high rates.
Citation: Wells EA, Donovan DM, Daley DC, et al. Is Level of Exposure to a 12-Step Facilitation Therapy Associated with Treatment Outcome? Journal of Substance Abuse Treatment 2014 (in press).