Can Those With Dual Diagnoses Benefit From Twelve-Step Programs?

Studies and testimonials have shown that participation in twelve step programs like Alcoholics Anonymous and Narcotics Anonymous can play an important role in the recovery process, especially for young adults.  However, a recent study has shown that twelve-step organizations such as AA and NA can also be of benefit to those young people that are also struggling with psychiatric disorders as well as substance abuse issues.  The study will be published in the February 2014 issue of Alcoholism: Clinical & Experimental Research.

dual diagnosis

Brandon Bergman, a postdoctoral fellow at the Massachusetts General Hospital Center for Addiction Medicine and a corresponding author to the study, stated there were concerns with dual diagnoses patients and twelve step groups.  One concern was those with a dual diagnosis may find it difficult to connect with others citing the social anxiety aspects of the twelve step meetings themselves.  Also, there had been some anecdotal reports that some members twelve step groups like AA and NA may be anti-medication and in some cases against psychotherapy.

Bergman does note, however, that research shows that most AA and NA members are in favor of psychotropic and anti-relapse/anti-craving medication use despite possible vocal objection from a minority demographic within those twelve step groups.  Christine Tomko, a senior research career scientist at the Department of Veteran Affairs and a consulting professor in the Department of Psychiatry and Behavioral Sciences at Stanford University states that understanding the role of the twelve-step group  is important because of their accessibility and the potential for those groups to be a long-term outlet for continuing care.

Bergman and his colleagues followed 296 young adults aged 18-24 who attended a private not-for-profit residential treatment facility located in the upper Midwest in a time period from October 2006 to April 2008.  All participants were assessed at intake as well as at the three, six and twelve month marks in regards to attendance at twelve step meetings, having a sponsor, social interactions with other members as well as the percentage of days they were abstinent.

Results showed those with an existing psychiatric disorder (mostly depressive or anxiety disorders) had more pronounced problems when coming into treatment but were more motivated to change their substance use.   After the one year mark, those with both substance abuse issues as well as a psychiatric disorder were attending twelve-step programs at the same or similar rates as those individuals with just the substance abuse issues.  It was noted; however, those with dual diagnoses had lower abstinence rates.

A reason the researchers noted in explaining the difference in abstinence rates could lie in the fact those with dual diagnoses have other issues that complicate the recovery process.  These issues are emotional and cognitive in nature and can add more stress on top of the addiction-related stresses, with can make it difficult for young people to keep abstinent.  However, Bergman noted that all patients in the study showed benefit from participation in twelve-step programs and suggested that clinicians should foster those patients with both substance abuse disorders as well as psychiatric disorders to actively participate in twelve-step programs.  Twelve-step groups may help focus those in the dual diagnoses demographic to obtain and work with sponsors.

The use of twelve-step programs and other mutual self-help groups can compliment those health care organizations, both privately and publicly funded; keep an eye on health care spending.  Bergman notes that participation in twelve-step groups have the potential to bolster abstinence and remission rates and keep individuals with these dual diagnoses out of emergency rooms.

 

 

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