Lapse and Relapse Rates in Narcotics Anonymous Versus Methadone Maintenance Treatment: A 12-Month Prospective Study

Objective: The present study aimed to compare lapse and relapse-free survival between patients treated in Narcotics Anonymous (NA) groups and Methadone Maintenance Treatment (MMT) centers and to determine the relationship between social support scale and treatment outcome. Method: This study was a prospective, 12-month cohort study using the random sampling method to select 100 newcomer patients treated by the NA Association as well as 100 patients in MMT centers. The data were collected using a demographic questionnaire and Social Support Appraisals (SSA) scale at the onset of the study along with follow-up phone calls every other week. Results: All participants were male, aged between 18 and 65 with a mean (SD) age of 38.98 (± 10.85) years. Prevalence of relapse in 12 months was 60.5%. The lapses in the MMT group and relapses in the NA group were significantly higher (P < 0.001). The younger patients with lower levels of education are at greater risk of lapse/relapse. The mean score of SSA was significantly higher in the MMT group than the NA group in all subscales, including friends, family, and the others' support (P < 0.001). The mean scores of SSA subscales for the participants without relapse in the NA group was significantly higher in comparison to the MMT group. Conclusion: Detection of factors related to drug abuse relapse/lapse may help addiction therapists to identify drug abuse patients with lapse/relapse and to develop treatment and policy guidelines to prevent relapse in addiction recovery.

Estimation and Probabilistic Linkage in Sample Surveys of Anonymous Organisations

<p>Drug use takes on many forms, normally this will be just the occasional alcoholic drink, certain individuals drug use develops into habitual use, or more extreme drugs, and then into full addiction. Some of these addicted individuals realise the harmful nature of their addition and join the anonymous support group, Narcotics Anonymous. This study focus' on the creation of population size estimates, and an estimate of the size of the persistent population between two survey years. These estimates are created from the 2004 and 2008 surveys run by the Narcotics Anonymous Fellowship, as this is an anonymous organisation with no register of the membership database maintained. Population size estimation for an anonymous organisation is established using simulation methods. The bootstrap estimation was used to estimate characteristics about the two populations. Probabilistic matching was used to identify individuals who were in both the 2004, and 2008 surveys. Once identi ed, a logistic regression model was used to establish what impacts an individual to remain in the programme. Factors that impacted an individual being persistent in the population included the individual education, employment status, and if they had worked through all the 12 steps of Narcotics Anonymous.</p>

Estimation and Probabilistic Linkage in Sample Surveys of Anonymous Organisations

<p>Drug use takes on many forms, normally this will be just the occasional alcoholic drink, certain individuals drug use develops into habitual use, or more extreme drugs, and then into full addiction. Some of these addicted individuals realise the harmful nature of their addition and join the anonymous support group, Narcotics Anonymous. This study focus' on the creation of population size estimates, and an estimate of the size of the persistent population between two survey years. These estimates are created from the 2004 and 2008 surveys run by the Narcotics Anonymous Fellowship, as this is an anonymous organisation with no register of the membership database maintained. Population size estimation for an anonymous organisation is established using simulation methods. The bootstrap estimation was used to estimate characteristics about the two populations. Probabilistic matching was used to identify individuals who were in both the 2004, and 2008 surveys. Once identi ed, a logistic regression model was used to establish what impacts an individual to remain in the programme. Factors that impacted an individual being persistent in the population included the individual education, employment status, and if they had worked through all the 12 steps of Narcotics Anonymous.</p>

Religiös-spirituelles Befinden und Abhängigkeit bei polytoxikomanen Patienten

Zusammenfassung. Zielsetzung: Substanzgebrauchsstörungen haben eine multifaktorielle Ätiologie und sind in allen Gesellschaftsschichten verbreitet. Langfristige Abstinenz von allen psychotropen Substanzen, inklusive Substitutionsmitteln, bleibt für viele Süchtige ein schwer erreichbares Ziel. Hier soll der Einfluss von spirituellen Inhalten und Praktiken auf erfolgreiche Abstinenz beleuchtet werden, da Spiritualität als eine Grundlage der Wirksamkeit von Narcotics Anonymous (NA) Selbsthilfegruppen (SHG) angenommen wird. Methodik: Polytoxikomane Patienten (PP0, n = 43, 12w, 31 m) in stationärer bzw. ambulanter Suchtbehandlung wurden mit einer Stichprobe (PPNA, n = 55, 26w, 29 m), welche mind. 12 Monate konsumfrei von psychotropen Substanzen leben und regelmäßig NA-Treffen besuchen, hinsichtlich ihres religiös-spirituellen Befindens (RSB) verglichen. Zudem wurde der Zusammenhang von Intensität des RSB und Dauer der Abstinenz untersucht. Ergebnisse: Die Ergebnisse zeigen signifikant höhere RSB-Werte bei PPNA gegenüber PP0. Ein Zusammenhang von Dauer der Konsumfreiheit und Ausmaß an RSB konnte jedoch nicht gefunden werden. Schlussfolgerung: Erfolgreich abstinente polytoxikomane Patienten unterscheiden sich im Ausmaß des religiös-spirituellen Wohlbefindens von noch Abhängigen, der Wirkmechanismus bleibt jedoch weiter unklar. Längsschnittsorientierte Forschung ist notwendig, um Erkenntnisse hinsichtlich der kausalen Zusammenhänge von Spiritualität und Abstinenz bei Menschen mit Substanzkonsumstörung weiter zu ergründen.

People, Places, and Things

Chapter 7 describes the life history of Vernon, a middle-aged Black man with a history of crack addiction and four prior imprisonments. He moved to Houston in the wake of Hurricane Katrina and has successfully desisted from crime. In self-help, peer-group programs such as Alcoholics Anonymous and Narcotics Anonymous, it is commonly stressed that to manage addiction it is necessary to avoid the “people, places, and things” associated with previous substance use. Doing so is easier said than done, given that a lack of income and limited housing opportunities often push individuals back to the same environments where they used drugs in the past. Vernon’s case adds validity to the notion that residential change can provide the foundation for true behavioral change for people with substance abuse problems by separating them from the people and places of their past and by fostering an alternate set of daily routines and situations.

Surrender to win: Constructions of 12-step recovery from alcoholism and drug addiction

This article focuses on the ways in which members of Alcoholics Anonymous and Narcotics Anonymous construct themselves as being in recovery from addiction. In this original study, data were taken from 19 participants. They were analysed using Willig’s six-stage Foucauldian discourse analytic method. This method is suited to enabling the analyst to locate discourse resources used by participants within broader, dominant, discourses, and for exploration of the implications of these constructions for subjectivity and practice. This article presents a discussion of analytic findings. Mainstream academia has often constructed 12-Step recovery as a largely totalising discourse. This is likely to have negatively prejudiced health professionals and may help explain relatively low referral rates into 12-Step resources for addicted clients. However, our analysis suggested that participants constructed themselves not as subjected by Alcoholics Anonymous and Narcotics Anonymous discourse, but as drawing on it in ways aligned with agency, in order to practice care of the self in pursuit of various ethical goals. This implies 12-Step recovery to be less antithetical to, and indeed more aligned with, humanistic practitioner values than is perhaps often assumed to be the case. This finding suggests that practitioners may need to consider reappraising their view of 12-Step recovery. The discussion will therefore focus on the agency-structure dialectic that seemed to be at the heart of participant constructions of addiction and recovery. It is also a finding which points to an urgent need for more qualitative studies in the currently under-researched, and hence perhaps poorly understood, area of 12-Step recovery from addiction.