The purpose of this study was to systematically assess the attitudes of Alcoholics Anonymous (AA) members toward the newer medications used to prevent relapse (e.g., naltrexone) and to assess their experiences with medication use, of any type, in AA.
Using media solicitations and snowball sampling techniques, 277 AA members were surveyed anonymously about their attitudes toward use of medication for preventing relapse and their experiences with medication use of any type in AA.
Over half the sample believed the use of relapse-preventing medication either was a good idea or might be a good idea. Only 17% believed an individual should not take it and only 12% would tell another member to stop taking it. Members attending relatively more meetings in the past 3 months had less favorable attitudes toward the medication. Almost a third (29%) reported personally experiencing some pressure to stop a medication (of any type). However, 69% of these continued taking the medication.
The study did not find strong, widespread negative attitudes toward medication for preventing relapse among AA members. Nevertheless, some discouragement of medication use does occur in AA. Though most AA members apparently resist pressure to stop a medication, when medication is prescribed a need exists to integrate it within the philosophy of 12-step treatment programs.
"Additional anecdotal concerns have centered around AA's position on potentially helpful medications. In general, surveyed AA members have been found to be supportive of the use of psychotropic (e.g., antidepressants, antipsychotics) and relapse prevention medications (e.g., naltrexone, acamprosate , disulfiram), although there may be a vocal minority who oppose it (Meissen, Powell, Wituk, Girrens, & Arteaga, 1999; Rychtarik, Connors, Dermen, & Stasiewicz, 2000; Tonigan & Kelly, 2004). However, it is unclear whether this oppositional minority is specific to AA membership or is a more general facet of individuals attempting to recover; at least one study of alcohol-dependent individuals found that AA participation was unrelated to opposition to the use of medications (Tonigan & Kelly, 2004). "
[Show abstract][Hide abstract] ABSTRACT: Peer-led mutual-help organizations addressing substance use disorder (SUD) and related problems have had a long history in the United States. The modern epoch of addiction mutual help began in the postprohibition era of the 1930s with the birth of Alcoholics Anonymous (AA). Growing from 2 members to 2 million members, AA's reach and influence has drawn much public health attention as well as increasingly rigorous scientific investigation into its benefits and mechanisms. In turn, AA's growth and success have spurred the development of myriad additional mutual-help organizations. These alternatives may confer similar benefits to those found in studies of AA but have received only peripheral attention. Due to the prodigious economic, social, and medical burden attributable to substance-related problems and the diverse experiences and preferences of those attempting to recover from SUD, there is potentially immense value in societies maintaining and supporting the growth of a diverse array of mutual-help options. This article presents a concise overview of the origins, size, and state of the science on several of the largest of these alternative additional mutual-help organizations in an attempt to raise further awareness and help broaden the base of addiction mutual help.
Journal of Groups in Addiction & Recovery 04/2012; 7(2-4):82-101. DOI:10.1080/1556035X.2012.705646
"Psychosocial support has been the mainstay of treatment for alcohol dependence, whereas pharmacotherapy has traditionally played an adjunctive role (Moak, 2004). In practice, some of the barriers to widespread medication use include a lack of awareness, deficiencies in efficacy data, medication safety and addiction concerns, patient noncompliance, and resistance to the use of medications by some members of Alcoholics Anonymous (Rychtarik et al., 2000; Mark et al., 2003). "
[Show abstract][Hide abstract] ABSTRACT: : The impact of intramuscular, injectable, extended-release naltrexone (XR-NTX; Vivitrol) on counseling and support group participation was examined in a post hoc analysis of a 24-week, randomized, double-blind study in 624 alcohol-dependent adults, most of whom were nonabstinent at baseline.
: Patients were offered 6 monthly injections of XR-NTX 380 mg, XR-NTX 190 mg, or placebo (n = 205, 210, and 209, respectively) and 12 sessions of manualized brief counseling. Voluntary participation in extramural counseling (eg, couples or family therapy) and self-help support groups (eg, Alcoholics Anonymous) was permitted and assessed.
: The proportion of patients attending all 12 Biopsychosocial, Report, Empathy, Needs, Direct advice, and Assessment sessions was nonsignificantly greater for XR-NTX 380 mg (45%) than for placebo (39%), as was the proportion attending extramural counseling (10% vs 7%) and support groups (13% vs 10%). Attendance rates were intermediate with XR-NTX 190-mg. Attending self-help groups was significantly (P = 0.04) related to reduced heavy drinking across all treatment groups.
: XR-NTX is compatible with counseling and support group participation in the treatment of alcohol dependence.
Journal of Addiction Medicine 09/2010; 4(3):181-5. DOI:10.1097/ADM.0b013e3181c82207 · 1.76 Impact Factor
"Because these approaches do not specifically address the role of medication in recovery or medication adherence, investigators must typically develop some alternate means of addressing medication adherence, for example through scheduling additional meetings with study physicians or other medical staff. Moreover, it is important to recognize that acceptance of pharmacotherapy, while increasing, remains variable in selfhelp groups (Rychtarik et al., 2000; Swift et al., 1998). "
[Show abstract][Hide abstract] ABSTRACT: Behavioral therapy platforms have become virtual requirements in pharmacotherapy trials due to their utility in reducing noise variability, preventing differential medication adherence and protocol attrition, enhancing statistical power and addressing ethical issues in placebo-controlled trials. Selecting an appropriate behavioral platform for a particular trial requires study-specific tailoring, taking into account both the stage of development of the medication being evaluated, as well as the specific strengths and weaknesses of a broad array of available empirically supported behavioral therapies and the range of their possible targets (e.g., enhancing medication adherence, preventing attrition, addressing co-morbid problems, fostering abstinence, and targeting specific weaknesses of the pharmacologic agent). Choosing a suitable behavioral platform also requires consideration of the characteristics of the population to be treated, stage of scientific knowledge regarding the medication's effects, appropriate balance of internal and external validity, and consideration of potential ceiling effects. Available manualized behavioral treatments are reviewed, noting their strengths and limitations as behavioral therapy platforms for pharmacotherapy trials and as potential concomitant therapies in clinical practice.
Drug and Alcohol Dependence 09/2004; 75(2):123-34. DOI:10.1016/j.drugalcdep.2004.02.007 · 3.42 Impact Factor
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