Addiction Medicine: Closing the Gap between Science and Practice

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help patients reduce their substance-related
problems.^359 They are incorporated into many
formal treatment programs, can be an important
part of chronic disease management and
constitute the most frequently-accessed resource
among people with addiction involving alcohol
and other drugs and related problems.^360
National data indicate that an average of five
million people ages 12 and older attend an
alcohol or other drug use mutual support group
each year. Slightly less than half (45.3 percent)
of the attendees participated in support groups
for addiction involving alcohol; 21.8 percent
participated in support groups for addiction
involving other drugs and 33.0 percent
participated in support groups for co-occurring
addiction involving alcohol and other drugs.* 361


Although there are many types of mutual
support programs, most have many
characteristics in common:^362


 Group members share the same problem or
status;


 Groups are run using self-directed
leadership; that is, members, rather than an
outside governing figure, are in charge of
the program;


 Group members share their experiences and
lessons learned;


 Members share the goal of changing some
aspect of their personal behavior;


 Reciprocal helping is the norm;


 Members participate on a voluntary basis;
and


 Programs may accept donations but do not
charge for membership.^363


Some organizations focus more on providing
fellowship, information or self-acceptance while
others attempt to address the origin of



  • Comparable data on rates of participation in


Nicotine Anonymous are not available.


participants’ addiction problems.^364 Programs
also vary in terms of the methods used to
address addiction, the extent to which there is an
emphasis on spirituality or religion, whether
members are encouraged to participate in
political advocacy,† whether friends and family
members are included in group meetings, the
extent to which the group facilitates connection
with treatment professionals working in an
advisory role‡ and whether the program accepts
external funds.^365

The 12-step groups, such as Alcoholics
Anonymous (AA) and Narcotics Anonymous
(NA) are some of the best known and most
widely available mutual support programs.§ 366
They provide participants with 12 steps to
follow during the process of recovery.^367 These
programs generally begin with the acceptance of
one’s addiction and--through a process of self-
exploration--participants take action to make
changes toward recovery.^368

Other core components of these programs are
taking responsibility for the recovery process,
sharing personal experiences, recognizing the
existence of a higher power, helping others and
lifetime commitment to the program.^369 Outside
of the group meetings, sponsorship** plays an
important role in most 12-step programs. Each
new group member finds a sponsor to serve as a
role model, program guide and first line of
support in the case of a potential or actual
relapse.^370 It is estimated that AA, the oldest

† e.g., unlike organizations such as Alcoholics
Anonymous (AA) and Narcotics Anonymous (NA)
which require anonymity, the Faces and Voices of
Recovery organization seeks to organize and
mobilize individuals with histories of addiction, their
families and friends in public policy advocacy
efforts.
‡ Professionals may work in an advisory role or they
may serve as guest lecturers.
§ There also are 12-step programs for individuals
dealing with gambling and other types of addiction,
and with a family member’s or friend’s addiction,
such as Al-Anon and Alateen.
** Sponsors typically have completed at least one year
of abstinence with the program and are of the same
sex as the new member (or a different sex for gay
members).
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