One-Year Outcomes among Members of a Dual-Recovery Self-Help Program.

Research Objective: Self-help is gaining increased acceptance among treatment professionals as empirical support for of its effectiveness is growing and the advent of managed care warrants the use of cost-effective modalities. Traditional “one disease-one recovery” self-help programs cannot serve adequately the needs of the dually-diagnosed.

This paper presents one-year outcome data from a longitudinal study of the effectiveness of self-help for the dually-diagnosed.

Subjects are members of Double Trouble in Recovery (DTR), a 12-step self-help program designed to meet the special needs of those diagnosed with both a mental health disorder and a chemical addiction.Study.

Design: The study uses a 12-month prospective longitudinal design with follow-ups at 12 and 24 months after baseline. Subjects (N = 310) were recruited at 25 DTR meeting sites throughout New York City. Semi-structured instruments assess history and current status of mental health and substance abuse, treatment in both areas, and self help participation (DTR as well as traditional 12-step groups such as AA and NA).

Population Studied: Community-based individuals dually-diagnosed with a mental health disorder and substance abuse.

Principal Findings: S’s are mostly members of underserved minority groups with long histories of substance abuse and mental health disorders.

Most S’s attend outpatient treatment (for drug use, mental health or dual-diagnosis - 77%) and take psychotropic medications (87%).

At the 12 months follow-up,

• 76% were still attending DTR;
• 68% were also attending AA or NA.

Mean number of symptoms S’s. experienced in the past year decreased significantly;

• two-thirds (69%) of S’s reported that their mental health was “better” in the past month than it was at baseline.
• One-third (29%) reported substance use in the past year, compared to 42% at baseline (p = .002).

Substance use (less) was significantly associated with DTR attendance:

• Total time abstinent was related to lifetime length of DTR attendance (r = .25, p = .002) and
• past year substance use was related to number of months of DTR attendance in the past year (r = -.17, p = .02).

Conclusions: For dually-diagnosed individuals, continued participation in dual recovery self-help groups plays a significant role in the recovery process, particularly in the area of substance use.

Implications for Policy, Delivery or Practice: Participation in dual-recovery self-help groups, both during and after formal treatment, should be encouraged as part of an integrated lifelong recovery plan for dually-diagnosed individuals.

Research; One-Year Outcomes among Members of a Dual-Recovery Self-Help Program. Laudet A, Magura S, Vogel H, Knight E, Staines G; Abstr Acad Health Serv Res Health Policy Meet. 2000; 17.

More at; Double Trouble in Recovery

See also;

• 12-Step Treatment More Effective than Alternative
• AA and Treatment Work Better Together
• Subscribe to Twelve Step Facilitation by e-Mail

Dual Diagnosis; Counseling the Mentally Ill Substance Abuser by Katie Evans, J. Michael Sullivan Read more about this title…

Alcohol factors in suicide mortality rates in Manitoba, Canada.

OBJECTIVE: To identify alcohol-related factors that influence mortality rates from suicide.

METHOD: We examined the impact of per capita consumption of total alcohol, spirits, beer, and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total, male and female suicide mortality rates in Manitoba during 1976 to 1997. Time series analyses with autoregressive integrated moving average modelling were applied to total, male and female suicide rates. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines.

RESULTS:

• Total alcohol consumption, and consumption of beer, spirits, and wine individually, were significantly and positively related to female suicide mortality rates.
• Spirits and wine were positively related to total and male mortality rates.
• AA membership rates were negatively related to total and female suicide rates.
• Unemployment rates were positively related to male and total suicide rates.

CONCLUSIONS:

The data confirm the important relations between per capita consumption measures and suicide mortality rates.

Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership can exert beneficial effects observable at the population level.

Mann RE, Zalcman RF, Rush BR, Smart RG, Rhodes AE. Can J Psychiatry. 2008 Apr;53(4):243-51. Alcohol factors in suicide mortality rates in Manitoba.

see also;

• 12-Step Treatment More Effective than Alternative
• AA Offers Recovery Not Religion
• Brief-TSF can assist patients cease alcohol consumption.
• Subscribe to Twelve Step Facilitation by e-Mail

Understanding and Counselling the Alcoholic by Howard J. Clinebell Amazon books; Read more about this title…

NIAAA Expert Discusses Minority Disparities in Alcohol Use and Treatment

In our continuing editorial series with experts from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Coalitions Online interviewed Ricardo Brown, Ph. D., Health Science Administrator and Minority Health and Health Disparities Coordinator.

Here, in recognition of Black History Month, Dr. Brown discusses the disparities in alcohol use and treatment among minorities and stresses the need for greater minority participation in clinical studies.

Q: What are the major differences in alcohol use among minorities?

Among Asian Americans, Chinese Americans have higher rates of abstinence from alcohol, while Japanese Americans report higher rates of heavy drinking. With respect to adolescent drinking, African American teens drink less than non-Hispanic white and Latino teens.

Q: How do the health effects and mortality rates of alcohol use differ among minorities?

Despite having higher abstinence rates, alcohol-related deaths are higher among African-American males than white males. Alcohol-related mortality rates for white Hispanic Latino men is double that for non-Hispanic white men. Among Native Americans, the leading cause of death is alcohol-related.

Q: What are some of factors that might influence these varying rates?

Genes and environmental factors, and their interaction, play an important role.

Environment can play a part in shaping use, treatment and prevention, and some people have a genetic predisposition to alcohol drinking.

Some examples of environmental factors are location and insurance coverage. For example, minority patients who enter treatment programs generally have success rates that are equal to those of white patients. However, depending on where they live and the resources of their neighborhood, they may not have access to treatment.

Hispanics/Latinos and African Americans are also less likely to have insurance coverage for treatment. However, we need to conduct more studies to determine the exact multi-dimensional factors that influence use of alcohol. Getting more minorities to participate in clinical trials is a challenge we’re facing now and one way to address the disparities is by getting increased participation by minority groups so we can understand the underlying mechanisms responsible for disparities between groups of people.

Q: What is the role of the community in helping to address these disparities?

They can be a stronger force in encouraging people from all walks of life to participate in clinical and epidemiological studies, so that the outcomes of those studies can be applicable to all groups. It’s also important for any local community or university-based group to be involved in their local alcohol research center, which are located throughout the country.

Q: What efforts does the NIAAA do to address these disparities?

Our Director Dr. Ting-Kai Li is aware of these disparities and he’s working closely with the National Center for Minority Health Disparities and other organizations to address them. He is also developing mechanisms for increasing enrolment of African-Americans and other ethnic minorities in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Dr. Ricardo Brown is NIAAA’s Health Science Administrator and Minority Health and Health Disparities Coordinator. For more information about the NIAAA and its programs, visit www.niaaa.nih.gov.

There is a culture clash between alcohol marketing and public health aspirations

It is of no coincidence that a number of recent Harm Reduction Digests have addressed the issue of the reduction of alcohol-related harm.

Despite the dominant focus on illicit drug use in the popular discourse, alcohol remains Australia’s number one drug problem, as it is in many other developed countries.

Munro and de Wever use the ‘four Ps’ of marketing:

• product,
• price,
• place and
• promotion, to critique the two decades industry self-regulation of alcohol marketing.

They conclude that if we are going to develop policies which effectively change Australian drinking culture to reduce alcohol-related harm, we need first to accept that the alcohol industry and the health field have separate and conflicting interests.

Research; Geoffrey Munro & Johanna de Wever. Drug and Alcohol Review, Volume 27, Issue 2 March 2008 , pages 204 – 211. Culture clash alcohol marketing and public health aspirations

See also;

• Brief-TSF can assist patients cease alcohol consumption.
• Alcohol Science Database

Alcohol and Public Policy: No Ordinary Commodity by Thomas Babor Read more about this title…