Young adults and addiction

Young adults undergoing treatment for addiction may benefit from regular participation in 12 step-based self-help schemes after they are discharged. A collaborative study by the Center for Addiction Medicine at Massachusetts General Hospital and Harvard Medical School and the Butler Center for Research in Hazelden found young people who engage in these support groups benefit from an improvement in their substance abuse outcomes over time.

Research involving 300 18-24-year-olds attending 12 step-based residential treatment for addiction found that attendance on average peaked at approximately three visits a week three months post-discharge and an even stronger relationship was found for active group involvement.

Overall, the study indicated that while attending these meetings is beneficial, it is more effective if the young person in question is actively involved in such a session.

Dr Valerie Slaymaker of the Butler Center commented: "We were pleased to find young adults can affiliate and fully engage in these support groups - and their engagement improves substance use outcomes over time."

Chartered Psychologist Michael Cohen said: "I believe that participation in a 12 step-based programme is certainly beneficial for many individuals. It does not suit everyone but addicts need to be open minded to treatment. Every group is different and people need to learn to take away from the group what is beneficial to them. Obviously it is more effective when clients can fully participate in the group process but the problem is often that individuals with a dependency or addiction problem are not 'resistant' to treatment, but are 'ambivalent'."

A second Chartered Psychologist, John Castleton, added:

"This is a useful addition to the growing volume of information on treatment outcomes for problematic substance use. AA or NA members share their experiences and provide mutual support that aims to be 24-7, which is not available from most community-based programmes.

"What must be recognised, however, is that the abstinence-based,12-step approach, does not suit everyone. Fewer than 10 per cent of people with drug/alcohol dependence will have continuous abstinence following treatment and the majority experience relapses, albeit with significant periods of stability.

"UKATT, Britain's largest alcohol treatment trial, found that people gravitate towards goals that they feel are feasible. And Project Match (a large scale, US study published in 1997), found no significant differences between outcomes from 12-step, cognitive-behavioural therapy, or motivational interviewing.

"Fundamentally, recovery involves a person making substantial changes to their life-style and this takes time. NICE has emphasised the importance of continued engagement with support services after a period of intensive treatment (such as rehab). Outcomes tend to improve with retention and active engagement in treatment and support.

"These ambivalent clients are generally adept at hiding in the group and there can be a tendency for the facilitator or group members to leave less motivated clients alone. However, this overlooks the valuable role, which could be played in helping clients resolve their ambivalence."