August 21, 2014 / 10:13 PM / 4 years ago

AA can help young adults, but mechanisms unclear: study

NEW YORK (Reuters Health) - Alcoholics Anonymous can help people, young and old, recover from drinking problems, but young adults seem to benefit mainly - and only - from certain aspects of the program, according to a small U.S. study.

The results may help to better tailor AA for a new generation, researchers say, and help young adults feel more comfortable in the heart of the program, the group meetings.

“We now know that in addition to the mechanisms we traditionally target, there may be other mechanisms that are particularly important for younger people,” said Bettina Hoeppner, a psychologist at Harvard University in Boston, Massachusetts, who led the study.

Hoeppner and her team write that young people - who may face more temptations to drink in a social context and have shorter addiction histories, and hence less to share - may face a “barrier” to becoming engaged with the values of AA.

“Yes, it may feel alienating to attend meetings with folks who likely will have quite different life circumstances, but chances are, going to the meetings will help, possibly exactly because the other members will be able to provide a new and wider perspective on substance use and the problems it causes, and the efforts to overcome it,” Hoeppner told Reuters Health.

AA is by far the most accessible support for recovery, with over 100,000 local groups, 2 million members worldwide and no financial cost to join, she said.

The 12-step program with spiritually-grounded principles focuses on helping an addict avoid the compulsion to drink alcohol.

Past research has identified several key ways the regimen helps addicts resist the urge to drink, Hoeppner’s team writes in the journal Drug and Alcohol Dependence.

These include learning to cope in a high-risk social context; dealing with setbacks such as depression, anger, boredom and anxiety; embracing spiritual practices; and creating a social network that includes people who drink alcohol as well as those who don’t.

People under age 30 make up only 13 percent of AA’s membership, according to a 2011 survey conducted by the organization, Hoeppner points out, yet “young adults are currently the age group with the highest prevalence of substance use - so that’s one reason we should care.”

To see what accounts for successful recovery in AA among young people, Hoeppner’s team analyzed the recovery efforts of almost 2,000 adults who participated in a 12-week treatment program. They compared almost 300 participants between the ages of 18 and 29, to about 1500 counterparts 30 years old or older.

After treatment, the participants were required to check-in every three months for a year and a half and describe their alcohol use, AA meeting attendance, spiritual or religious practices, depression, self control and social networks.

Even though both groups attended a similar number of meetings, younger people were slightly less successful at abstaining from alcohol than older members of the program. Thirty percent of young adults were still completely abstinent at 15 months, compared to 39 percent of the over-30 group.

The young adults who did drink reported consuming less alcohol than they had before the intervention, however.

In the analysis of why participants were successful in the program, the over-30 group benefited from up to five of the six “key” skills known to help recovery, but the young adults benefited from only two.

Socializing with fewer “pro-drinkers” and being able to “refuse a drink” in high-risk social situations were the skills from AA that determined the young adults’ success.

“I agree with their conclusions as far as they go, but I think the study method obscures some pretty important points,” said Ned Presnall, a clinical social worker at Clayton Behavioral in Saint Louis, Missouri.

Presnall, who was not involved in the study, questioned its relevance to substance abuse, a bigger problem for young adults.

Referring to a 2012 database of Americans entering treatment for addiction, he pointed out that only 23 percent of adults between the ages of 18 and 20 reported alcohol as their primary abused substance compared to 55 percent of adults between 40 and 45.

“Since part of AA’s strategy is attracting people with drug and alcohol problems, one measure of its effectiveness is its ability to attract young adults,” he emphasized.

Hoeppner said, “If you are a young adult struggling with substance use, try AA. Don’t let the fact that you’ll likely be among the few younger people there deter you: that might actually be one of the things that helps you. And if you want to help a young person, suggest going to AA or another mutual help group. It’s not for everyone, but it can help.”

SOURCE: Drug and Alcohol Dependence, online July 23, 2014.

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