Daily drinking and social network interactions in network support treatment.

Abstract

Objective: Social networks can be powerful determinants of drinking. Network Support (NS) treatment was designed to help persons with alcohol use disorder alter their social network to be more supportive of abstinence and less supportive of drinking. The present study was intended to determine how NS treatment altered behavior on a daily basis. It was expected that, relative to those treated in a packaged cognitivebehavioral treatment (PCBT), NS patients would report fewer daily contacts with drinking persons and increased contacts with nondrinking persons. Method: Patients (N = 193) treated in our second NS trial provided daily recordings of drinks consumed, urge to drink, and self-efficacy for not drinking, as well as reports of associations with drinking and nondrinking friends, via an interactive voice response system. Daily recordings (N = 146) were collected during the first 6 months of the 27-month study. Multilevel modeling was used to analyze daily network variables over time by treatment. Time-varying effect model (TVEM) analyses were also conducted to assess the influence of daily-varying social contacts on daily drinking, drinking urges, and self-efficacy. Results: Consistent with hypotheses, NS patients reported significantly less daily drinking associated with contacts with drinkers than did PCBT patients. Patients in both treatments reported increases in self-efficacy and decreases in urges to drink over days as a function of contact with nondrinkers. Conclusions: NS treatment was successful in helping patients change their social networks, as well as their responses to social influences, and those changes had effects on day-to-day drinking levels. Public Health Significance StatementThis study indicates that social network associations may play a significant role in determining alcohol treatment outcomes. Attention to social network influences should be incorporated in all treatment for alcohol use disorder.