Is it beneficial to have an Alcoholics Anonymous sponsor?

Abstract

Alcoholics Anonymous (AA) attendance is predictive of increased abstinence for many problem drinkers and treatment referral to AA is common. Strong encouragement to acquire an AA sponsor is likewise typical, and findings about the benefits associated with social support for abstinence in AA support this practice, at least indirectly. In spite of this widespread practice, however, prospective tests of the unique contribution of having an AA sponsor are lacking. This prospective study investigated the contribution of acquiring an AA sponsor using a methodologically-rigorous design that isolated the specific effects of AA sponsorship. Participants were recruited from AA and outpatient treatment. Intake and follow-up assessments included questionnaires, semi-structured interviews, and urine toxicology screens. Eligibility criteria limited prior treatment and AA histories to clarify the relationship of interest while, for generalizability purposes, broad substance abuse criteria were used. Of the 253 participants, 182 (72%) provided complete data on measures central to the aims of this study. Overall reductions in alcohol, marijuana and cocaine use were found over 12-months and lagged analyses indicated that AA attendance significantly predicted increased abstinence. During early AA affiliation but not later logistic regressions showed that having an AA sponsor predicted increased alcohol-abstinence and abstinence from marijuana and cocaine after first controlling for a host of AA-related, treatment, and motivational measures that are associated with AA exposure or which are generally prognostic of outcome.

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

“…Although these approaches may enable evaluation of the effectiveness of 12-step programs in attenuating all alcohol and drug use, they obscure possibly important temporal interactions between use of different classes of substances. For example, Tonigan and Rice (2010) found that 41% of an AA-recruited sample reported being abstinent from alcohol use at their 6-month follow-up interviews. However, a smaller percentage of the sample (31%) was abstinent from use of alcohol, marijuana, and cocaine during the same follow-up period.…”

“…This is potentially an important benefi t of such programs, given the increasing prevalence of polysubstance use disorders over the past 2 decades (Griffi n et al, 2009). Along these lines, it is estimated that 64% of alcoholics also use illicit drugs (Tsuang et al, 1994), including marijuana (42%), cocaine (34%), and opioid drugs (20%), among others (Tonigan and Rice, 2010). Furthermore, roughly 50% of all alcoholics suffer from comorbid illicit substance use disorders (Ross, 1993), an estimate that is consistent with the comorbidity rate reported in the Alcoholics Anonymous Triennial Survey (1990).…”

“…In general, fi ndings indicate that 12-step program attendance predicts increased abstinence from a variety of substances. For example, results from meta-analytic reviews and prospective studies indicate that AA attendance predicts reduced alcohol consumption and complete abstinence from alcohol (e.g., Emrick et al, 1993;Kaskutas et al, 2002;Tonigan and Rice, 2010;Tonigan et al, 1996). Likewise, participation in 12-step programs has been shown to predict reduced global drug use (e.g., Timko and Sempel, 2004;Timko et al, 2006;Witbrodt and Kaskutas, 2005) as well as the use of specifi c drugs such as marijuana, opiates, and psychostimulants (Carroll et al, 2000;Gossop et al, 2007;Toumbourou et al, 2002;Weiss et al, 2005;Worley et al, 2008).…”

“…One strategy has been to investigate and report alcohol and illicit drug use separately, allowing readers to evaluate program effectiveness based on their intended purposes (e.g., Timko et al, 2006). Alternatively, some studies have involved combining alcohol and illicit drug use into unitary nominal or ordinal abstinence-based outcome measures (e.g., Tonigan and Rice, 2010;Weisner et al, 2003;Witbrodt and Kaskutas, 2005). Although these approaches may enable evaluation of the effectiveness of 12-step programs in attenuating all alcohol and drug use, they obscure possibly important temporal interactions between use of different classes of substances.…”

Longitudinal Trajectories of Readiness to Change: Alcohol Use and Help-Seeking Behavior

“…To control for prior learning effects when investigating change processes, the parent study excluded adults who had prior success at achieving abstinence (Tonigan and Beatty, 2011;Tonigan and Rice, 2010). Thus, participants were excluded from the study if they had already achieved alcohol abstinence for 12 months or longer or had attended AA for more than 4 months.…”