Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii

Dale, Elizabeth; Kelly, Peter J.; Lee, K. S Kylie; Conigrave, James H.; Ivers, Rowena; Clapham, Kathleen

doi:10.1016/j.addbeh.2019.106038

Cited by 20 publications

(17 citation statements)

References 27 publications

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“…sweat lodges) in recovery that are important to indigenous peoples [ 46 ]. Being able to measure the value of culture in Aboriginal rehabilitation services could help corroborate the connections between culture, treatment and recovery [ 51 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia

James

Lee

Courtney

et al. 2020

Addict Sci Clin Pract

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Background: Aboriginal alcohol and other drug residential rehabilitation (residential rehabilitation) services have been providing treatment in Australia of over 50 years. However, there are no studies in Australia or internationally that document characteristics of clients attending Indigenous residential rehabilitation services worldwide. This is the first multi-site paper to describe key client characteristics of six Indigenous (hereafter Aboriginal Australians as the term recommended by the Aboriginal Health and Medical Research Council of New South Wales) residential rehabilitation services in Australia. Methods: All recorded client admissions between 1 January 2011 to 31 December 2016 were considered from six operating services in the Australian state of New South Wales. Data collected were classified into categories based on demographics, treatment utilisation, substance use, mental health and quality of life characteristics. Means, median and percentages were calculated (where appropriate). Results: There were 2645 admissions across the six services in the study period, with an average of 440 admissions per year across all services. Participants were aged between 26 to 35 years, with fewest participants aged 46 +. Program length ranged from 12 to 52 weeks (mean of 12 weeks). The completion rates and length of stay for each service ranged from less than two to more than 12 weeks. The principal drug of choice was alcohol and amphetamines in half of the services. Not all services used them, but a range of tools were used to measure treatment, substance use and mental health or quality of life outcomes. Conclusion: This study is the first internationally to describe the key features of multiple Aboriginal residential rehabilitation services. The variation in tools used to collect client data made it difficult to compare client characteristics across services. Future research could explore predictors of treatment completion, identify opportunities for standardisation in client assessments and validate cultural approaches of care. These efforts would need to be guided by Aboriginal leadership in each service.

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Section: Discussionmentioning

confidence: 99%

Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia

James

Lee

Courtney

et al. 2020

Addict Sci Clin Pract

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“…above recommended limits 'hazardous drinking' or an alcohol use disorder), OR aimed at improving accessibility or acceptability of alcohol care in primary health care services; (3) the program or interventions were implemented in a primary care setting or other setting that was readily available to individuals in the community on an outpatient basis and; (4) data on First Nations participants was presented separately to other ethnic groups. Studies focusing on ' Alcoholics Anonymous' or similar mutual support groups were excluded as they are the subject of a separate review [48]. Studies which focused solely on screening were excluded.…”

Section: Table 1 Search Strategymentioning

confidence: 99%

What can primary care services do to help First Nations people with unhealthy alcohol use? A systematic review: Australia, New Zealand, USA and Canada

Purcell‐Khodr

Lee

Conigrave

et al. 2020

Addict Sci Clin Pract

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Background: First Nations peoples of Australia, New Zealand, the United States of America (USA) and Canada are more likely to be non-drinkers than other people in these countries. However, those who do drink may be at greater risk of alcohol-related harms (at a population level) due to the ongoing impacts from colonisation and associated oppression. Addressing unhealthy drinking (drinking above recommended limits including alcohol use disorders) in primary care settings is one important way to increase accessibility of treatment. Methods: This systematic review identifies peer-reviewed studies of alcohol treatments delivered in primary care or other non-residential settings for First Nations peoples of Australia, New Zealand, USA and Canada. Literature searches were conducted in seven academic databases from their inception until March, 2020. We assessed evidence of treatment or implementation effectiveness, perceived acceptability or accessibility, and the study quality as assessed by the AXIS tool and by a measure of community participation in the research process. Results: Twenty-eight studies were included, published between 1968 and 2018. Studies reported on a range of alcohol treatments, from brief intervention to ambulatory withdrawal management, relapse prevention medicines, and cultural therapies. Brief intervention was the most studied approach. Cultural healing practices and bicultural approaches were a key theme amongst several studies. Four studies measured treatment effectiveness, including one randomised controlled trial (naltrexone vs naltrexone plus sertraline vs placebo) and two uncontrolled trials of disulfiram. Of the six implementation studies, three were (hybrid) effectiveness-implementation designs. Most of the remaining studies (n = 21) focused on treatment accessibility or acceptability. Community participation in the research process was poorly reported in most studies. Conclusions: Research evidence on how best to care for First Nations peoples with unhealthy alcohol use is limited. Trials of naltrexone and disulfiram presented promising results. Cultural and bicultural care were perceived as highly important to clinical staff and clients in several studies. More effectiveness studies on the full scope of alcohol treatments are needed. Greater community participation in research and more transparent reporting of this in study methods will be key to producing quality research that combines scientific rigour with cultural appropriateness.

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“…There is limited understanding of the effectiveness for Indigenous peoples of one‐to‐one counselling or group programmes, whether professionally conducted or peer‐based, such as Smart Recovery or Alcoholics Anonymous [14]. This needs to change, given how readily Indigenous peoples are referred to counselling services or are encouraged to attend group programmes.…”

Section: Treatment Researchmentioning

confidence: 99%

Alcohol and drug research with Indigenous peoples: where do we go from here?

Doyle

2020

Addiction

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Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii

Cited by 20 publications

References 27 publications

Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia

Understanding the client characteristics of Aboriginal residential alcohol and other drug rehabilitation services in New South Wales, Australia

What can primary care services do to help First Nations people with unhealthy alcohol use? A systematic review: Australia, New Zealand, USA and Canada

Alcohol and drug research with Indigenous peoples: where do we go from here?

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