Edward Day, Sabrina Kirberg and Nicola Metrebian
Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use…
Abstract
Purpose
Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues.
Design/methodology/approach
A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS).
Findings
A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001).
Practical implications
A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate.
Originality/value
The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.
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The purpose of this paper is to identify risk factors for interruptions in opioid dependence treatment and barriers to (re) entering effective treatment through real-world insight…
Abstract
Purpose
The purpose of this paper is to identify risk factors for interruptions in opioid dependence treatment and barriers to (re) entering effective treatment through real-world insight on current opioid dependence treatment in the UK.
Design/methodology/approach
Project Access UK, a national survey deployed across multiple regions in England, Wales and Scotland, collected data on the perspectives of patients receiving medication-assisted treatment (MAT) for opioid dependence (n=248), out-of-treatment opioid users (n=196), and physicians (n=100).
Findings
Both patients and users reported multiple prior episodes of MAT and detoxification. Among patients, 57 per cent reported continuing illicit drugs use in addition to their treatment, 25 per cent had misused (injected or snorted) and 30 per cent had diverted (sold or given away) prescribed opioid medications. Diverted medications were currently being used by 26 per cent of out-of-treatment users; of these, 21 per cent used methadone. Supervised dosing was rated as the condition of treatment with the biggest impact on daily life. Daily supervision was a requirement for 44, 34 and 23 per cent of patients receiving methadone, mono-buprenorphine and buprenorphine-naloxone, respectively.
Practical implications
Interruptions to opioid dependence treatment in various forms can hamper the recovery of opioid-dependent patients. The benefits of MAT may not be fully realised if treatment is interrupted due to compliance failure, or inflexible treatment programmes leading to premature treatment exit. These findings serve to highlight areas in which treatment disruption can potentially be addressed.
Originality/value
Consideration of these findings may aid in the optimisation of treatment delivery practices to better meet the UK policy of recovery, and ultimately improve patient outcomes.