The effects of continuing care on emerging adult outcomes following residential addiction treatment

Abstract

Background: Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults' participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts.

Methods: Emerging adults (N=284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, substance use disorder (SUD) medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates.

Results: Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups).

Conclusions: Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment.

Keywords: 12-Step mutual-help organizations; Continuing care; Emerging adulthood; Substance use disorders.

Figure 1

Raw Abstinence Rates During the 12-Month Follow-Up Period as a Function of Sober Living Environment Residence (SL) and 12-Step Mutual-Help Organization Involvement (MHO). SL was split by mean percent days (15.5% or lower [low] versus greater than 15.5% [high]), and MHO was split by mean number of activities (five or lower [low] versus six or greater [high]). Note that only four patients had High SL / Low MHO, none of whom were abstinent during follow-up (not shown).