Effects of Treatment Type on Alcohol Consumption Partially Mediated by Alcoholics Anonymous Attendance

ABSTRACT

Background: As insurance coverage, funding sources and venues for drug and alcohol treatment evolve in the United States, it is important to assess how the type of treatment received may impact long-term outcomes. The current study aims were to examine effects of treatment type on alcohol consumption in the year after treatment intake and to test mediators of effects of treatment type on later alcohol use. Methods: Longitudinal data from clients in inpatient and outpatient alcohol treatment programs in California (n = 560) were used in ordinary least squares path analysis adjusting for respondent characteristics typically associated with both treatment completion and alcohol use. The primary outcome was amount of alcohol consumed in the 12 months after treatment entry; hypothesized mediators were treatment duration and participation in Alcoholics Anonymous (AA). Results: Despite higher baseline problem severity and a shorter treatment duration, inpatient clients consumed less alcohol after treatment than outpatient clients (B [95% CI] = −0.95 [−1.67, −0.23]). AA involvement was a significant mediator of the relationship between treatment type and alcohol consumption, with inpatient clients being more involved in AA and also drinking less after treatment than outpatient clients; the bias-corrected bootstrap 95% confidence interval for the indirect effect (B = −0.20) was entirely below zero (−0.43 to −0.05). Conclusions: Outpatient clients may benefit from customized posttreatment recommendations to identify additional resources to assist in the recovery process during the first year after treatment.

KEYWORDS:

• Alcohol treatment
• 12-step programs
• treatment outcomes

Acknowledgments

We would like to thank Amy Mericle, PhD, for her review and editorial comments. Funding for the current analysis was received from the National Institute on Alcohol Abuse and Alcoholism grant R01AA020328. The original longitudinal study was supported by NIAAA grants R01AA09750, P50AA005595, and R01AA015927. The NIAAA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Author contributions

All authors contributed to the conceptualization of the study. KKJ and JLK conducted the analyses and drafted the manuscript. JW and LAK contributed to the interpretation of the results and the editing of the manuscript. LAK also was involved in data collection for the original longitudinal study. All authors have read and are in agreement with the current manuscript.

Additional information

Funding

National Institute on Alcohol Abuse and Alcoholism(10.13039/100000027, P50AA005595, R01AA015927, R01AA020328, R01AA09750)