Aims: Many individuals entering treatment are involved in social networks and activities that heighten relapse risk. Consequently, treatment programs facilitate engagement in social recovery resources, such as Alcoholics Anonymous (AA), to provide a low risk network. While it is assumed that AA works partially through this mechanism, research has been limited in rigor and scope. This study used lagged mediational methods to examine changes in pro-abstinent and pro-drinking network ties and activities.
Design, Setting, Participants: Subjects were adults (N = 1,726) participating in a multisite, randomized controlled trial of alcohol treatments. Generalized linear modeling (GLM) tested whether changes in pro-abstinent and pro-drinking network ties and drinking and abstinent activities explained AA’s effects.
Measurements: Participants were assessed at treatment intake, and 3, 9, and 15 months later using the Form 90 and the Important People and Activities (IPA) questionnaire.
Results: Greater AA attendance facilitated substantial decreases in pro-drinking social ties and significant, but less substantial increases in pro-abstinent ties. Also, AA attendance reduced engagement in drinking-related activities and increased engagement in abstinent activities. Lagged mediational analyses revealed that it was through reductions in pro-drinking network ties and, to a lesser degree, increases in pro-abstinent ties that AA exerted its salutary effect on abstinence, and to a lesser extent, on drinking intensity.
Conclusions: AA appears to facilitate recovery by mobilizing adaptive changes in the social networks of individuals exhibiting a broad range of impairment. Specifically, by reducing involvement with pro-drinking ties and increasing involvement with pro-abstinent ties. These changes may aid recovery by decreasing exposure to alcohol-related cues thereby reducing craving, while simultaneously increasing rewarding social relationships.
Funding Source: This research was supported by a grant from the US National Institute on Alcohol Abuse and Alcoholism (NIAAA; R21 AA016762; Mechanisms and Moderators of Behavior Change in Alcoholics Anonymous).
Declaration: The authors have no financial interests, relationships, or affiliations relevant to this manuscript, thus no conflict exists.