The ways public health collectively treats, talks about, and understands addiction and substance use disorders is changing.
This is, in part, thanks to people in recovery, mental health advocates, and groundbreaking science. They show us that addiction is multilayered and complex and that there are many ways to treat it.
A new study published this summer looked at different types of support groups—including SMART Recovery, LifeRing Secular Recovery, Women for Sobriety, and the more well-known Alcoholics Anonymous—and found that people who have issues with alcohol and attend support groups see similar benefits in their recovery, no matter which type they choose.
To better understand what these findings mean for community health workers, Public Good News talked with Sarah Zemore, senior scientist at the Alcohol Research Group.
She shared more on the benefits of peer-led and mutual-help groups and why more options are a good thing.
Here’s what she said.
[Editor’s note: The contents of this interview have been edited for length and clarity.]
Public Good News: Can you tell us more about your study’s findings? What should community health workers know?
Sarah Zemore: The findings are pretty clear that we can refer people to a range of empirically supported mutual help groups. Not only 12-step programs like Alcoholics Anonymous and Narcotics Anonymous, but also these second-wave mutual help groups that we’ve studied: Women for Sobriety, LifeRing, and SMART Recovery.
The bottom line is that all of these groups are highly effective. We found that there was a highly significant relationship between greater mutual-help group involvement and better alcohol outcomes, regardless of which mutual-help group you attended. Whether it was 12-Step only, WFS only, LifeRing only, SMART only, or a mix of groups, right? If you were involved, you did well, and those were impressive effect sizes.
PGN: Can you clarify what you mean by involvement?
S.Z.: So we measured involvement as an index or a summary score that included not only meeting attendance, but also other things that people did to connect with the attendees, including having a close friend or sponsor in the group, volunteering or doing service work in the group, and having a regular or home group.
So, in other words, it was a measure of how you are connecting with the group. Do you have friends there? Like, is this particular meeting part of your regular life? And I think that’s really important to emphasize, because people sometimes feel like, ‘well, if I just go to meetings, that should be enough, right? That’s it, I’m done.’ But people need to be doing more than just attending meetings. That’s the first step. But it’s not enough.
PGN: Were there other challenges or opportunities for mutual-help groups that your study found?
S.Z.: We did find that involvement was lower among young adults ages 18 to 29 in any mutual-help group. And this has also been a very consistent finding in other work.
So, I think that suggests that young people may need special guidance and support in connecting with a meeting that works for them. Because if you look at the mean age of the people participating in groups, they’re very middle aged.
So, a young adult may not have peers of the same age to connect with in meetings. Young people also are less likely to commit to abstinence.
They tend to have other recovery goals. There’s maybe a willingness to experiment with it, but, you know, to really commit to abstinence is asking a lot of a young adult.
PGN: How would you describe the changes in your field in understanding alcohol use disorder?
S.Z: There has been quite a change in terms of how people think about recovery. The field, including researchers and practitioners, have been much more aware and embracing of different pathways to recovery.
One example is that harm reduction has been embraced by folks treating alcohol use disorders, and that’s quite new.
It used to be that abstinence was the only acceptable goal.
So, people are realizing this proliferation of recovery. I mean, many people have realized this for a long time.
But this is the scientists, right? They’re coming around to understanding recovery as a multi-dimensional process of growth and development that happens over many years.
It’s not something that people can achieve in a short time frame, it does involve change in many different areas, not just in substance use.
And I think that can look different for different people. So, I think the field as a whole is embracing diverse pathways to achieving health.
And this study is also consistent with that. The growth of these second-wave groups is consistent with that.
People are getting that it’s not necessary to [only] pursue AA to recover. You can do it in all sorts of ways.