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Pathways to Long-Term Abstinence

Principal Investigator: Alexandre B. Laudet, PhD, NDRI

Co-Investigator:William L. White, MA, Chestnut Health Systems/Lighthouse Institute

Funding Source: National Institute on Drug Abuse Grant DA14409

Funding period: 9/30/02 - 5/31/09

Participation in substance abuse treatment has consistently proven effective in reducing substance use. However, treatment gains are often not maintained; relapse may occur rapidly after treatment ends and relapse risk remains high for several years. Affiliation with self-help groups (SH) been shown to extend treatment effects. Treatment and SH study findings bear on predictors of short-term abstinence; it is not known whether these findings can be generalized to long-term abstinence. Moreover, SH affiliation studies have typically used treatment samples of alcoholics (often white men) in Alcoholics Anonymous (AA). Little is known about the effects of SH affiliation among other groups of individuals, especially illicit polysubstance users who may attend Narcotics Anonymous rather than or in addition to AA. Illicit drug users differ from alcohol-dependent persons in critical ways that bear on long-term prognosis and the NA membership differs from AA. Even less is known about the change processes underlying the benefits of SH. The investigation of predictors of long-term abstinence will contribute to enhancing the likelihood of breaking the relapsing cycle of addiction by informing treatment, especially relapse prevention programs, and a longitudinal study of SH affiliation and its underlying processes will inform referral patterns for drug users, elucidate the critical ingredients of affiliation driving therapeutic benefits of SH, a widely used recovery resource, and provide valuable information about the dynamic process of change implicated in the resolution of addiction.

This application proposes a longitudinal community-based naturalistic investigation of the predictors of long-term abstinence from illicit drugs with special focus on SH affiliation and underlying change processes. The sample will be a cohort of abstinent individuals (N = 300) stratified by length of abstinence at recruitment (3- to 18-month and 18- to 36- months); subjects will be followed-up for 3 years. The aims are:

  1. To determine whether predictors of short-term abstinence can be generalized to long-term abstinence.
  2. To study longitudinal patterns of affiliation with self-help among illicit drug users.
  3. To examine the relationship between these patterns and the maintenance of long-term abstinence. [Aims 2 and 3 would constitute the 1st long-term, longitudinal investigation of self-help among illicit drug users not recruited in a treatment setting].
  4. To elucidate the processes underlying the demonstrated benefits of affiliation with self-help among drug user by testing a conceptual model building on and integrating previous findings.

Publications and Presentations:

Laudet, A., Savage, R. and Mahmood, D. (2002) Pathways to long-term recovery: A preliminary investigation. Journal of Psychoactive Drugs, 34(3), 305-311. View abstract

Laudet, A. and White, W. (2004) Toward A Recovery Research Agenda: Promises, Pitfalls and Preliminary Experience. Presented at the 47th International Conference of the International Council on Alcohol and Addictions, Venice, Italy

Laudet, A. and White, W. (nov. 2004) An Exploration of Relapse Patterns Among Former Poly Substance Users. Presented at the 132nd Annual Meeting of the Amer. Public Health Association, Washington DC.

Laudet, A., White, W. and Morgen, K. (2005) Patterns and Predictors of Sustained Recovery Among Former Poly-substance Drug Users. Poster presented at the 677h Annual Scientific Meeting of the CPDD, Orlando

Laudet A., White, W. (sept. 2005) The Role of Spirituality, Faith and Life Meaning in the Addiction Recovery Process. 28th Congress of the World Federation for Mental Health (WFMH) – Cairo, Egypt

Laudet, A., White, W., & Morgen, K. (2005) What does recovery mean to you? Definition, goals, and experiences from the recovering community. 133rd  Annual Meeting of the APHA, Philadelphia

Laudet, A., Morgen, K., & White, W. (2006) The role of Social Supports, Spirituality, Religiousness, Life Meaning and Affiliation with 12-step Fellowships in Quality of Life Satisfaction among Individuals in Recovery from Alcohol and Drug Use. Alcoholism Treatment Quarterly, 24: ½, 33-74.
View abstract
Click here for free full text in pub med central

Laudet and White. Three-year patterns of 12-step attendance and involvement as predictors of stable recovery from polydrug use. Poster presented, 68th Annual Scientific Meeting of the College on Problems of Drug Dependence (CPDD), Scottsdale, AZ, 6/06

White and Laudet. Life meaning as potential mediator of 12-step participation benefits on stable recovery from polysubstance use. Poster presented, 68th Annual Scientific Meeting of the College on Problems of Drug Dependence (CPDD), Scottsdale, AZ, 6/06

Laudet, A. and White, W. (2006) Quality of life and addiction recovery: Patterns and determinants. Presentation at the annual meeting of the International Society for Quality of Life Research, Lisbon, Portugal, Oct 10-14.

Laudet, A. and White, W. (2007) Predicting sustained remission from polysubstance use: A three-year follow-up study. Poster presentation at the 69th Annual Scientific Meeting of the College on Problems of Drug Dependence (CPDD), Quebec, Canada.

Laudet, A. and White, W. (2008) Deconstructing 12-step involvement as predictor of sustained abstinence from polydrug use. Presented at the 70th Annual Scientific Meeting of the College on Problems of Drug Dependence (CPDD), San Juan, Puerto Rico.

Laudet, A. (2007) What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment, 33(3): 243-256.

Laudet, A. & White, W.. (2008) Recovery Capital as Prospective Predictor of Sustained Recovery, Life satisfaction and Stress among former poly-substance users. Substance use and Misuse, Vol. 43(1), 27-54.

Laudet, A., Becker, J. & White, W. (2009) Don't wanna go through that madness no more: Quality of life satisfaction as predictor of sustained substance use remission. Substance use & Misuse, 44(2),227-252.

Laudet, A (2008) The Road to Recovery: Where are we going and how do we get there? Empirically-driven conclusions and future directions for service development and research. Substance Use & Misuse, 43 (12/13), 2001-2020.

Laudet, A (2008) Introduction to Special Issue on International Perspectives on Recovery: Substance Use and Misuse 43 (12/13), 1681-1684.

Press Release:

Scientific study of recovery process sheds new light on role of spirituality. February 27, 2006.

First Large-Scale Study Exploring Addiction Recovery from a Lived Experience Perspective. September, 2007.

 

For additional information on this project, please contact us

The Center for the Study of Addictions and Recovery is part of the Institute for Treatment and Services Research.