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Washington Association of Alcoholism and Addiction Programs

Washington Association of Alcoholism and Addiction Programs. The Sixth Annual Providers Conference April 19-20, 2012. The Evidence for Abstinence. Mick Oreskovich MD FACS UW Clinical Professor of Psychiatry and Behavioral Sciences RCKC BOD 1997-.

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Washington Association of Alcoholism and Addiction Programs

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  1. Washington Association of Alcoholism and Addiction Programs The Sixth Annual Providers Conference April 19-20, 2012

  2. The Evidence for Abstinence Mick Oreskovich MD FACS UW Clinical Professor of Psychiatry and Behavioral Sciences RCKC BOD 1997-

  3. The absence of evidence is not the evidence of absence!

  4. Popular Perspectives on the Effectiveness of Alcoholics Anonymous • AA members: I know AA works and there is no need for research to prove that • AA critics: AA is a cult; have to believe in God; steps are a brain washing-Chris Prentiss (Passages) • Cochrane Review: lack of experimental evidence for effectiveness of AA and TSF • Send people to AAfirst not treatment (Moos et al, 2004)

  5. *Abstinence Associated with Regular AA Attendance *Adapted from Kaskutas: Alcoholics Anonymous Effectiveness: Faith Meets Science. 2009; Male VA Patients >3000; Ouimette et al.,1998; Thurstin et al.,1987

  6. *Abstinence Related to Meeting Frequency *Adapted from Kaskutas 2009 Male VA residential patients n = 2376 Moos et al., J Clin Psychol 2001

  7. Abstinence Associated with Meeting Frequency (adapted from Kaskutas 2009) Fiorentine1999: 250 outpatients

  8. Abstinence Related to “Dose” of AA (adapted from Kaskutas 2009) meetings 461 untreated drinkers Moos & Moos, J Clin Psychol 2006 Also see Moos & Moos, JSAT 2004

  9. AA versus Outpatient (adapted from Kaskutas 2009) a Ouimette et al., J Stud Alcohol 1998b Timkoet al., J Stud Alcohol 2000 aMale VA inpatients bPreviously untx prob drnkrs n= 3018 n= 466

  10. *Kaskutas 2009: Project Match: Randomize to TSF, Motivational Interview, CBT (outpatient only) p = .0024 p < .007 Project MATCH n= 806 outpatients at yr 3 PMRG, J Stud Alcohol 1997 PMRG, ACER 1998

  11. Randomize to TSF: Aftercare sample Project MATCH aftercare n = 714 at 1-year follow-up PMRG, J Stud Alcohol 1997

  12. Conclusions: • Rates of abstinence twice as high for those who attend AA • Higher levels of attendance relate to higher levels of abstinence • Prior AA attendance predictive of subsequent abstinence • Mechanisms of action predicted by theories of behavior change are evident at the meetings, in the 12 Steps, and in the Fellowship

  13. Thank You!moreskovich@psychiatricmedicine.comQuestions?

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