The Paucity of Attention to Narcotics Anonymous in Current Public, Professional, and Policy Responses to Rising Opioid Addiction

Latent class analysis of perceived stigma among older adults receiving medications for opioid use disorder

RATIONALE

Public stigma surrounds individuals who use medication for their recovery from a substance use disorder. However, we know little about subgroups of individuals with varying levels of perceived stigma and how these levels may be associated with physical and mental health-related quality of life (HRQOL) and social support.

METHODS

We used latent class analysis to define subgroups of people aged 50-72 years of age (N = 104) who were enrolled in eight medication for opioid use disorder (MOUD) programs to explore subgroupings and correlates of group membership.

RESULTS

We found evidence for three distinct classes of individuals and named the classes 1) the high stigma class, 2) the embarrassed class, and 3) the low stigma class. We found that people in the high-stigma class reported more rejection, more abstinence-based support group involvement, and reduced mental HRQOL.

CONCLUSIONS

Results suggest reducing stigma among people on MOUD may help to boost mental HRQOL and improve social support receipt. The results are consistent with iatrogenic effects of AA/NA support groups such that these treatment modalities may increase stigma due to their focus on abstinence-only treatment for substance use disorders.

The Protective Wall of Human Community: The New Evidence on the Clinical and Public Health Utility of Twelve-Step Mutual-Help Organizations and Related Treatments

Mutual-help organizations (MHOs) such as alcoholics anonymous (AA) are the most commonly sought source of help for alcohol and other drug (AOD) problems in the United States. Popularity, however, is not commensurate with efficacy; hence, following a call for more rigorous research on AA and 12-step treatments from the Institute of Medicine in 1990 a flurry of clinical trials, cost-effectiveness analyses, and mechanisms studies, have been published during the past 30 years. This body of work has now revealed the true clinical and public health utility attributable to these freely available resources in aiding addiction remission and recovery. AA, and possibly similar organizations, may be the closest thing public health has to a "free lunch" in terms of their ability to facilitate higher rates and longer durations of sustained remission while substantially reducing health care costs.

"Personal recovery depends on NA unity": an exploratory study on recovery-supportive elements in Narcotics Anonymous Flanders

BACKGROUND

Mutual aid organizations, such as Narcotics Anonymous (NA), can provide support in substance use disorder (SUD) recovery processes. However, research on NA and its recovery-supportive elements is scarce and perspectives of NA-members remain understudied, in particular outside the US. Therefore, this study aims to gain insight into recovery-supportive elements of NA, as experienced by its members.

METHODS

To explore the perspectives on and experiences with recovery-supportive elements in NA, 11 in-depth interviews with NA-members were conducted in Flanders (Belgium). Interviews were audio-taped, transcribed verbatim and analyzed by using CHIME-D, a personal recovery framework (Connectedness, Hope, Identity, Meaning in life, Empowerment, Difficulties) developed by Leamy and colleagues in 2011.

RESULTS

Various recovery-supportive elements of NA were highlighted, with Connectedness as a key component including opportunities for building up a social network and for providing a safety net or sounding board. Elements that enabled Connectedness were 1) a non-judgemental approach, and 2) mutual understanding through sharing in NA. Other elements of the CHIME-D framework were less frequently mentioned, although these were inextricably linked to Connectedness.

CONCLUSIONS

Connectedness appeared to be the crucial recovery-supportive element in NA, emphasizing the relational character of SUD recovery. Although other elements of the CHIME-D framework were identified, these were closely related to and intertwined with the concept of connectedness.

Cross-cultural Applicability of the 12-Step Model: A Comparison of Narcotics Anonymous in the USA and Iran

Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking recovery from addiction, reports 27,677 meetings in the USA, where it was founded, but there is limited literature on its adaptability cross-culturally. We studied NA within the Islamic Republic of Iran to ascertain its relative adaptation in a different cultural setting.

The Opioid Epidemic in West Virginia

The rate of overdose related to the use of licit and illicit opioids has drastically increased over the last decade in the United States. The epicenter has been West Virginia with the highest rates of overdoses accounting for 41.5 deaths per 100 000 people among the 33 091 deaths in 2015. The purpose of this research was to examine and analyze the cause of the opioid epidemic and subsequent responses to it in the state of West Virginia. This study conducted a literature review using 37 references that were published between the years 2009 and 2018, complemented with a semistructured interview. The number of people injecting drugs has increased from 36% in 2005 to 54% in 2015. The total US cost of prescription opioid abuse in 2011 has been estimated at $25 billion, and criminal justice system costs to $5.1 billion. The reasons for this opioid epidemic incidence in West Virginia have been a combination of sociocultural factors, a depressed economy, lack of education, and a high rate of prescribing and dispensing of prescription opioids.