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This analysis examines patient experiences and outcomes with 12-step recovery group attendance during buprenorphine maintenance treatment (BMT), two approaches with traditionally divergent philosophies regarding opioid medications for treatment of opioid use disorder. Using quantitative (n = 300) and qualitative (n = 20) data collected during a randomized trial of counseling services in buprenorphine treatment, this mixed-methods analysis of African Americans in BMT finds the number of NA meetings attended in the prior 6 months was associated with a higher rate of retention in BMT (p < .001) and heroin/cocaine abstinence at 6 month follow-up (p = .005). However, patients whose counselors required them to attend 12-step meetings did not have better outcomes than patients not required to attend such meetings. Qualitative narratives highlighted patients' strategies for managing dissonant viewpoints on BMT and disclosing BMT status in community 12-step meetings. Twelve-step meeting attendance is associated with better outcomes for BMT patients over the first 6 months of treatment. However, there is no benefit to requiring meeting attendance as a condition of treatment, and clinicians should be aware of potential philosophical conflicts between 12-step and BMT approaches., (Copyright © 2015 Elsevier Inc. All rights reserved.)

There are four main ideas in relapse prevention. First, relapse is a gradual process with distinct stages. The goal of treatment is to help individuals recognize the early stages, in which the chances of success are greatest. Second, recovery is a process of personal growth with developmental milestones. Each stage of recovery has its own risks of relapse. Third, the main tools of relapse prevention are cognitive therapy and mind-body relaxation, which are used to develop healthy coping skills. Fourth, most relapses can be explained in terms of a few basic rules. Educating clients in these rules can help them focus on what is important: 1) change your life (recovery involves creating a new life where it is easier to not use); 2) be completely honest; 3) ask for help; 4) practice self-care; and 5) don't bend the rules.

Two chapters in Liber Novus throw fresh light on Jung's epistemology of addiction. Taking these as a starting point, the nature of the challenges that patients confront in leaving addiction behind are explored. It is suggested that an archetypal process of separation is constellated at the point of quitting as the precursor to a life without the object of the addiction. A short account is given of Jung's part in the inception of Alcoholics Anonymous and the potential role of a 'conversion experience' as an initiation into psychological reorientation away from the negative individuation experienced by the hero. The case of a patient addicted to heroin illustrates the contribution of an analytic approach in an NHS setting, along with other workers in a rehabilitation centre. Certain challenges of working with addicted people are outlined, including arousal of the psychotherapist's rescue fantasies., (© 2015, The Society of Analytical Psychology.)

Objective: Therapeutic interventions can be classified into two distinct approaches: abstinent and maintenance method. Currently, there are no clear criteria for referring addicted patients to one of these modalities. We aimed to compare the personality characteristics of individuals with addiction who attended narcotics anonymous sessions with those who received methadone maintenance therapy., Methods: This was a cross- sectional study. The participants were NA members and patients who were undergoing methadone maintenance treatment in outpatient clinics. Using the randomized cluster sampling method, 200 individuals with opioid dependence were selected (each group 100 persons). Data were collected through a demographic questionnaire and the five-factor personality inventory (NEO-FFI). Comparison of the mean scores of NEO-PPI in the two groups was performed by independent t test, and qualitative variables were compared using the Chi-square test., Results: We found a significant difference between the MMT and NA groups with respect to neuroticism, extroversion, and agreeableness. No significant difference was found in the subscales of conscientious and openness., Conclusion: People who regularly attended the NA sessions had lower neuroticism and higher agreeableness than patients who were under the maintenance modality. Whether this is the cause or effect of attending NA sessions requires future large-scale cohort studies.

Substance use disorder, which is often comorbid with post-traumatic stress disorder (PTSD), is a problem confronted by many veterans. To determine the potential utility of Narcotics Anonymous (NA) for veterans, 508 NA attendees were studied. Veterans (n = 172) were more likely to have been referred by a professional than were non-veterans (77% vs. 27%, respectively); 70% had been hospitalized for alcohol or drug problems, and 51% had been treated for non-substance psychological problems. The 70% of veterans who reported at least 1 of 3 service-related stressful experiences were more likely to report PTSD-related symptoms. NA can serve as a recovery resource for certain veterans with substance use disorders, with or without PTSD.

Research investigations on twelve-step groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have addressed a number of resources associated with 12-step recovery. However, little is known about the role of wisdom, and whether aspects of 12-step participation might increase this resource among 12-step members. An exploratory analysis revealed that participants who reported having a "spiritual awakening" and considered themselves "members" of 12-step groups reported significantly higher levels of wisdom. Twelve-step meeting attendance was not significantly related to wisdom scores. Findings suggest certain aspects of 12-step involvement are associated with wisdom and may play a role in substance abuse recovery.