12‐step programs for reducing illicit drug use

This Campbell systematic review examines the effectiveness of 12‐step programs in reducing the use of illicit drugs. The review summarises findings from 10 studies, nine of which were conducted in the United States. The main evidence presented in this review suggests that 12‐step programs for reducing illicit drug use are neither better nor worse than other interventions. This conclusion should be read with caution given the weakness of the evidence from the studies. The power to detect a difference between the 12‐step interventions and alternative psychosocial interventions was low and the estimated effect sizes were small. Many studies failed to adjust for the fact that the intervention is administered to groups, and so may overestimate effects. Given all these shortcomings, further evidence regarding the effectiveness of this type of intervention, especially in self‐help groups, is needed. Executive summary Background The effects of substance dependence have serious implications for the individual, the family and friends of the substance dependent individual, andsociety at large. Practitioners and public health policy makers have an interest in finding effective treatments that are also cost‐effective. This review examined the effectiveness of 12‐step programs aimed at illicit drug dependent participants compared to no intervention, treatment as usual, and other interventions. Objectives The main objective of this review was to systematically evaluate and synthesise effects of 12‐step interventions for participants with illicit drugdependence against no intervention, treatment as usual, and alternative interventions. The primary outcome of interest was drug use. Secondary outcomes of interest comprised criminal behaviour, prostitution, psychiatric symptoms, social functioning, employment status, homelessness and treatment retention. Search methods An extensive search strategy was used to identify studies meeting inclusion criteria. We searched electronic bibliographic databases in January 2010, October 2011, July 2013,August 2015, and September 2016. Searches for this review were performed on multiple international and Nordic databases. In total 11 databases were searched including PsycInfo, SocIndex, and Medline. A substantial range of grey literature sources were searched including governmental repositories, targeted web sites and trial registers. We checked the reference lists of primary studies, hand‐searched relevant key journals, and searched the