Interaction between narcotics anonymous and medications for opiate use disorder among 4382 United States survey...

Individuals with opioid use disorders have historically been undertreated for their disease. These individuals may benefit from integrated treatment approaches that combine psychosocial counseling, medication for opioid use disorders (MOUD), and participation in mutual aid support groups. However, there are many barriers to integration of these recovery support modalities, including stigma and bias against MOUD within the Twelve Step community. The objective of the current study is to investigate the experience of Narcotics Anonymous (NA) members whose primary drug problem was opioids, some taking MOUD, while participating in Twelve Step meetings.

Narcotics Anonymous Worldwide Services (NAWS) conducts a triennial membership survey that is available to all members, either online or at their international membership conference. A sample of U.S. based members whose primary drug of SUD was opioids was identified (N = 4382). The sample was analyzed as a whole, as well as subdivided into groups based on utilization of MOUD and medications to treat addiction. In order to aid and improve treatment, groups were compared and characterized based on responses to a 37-item survey that included demographics, substance use history, NA involvement, and psychosocial adjustment.

Of the sample analyzed, 944 (22.4%) were on medication for addiction when they attended their first NA meeting, and 322 (7.3%) reported MOUD use at the time of the survey. Members with past opioid addiction who were currently taking MOUD had fewer years as NA members, lower rates of sponsorship (62.9% versus 93.7%), higher rates of attendance to addiction treatment (94.0% versus 83.2%), and higher rates of taking medication for mental health issues (60.4% versus 28.8%) compared to members not taking MOUD. Members who had taken medication to treat addiction, past or present, did not statistically differ from members who had not taken medication to treat addiction regarding stable housing, educational advancement, or improved familial relationships.

In order to aid in improving treatment, we distinguished characteristics of community NA members who report opioid use as a primary problem, (a) who have experience with MOUD, from (b) those who do not have experience with MOUD.