Peer support and 2-year abstinence in alcohol use disorder: A nationwide prospective cohort study in recovery-support...

Peer support is considered an important component of recovery for individuals with alcohol use disorder (AUD); however, peer-support factors associated with sustained long-term abstinence remain unclear. Therefore, we examined the association between 2-year complete abstinence and peer-support factors among individuals with AUD at Drug Addiction Rehabilitation Centers (DARCs) nationwide in Japan.

This secondary analysis utilized data from a nationwide prospective cohort study of DARC users with AUD. Eligible participants were individuals with AUD, and trainee staff were excluded. Baseline data were collected via self-administered questionnaires; follow-up assessments were conducted at 6-month intervals over 2 years. Peer-support variables included program participation, relationships with peers and staff, and exposure to recovery role models. Multivariable analyses were performed using generalized estimating equations.

This study included 159 individuals with AUD from 36 facilities (mean age: 51.0 ± 11.1 years; 96.2% male). The 2-year complete abstinence rate was 45.9%, with 55.3% abstinent at 1 year. Positive relationships with other users (adjusted odds ratio [aOR]: 3.35, 95% confidence interval [CI]: 1.63-6.88) and exposure to recovery role models (aOR: 2.12, 95% CI: 1.26-3.54) were significantly associated with 2-year complete abstinence. Sensitivity analyses yielded consistent findings.

Among individuals with AUD utilizing recovery-support facilities, positive peer relationships and exposure to recovery role models were strongly associated with maintaining abstinence over 2 years. These findings highlight the importance of peer-oriented recovery-support within community-based treatment systems.