A few years back in a city far, far away, I asked a consultant addiction psychiatrist why he did not refer any of his patients to NA. “There’s not a shred of evidence that it works,” he said. Even then he was misinformed, but I’ve thought many times since then about how his patients were denied an opportunity to try mutual aid out for themselves. I occasionally ask mutual aid fellowship members if they were referred there by professionals. A minority are.
A study in the US sought to uncover how many military veterans were referred to NA in such a way. The authors were well aware of the high incidence of post traumatic stress disorder (PTSD) in veterans and spotted a gap in the evidence base. Despite the evidence that interpersonal support can help relieve the symptoms of PTSD, nobody had looked at whether Narcotics Anonymous membership had anything to offer.
What did they do?
The NA World Services Office identified 16 meetings likely to have veterans as members and facilitated the delivery of a survey. Of the 508 NA members participating 172 were veterans and 336 were non-veterans. All completed a discreet questionnaire with veterans answering supplementary questions on their military experience. Uptake was estimated to be over 90%, something quite remarkable for this type of research.
- 70% were male;
- average age was 47;
- 10% homeless;
- 83% – at least one arrest;
- 54% history of IV drug use;
- average length of abstinent recovery was nearly nine years;
- two thirds had been in outpatient treatment before, and the same proportion had undergone in-patient treatment.
Narcotics Anonymous Participation
Only a third of folk had been referred to NA by a professional. 69% had been to 90 or more meetings in the past year. Nine out of ten had performed NA service, and the same number had a sponsor.
Narcotics Anonymous for Military Veterans
34% of respondents had been in the military with most serving as regular personnel. Almost half had served in a combat zone with around one in five suffering injury. Veterans tended to be older than non-vets, but their average duration of abstinence was the same. They were more likely than non-vets to have been referred to NA by a professional (77% vs. 27%) but tended to be less involved in the NA programme. The veterans tended to have significant mental health problems including PTSD symptoms
A few things struck me about this paper. One was the willingness of The World Service Office of NA to participate in the research – something that is hopeful for future mutual aid research. The drugs of choice of the US NA members in this study look to be different to those used by ‘typical’ NA members here. Crystal meth, crack and powder cocaine won’t feature much here, but benzos (not a problem in this sample) would certainly be a problem drug for Scottish members. There’s the obvious potential bias in the sample in that the NA World Services Office selected the meetings where Veterans were likely to be. This means that those in the study may not be representative and as I’ve said there will be limitations about how much this would apply in the UK.
Look at the high referral/uptake rate into NA by professionals for the veterans group compared to non-vets. Given that assertive referral techniques are easy to apply, I wonder how well we could do in the UK in this regard. Of course we have a fair bit to do with raising awareness and overcoming resistance.
“NA apparently can serve as a recovery resource for certain veterans with SUD [substance use disorder], with or without PTSD.”
Galanter M, Dermatis H, & Sampson C (2014). Narcotics anonymous: a comparison of military veterans and non-veterans. Journal of addictive diseases PMID: 25115224