Age differences in outcomes among patients in the “STimulant Abuser Groups to Engage in 12-Step” (STAGE-12) intervention.

Emerging adults (roughly 18-29 years) with substance use disorders can benefit from participation in twelve-step mutual-help organizations (TSMHO), however, their attendance and participation in such groups is relatively low. Twelve-step facilitation therapies, such as the Stimulant Abuser Groups to Engage in 12-Step (STAGE-12), may increase attendance and involvement, and lead to decreased substance use.

This study used data from the NIDA Clinical Trials Network STAGE-12 protocol (CTN-0031), a multisite randomized controlled trial, to examine whether age moderated the STAGE-12 effects on substance use and TSMHO meeting attendance and participation, The original STAGE-12 study involved assessments at baseline, mid-treatment (week 4), end-of-treatment (week 8), and 3- and 6-months post-randomization; participants were adults with DSM-IV diagnosed stimulant abuse or dependence (N=450) enrolling in 10 intensive outpatient substance use treatment programs across the U.S. A zero-inflated negative binomial random-effects regression model was utilized to examine age-by-treatment interactions on substance use and meeting attendance and involvement.

Analyses found that younger age was associated with larger treatment effects for stimulant use. Specifically, younger age was associated with greater odds of remaining abstinent from stimulants in STAGE-12 versus Treatment-as-Usual; however, among those who were not abstinent during treatment, younger age was related to greater rates of stimulant use at follow-up for those in STAGE-12 compared to TAU. There was no main effect of age on stimulant use. Younger age was also related to somewhat greater active involvement in different types of TSMHO activities among those in STAGE-12 versus TAU. There were no age-by-treatment interactions for other types of substance use or for treatment attendance, however, in contrast to stimulant use; younger age was associated with lower odds of abstinence from non-stimulant drugs at follow-up, regardless of treatment condition.

Conclusions: These results suggest that STAGE-12 can be beneficial for some emerging adults with stimulant use disorder, and ongoing assessment of continued use is of particular importance. More targeted research addressing the differences between younger and older adults and their unique responses to treatment is needed, so that developmental variations can be considered in the provision of substance abuse treatment. Age-appropriate treatment could have considerable effects on clinical outcomes and public health.

Related protocols: CTN-0031