Substance user’s social connections: Family, friends, and the foresaken

"How clients change their social connections after treatment is a strong indicator of substance-abuse outcomes one year and three years later," said Robert L. Stout, Ph.D., senior scientist and center director of the Decision Sciences Institute at the Pacific Institute for Research and Evaluation. "[We were interested in] why clients make good versus poor social choices." Stout will present his research at the 39th Annual Research Society on Alcoholism in New Orleans June 25-29, 2016.

"While clinicians have long urged clients to avoid 'bad' social contacts and foster 'good' ones, many relationships mix 'bad' and 'good' elements, and helpful connections may be lost at a time when they could be most useful," said Stout. "Clinicians lack specific guidance to target their therapeutic interventions to maximize impact on outcome. This study is designed to begin to provide the foundations for such guidance."

The presentation will provide preliminary results from a large (N=300) study following outpatient drug and alcohol clients for two years to examine how changes in new and old relationships are linked to substance abuse. The research focus was on factors associated with relationship breakups, observing how different types of relationships affect and are affected by substance use. The researchers also looked at how relationship changes ultimately affected treatment outcomes.

Findings confirm that the links between substance use and social connections are bidirectional and strong. Nearly 20 percent of relationship terminations are attributable to connections that pose a relapse risk to the client, while around 10 percent occur because of the client's continued use of substances. Family and partner relationships are the least likely to end (roughly 20% over two years), but about half of friendships seem to end over the span of two years.

"Alcohol problems involve biological, psychological, and social aspects," said Stout. "Our data show that social mechanisms substantially affect clinical outcomes over long periods of time, and deserve research attention comparable to biological and psychological factors. This underlines the importance of investigating how we can address social mechanisms in treatment to improve outcomes. The data also remind us that substance abuse strongly affects families and friends of alcohol abusers, accounting for much of the harm due to alcohol abuse. Therefore, intervening in the social connections of alcohol abusers may help to mitigate the damage done by alcohol misuse." Future reports, he said, will address new and/or renewed relationships.