ABSTRACT
Alcohol and other substance use disorders (SUD) are highly prevalent psychiatric conditions in most developed and many developing nations, conferring a prodigious burden of disease, disability, and premature mortality (World Health Organization 2014). During the past 50 years, increased substance-related harms have been accompanied by developments in clinical science and effective psychosocial and pharmacological treatments. While the advancements in professional care have been immensely valuable, the feasibility of managing these chronic disorders on a purely professional basis has been economically challenging. Professional services are typically only available during weekday business hours and delivered in an acute care format ending after a few weeks or months. The cost, rigidity, and time-limited nature of professional services, together with growing awareness of the long-term vulnerability to relapse for individuals suffering from SUD, has seen subsequent expansion of freely available community-based twelve-step mutual-help organizations (TSMHOs), such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) and many others, during the past fifty years (Kelly and White 2012). These organizations can serve as flexible long-term addiction recovery management resources and, from an intervention dissemination and impact perspective (e.g., Glasgow et al. 2003), have a wide reach available in most communities, appear to be readily adopted and implemented, and have been shown to have evident staying power existing and growing for more than 80 years (Kelly and Yeterian 2014).
