The impact of changes in social support on substance use outcomes among treatment seeking women
Creators: name: Peyser, Deena
Publisher: name: No Publisher Supplied
Year: 2019

description: Social support is a complex construct that plays an important role in promoting and sustaining abstinence among individuals with alcohol and substance use disorders. Social support networks naturally or purposefully change during substance use treatment and these changes may influence treatment outcomes. Increased recognition of the dynamic nature of social factors that can impact treatment outcomes among women with substance use disorders may allow for more tailored treatment interventions. This study focused on characterizing and comparing the composition of women’s social support networks at the beginning and end of a 12-week substance use intervention. Predictors of abstinence at treatment completion were examined with a novel focus on changes in social support that occur over treatment. Finally, the comorbidity of depression and whether it moderates the relationship between social support and substance use outcomes was explored. Participants included 52 women, ages 18 and older, enrolled in an intensive outpatient substance use treatment program. Given high attrition rates, multiple imputation was performed to address missing data, thus maximizing the data available for analysis. Within-subjects paired t-tests were used to assess changes in social support from baseline to treatment completion. Regression analyses were used to analyze the relationship between social support (at baseline, treatment completion, and change) and substance use outcomes (abstinence and drinks per drinking days (DDD)) at treatment completion. The results showed that network size significantly increased, but the percent of high risk (HR) users remained stable over treatment. There was a significant decrease in the percent of women and an increase in the percent of friends from work, per network, between the two time points. While the frequency of contact with HR users in networks remained stable over time, the frequency of contact with low risk (LR) users was not correlated over time and there was no significant association between percent of, and frequency of contact with, LR users at either time. Rates of abstinence increased significantly, yet baseline percent days abstinent was the only significant predictor of abstinence at treatment completion in the models examined. None of the baseline, treatment completion, or change variables was a significant predictor of DDD. Depression severity did not moderate the relationship between social support and substance use outcomes. The lack of significant network effects may be due to high dropout rates and limited power. In conclusion, this study focused on an understudied population and sheds light on the structure of social support networks among women at the start and completion of a substance use treatment program, as well as on changes in network composition over time. Future studies may investigate the impact of changes in social support on substance use using larger samples and assess post-treatment time points to ascertain whether long-term interventions focusing on social support may be beneficial. This knowledge may offer insight into the social support factors that influence abstinence among high risk women with alcohol and drug use disorders.