A comparison of recovery benefits associated with participation in SMART Recovery, AA, both SMART and AA, or neither, following a new alcohol use disorder recovery attempt

Background Self-Management and Recovery Training (SMART Recovery or “SMART”) is an internationally known “second-wave” addiction recovery mutual-help organization that has grown over several decades. Despite this, little is known empirically about who uses SMART and how they fare on important alcohol-specific outcomes over time relative to individuals using more established options such as Alcoholics Anonymous (AA), or indeed those who utilize both SMART and AA, or neither. Greater knowledge could deepen understanding of the clinical and public utility of SMART in its own right and inform clinical referral options. Methods A naturalistic, longitudinal cohort study (N = 361) of individuals recruited between February 2019 and February 2022 who were initiating a new alcohol use disorder (AUD) recovery attempt and self-selected into one of four groups at study entry: (1) SMART Recovery; (2) AA; (3) SMART + AA; and (4) neither SMART nor AA. Assessments were conducted at intake, 3 months, and 6 months and measured a variety of alcohol/drug-related and functioning outcomes. Results Compared to the AA and Both groups, SMART Recovery pathway participants exhibited a pattern of less severe clinical pathology and legal system involvement histories, along with higher psychosocial stability and recovery capital. In terms of meeting attendance frequency, the SMART group did not attend as many meetings as the AA or Both groups, but nevertheless was able to achieve levels of improvement in alcohol indicators (i.e., fewer drinking days, fewer heavy drinking days, and fewer alcohol-related consequences) and rates of early AUD remission similar to those of the AA and Both groups. Conclusions SMART Recovery may provide a valuable alternative source of recovery-specific support that may be a good fit, particularly for certain individuals with AUD. As such, it serves as a valuable addition to the menu of available community-based recovery-support service options.