Peer support and 2-year abstinence in alcohol use disorder: A nationwide prospective cohort study in recovery-support facilities.

AIM: Peer support is considered an important component of recovery for individuals with alcohol use disorder (AUD); however, peer-support factors associated with sustained long-term abstinence remain unclear. Therefore, we examined the association between 2-year complete abstinence and peer-support factors among individuals with AUD at Drug Addiction Rehabilitation Centers (DARCs) nationwide in Japan. METHODS: This secondary analysis utilized data from a nationwide prospective cohort study of DARC users with AUD. Eligible participants were individuals with AUD, and trainee staff were excluded. Baseline data were collected via self-administered questionnaires; follow-up assessments were conducted at 6-month intervals over 2 years. Peer-support variables included program participation, relationships with peers and staff, and exposure to recovery role models. Multivariable analyses were performed using generalized estimating equations. RESULTS: This study included 159 individuals with AUD from 36 facilities (mean age: 51.0 ± 11.1 years; 96.2% male). The 2-year complete abstinence rate was 45.9%, with 55.3% abstinent at 1 year. Positive relationships with other users (adjusted odds ratio [aOR]: 3.35, 95% confidence interval [CI]: 1.63-6.88) and exposure to recovery role models (aOR: 2.12, 95% CI: 1.26-3.54) were significantly associated with 2-year complete abstinence. Sensitivity analyses yielded consistent findings. CONCLUSION: Among individuals with AUD utilizing recovery-support facilities, positive peer relationships and exposure to recovery role models were strongly associated with maintaining abstinence over 2 years. These findings highlight the importance of peer-oriented recovery-support within community-based treatment systems.