The clinical implications of these findings are two-fold. First, as has been reported previously (Tonigan et al, 2003), regardless of the type of formal treatment, attending AA is likely to enhance abstinence. Second, whether patients attend AA or not, clinicians may wish to emphasize, in particular, the avoidance of former drinking acquaintances. Further, active engagement with abstinent acquaintances may provide an additional benefit. This emphasis on increasing alternative (non alcohol-related) rewarding social ties is a principal goal in well-supported approaches to treating addiction (e.g., the Community Reinforcement Approach; Azrin, 1976; Azrin et al., 1982). Regarding intensity of alcohol use (i.e., DDD), our analyses found mediational effects for reductions in pro-drinking ties only. The pattern of findings suggests when it comes to heavy alcohol use and relapse, pro-drinking network ties are detrimental even in the presence of pro-abstinent ties, and AA appears to work at least partially in reducing drinking intensity by reducing pro-drinking social networks.
