Explaining abstinence rates following treatment for alcohol abuse: a quantitative synthesis of patient, research design and treatment effects

Abstract

We examined the relationships of treatment, patient and research design characteristics to treatment outcome (i.e. abstinence rates) in a sample of 150 treatment conditions drawn from 100 alcohol treatment outcome studies published between 1980 and 1992. Treatment characteristics were related to abstinence rates: more intensive treatments had higher abstinence rates than less intensive treatments, whereas treatments with an expressed goal other than abstinence had lower abstinence rates than treatments with an abstinence goal. When the public vs. private ownership status of the treatment facility was taken into account, the presence of behavioral elements in the treatment condition also was related to higher abstinence rates. Because of inconsistent reporting in primary studies, we assessed the effects of only one patient pre-treatment characteristic; treatment conditions with a higher proportion of socially stable patients had better outcomes. Research design characteristics were also related to abstinence rates. Treatment conditions with shorter follow-ups and treatments drawn from studies that did not use criteria to exclude more impaired subjects had better outcomes. We discuss possible reasons why our findings regarding the effects of treatment intensity and the use of exclusionary criteria differ from those in previous reviews.

Blocking Dopamine D1-Like Receptors Attenuates Context-Induced Renewal of Pavlovian-Conditioned Alcohol-Seeking in Rats

“…Relapse is a significant problem faced by people with alcohol abuse disorders (McLellan et al, 1994; Monahan and Finney, 1996; Miller et al, 2001). Relapse can be facilitated by craving for alcohol (Evren et al, 2010), which may be elicited by alcohol-predictive environmental cues (Ludwig, & Wikler, 1974; Fox et al, 2007).…”

Frontal White Matter Integrity Predictors of Adult Alcohol Treatment Outcome

“…This feature is emphasized by the high rates of posttreatment relapse such that over 50% of individuals treated for AUD resume drinking at harmful levels within 1 year (2,3). With such high rates of resumption of use and in an effort to develop more targeted treatments, it is important to investigate the constellation of factors that contribute toward relapse.…”

Meta-analyses in alcohol and other drug abuse treatment research

“…Several meta-analyses have been conducted within the last decade on alcohol and other drug abuse treatments (Levin & Lehman, 1991;Agosti, 1994Agosti, , 1995Tonigan, Toscova & Miller, 1994;Edwards & Steinglass, 1995;Wells-Parker et al, 1995;Malec, Malec & Doniger, 1996;Monahan & Finney, 1996;Stanton & Shadish, 1997;Prendergast, Podus & Chang, 2000). For each meta-analysis Table 1 highlights the treatment(s) evaluated, the treatment population and the number of studies synthesized.…”

“…Furthermore, the conclusions drawn based on the vote-counts are potentially misleading. Monahan & Finney's (1996) meta-analysis examined the relationship between abstinence rates following alcohol treatment, treatment characteristics, patient characteristics and research design. Since they were interested solely in the relationships between these variables, not the effectiveness of alcohol treatment per se, they unyoked treatment and comparison groups, treating each separately in the analysis.…”