Initial Preference for Drinking Goal in the Treatment of Alcohol Problems: II. Treatment Outcomes

Adamson, Simon J.; Heather, Nick; Morton, Veronica; Raistrick, Duncan

doi:10.1093/alcalc/agq005

Cited by 109 publications

(96 citation statements)

References 24 publications

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“…Consistent with previous studies (e.g., Adamson et al, 2010;Hodgins, Leigh, Milne, & Gerrish, 1997;Meyer, Wapp, Strik, & Moggi, 2014), clients with at-risk alcohol consumption choosing abstinence showed higher rates of successful treatment outcomes at both follow-up assessments. This difference also remained significant, when controlling for baseline differences between the two goal groups.…”

Section: Discussionsupporting

confidence: 89%

“…Substantial reductions in alcohol consumption were achieved in both intervention approaches. However, the patients maintaining abstinence for a longer time period only contributed marginally to this effect (Adamson, Heather, Morton, & Raistrick, 2010;Heather, Adamson, Raistrick, & Slegg, 2010). Furthermore, clients preferring abstinence differed from clients who expressed a preference for non-abstinence.…”

Section: Introductionmentioning

confidence: 95%

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Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment

Haug

Eggli

Schaub

2016

Substance Use & Misuse

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Background: Few studies have compared characteristics of clients entering alcohol treatment who differ in their drinking goal preferences or have investigated the relevance of drinking goals as a predictor of treatment outcomes. Objectives: To investigate associations between baseline drinking goal preferences and client characteristics as well as treatment retention and outcomes among clients in outpatient alcohol treatment. Methods: Secondary data analyses on a longitudinal multicenter study investigating the effectiveness of outpatient alcohol treatment in Switzerland among 805 clients. Assessments were conducted at treatment admission, discharge, and at 6-and 12-month follow ups. At-risk drinking was assessed through the alcohol use disorders identification test. Treatment retention was defined as regular discharge with or without transition into another institution. Results: Clients aiming to abstain from drinking were more likely to be in retreatment, to be assigned to treatment by a health institution, to have no at-risk alcohol use, and to be already alcohol abstinent at the time of admission relative to clients who aimed to control their drinking. Clients without at-risk alcohol use at admission showed higher treatment retention when aiming for controlled drinking than for abstinence, while there was no difference in treatment retention among clients with at-risk use. Clients with at-risk use at admission were more likely to reach not-at-risk alcohol use status when aiming for alcohol abstinence than for controlled drinking.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 95%

Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment

Haug

Eggli

Schaub

2016

Substance Use & Misuse

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“…In other studies of alcohol-dependent or alcohol-abusing individuals, mostly in alcohol treatment settings but also in primary care-only settings, investigators found associations between a drinking goal of abstinence and improved alcohol use outcomes. [13][14][15][16][17] Finally, although not in a purely primary care setting, a trajectory-based investigation of alcohol use before treatment assignment among alcohol-dependent individuals revealed that very frequent drinkers, defined as a 75% probability of any alcohol use on a given day, benefited from acamprosate in that they were more likely to abstain from heavy drinking during the past 2 months of treatment. 18 In that same investigation, very frequent drinkers also benefited from the medication naltrexone in that they were more likely to be continuously abstinent.…”

mentioning

confidence: 99%

Alcohol Use Disorder Treatment: The Association of Pretreatment Use and the Role of Drinking Goal

Berger

Brondino

Fisher

et al. 2016

The Journal of the American Board of Family Medicine

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Background: In a recent study conducted in a family medicine setting, the medication acamprosate was found not to be efficacious in the treatment of alcohol dependence, but a drinking goal of abstinence was found to have positive effects on alcohol use outcomes. The purpose of this secondary analysis was to further understand which patients with an alcohol use disorder may be most successfully treated in a primary care setting.Methods: The study was exploratory and used a trajectory-based approach based on data from the acamprosate treatment trial of 100 participants (recruited mostly by advertisement) who were randomly assigned to receive either acamprosate or a matching placebo. Post hoc trajectories of alcohol use before treatment were identified to examine whether trajectory classes and their interactions with treatment arm (acamprosate or placebo), pretreatment drinking goal (abstinence or a reduction), and time predicted alcohol use outcomes.Results: Three distinct trajectory classes were identified: frequent drinkers, nearly daily drinkers, and consistent daily drinkers. Consistent daily drinkers with a goal of abstinence significantly improved over time on the primary outcome measure of percent days abstinent when compared with frequent and nearly daily drinkers. In addition, all participants with a goal of abstinence, regardless of trajectory class, significantly reduced their percentage of heavy drinking days over time.

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“…Raittiustavoitteeseen päätyneiden on todettu py syvän raittiina tai ainakin kohtuudessa paremmin kuin muunlaisen tavoitteen valinneet (19)(20)(21)(22). Tässä tutkimuksessa enemmistö tutkittavista valitsi alussa raittiustavoitteen.…”

Section: Pohdintaunclassified

“…Tässä tutkimuksessa enemmistö tutkittavista valitsi alussa raittiustavoitteen. Vaikka vain kol mannes heistä säilytti raittiustavoitteen koko seurannan ajan, niin heillä oli aikaisempien tutki musten (19)(20)(21)(22) tavoin vähemmän runsasta alko holin käyttöä ja enemmän raittiutta kuin vähen tämisen tavoitteekseen valinneilla.. Terveys on tärkeä koettu syy alkoholin käytön lopettamiselle (1)(2)(3)(4)(5)(6). Tässä tutkimuksessa monet riippumatta alun tavoitteesta olivat raittiina useita kuukausia sairastumisen jälkeen ja uudelleen sairastumisen pelko näytti useilla hillitsevän alkoholin käyttöä myös pitkällä aikavälillä.…”

Section: Pohdintaunclassified

Muutoksen polku alkoholin käytössä alkoholihaimatulehduksen jälkeen – yhdeksän vuoden seurantatutkimus

Lappalainen-Lehto¹,

Koski-Jännes²,

Aalto³

et al. 2017

SLA

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Alkoholihaimatulehdus voi olla henkeä uhkaava ja alkoholin käytön lopettamista pidetään keskeisenä keinona ehkäistä uudelleen sairastumista. Tässä yhdeksän vuoden laadullisessaseurantatutkimuksessa kuvataan ensimmäiseen alkoholihaimatulehdukseen sairastuneiden (n=43) alkoholin käytölle asettamia tavoitteita, niiden toteutumista sekä kokemuksia muutokseen vaikuttaneista tekijöistä. Muutosta kuvataan kulkemisena erilaisilla poluilla (raittius, lähes raittius, kohtuus, kivikko). Raittiustavoitteen alussa valinneilla oli vähemmän runsasta alkoholin käyttöä ja enemmän raittiutta, vaikka heistä vain kolmannes säilytti raittiustavoitteen koko seurannan ajan. Myös juomisen vähentämisen valinneilla käyttö väheni ja lähes puolet heistä pysyi kohtuudessa seurannan ajan. Terveysongelmat koettiin keskeiseksi syyksi raittiuteen sitoutumiseen ja halu elää normaalia sosiaalista elämää syyksi raittiuden tavoittelusta luopumiseen. Pelko haimatulehduksen uusimisesta voi hillitä alkoholin käyttöä myös pitkällä aikavälillä vaikka henkilö ei haluaisi tai pystyisi sitoutumaan raittiuteen. Vuosittaiset seurantakäynnit sairaalassa saattoivat muistuttaa sairastumisesta ja siten edistää tavoitteen saavuttamista. Jatkossa tarvitaan lisää pitkän aikavälin tutkimusta alkoholiongelmasta selviytymiskeinoista alkoholihaimatulehdukseen sairastumisen jälkeen.

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Initial Preference for Drinking Goal in the Treatment of Alcohol Problems: II. Treatment Outcomes

Abstract: The client's personal drinking goals should be discussed in assessment at treatment entry and as a basis for negotiation. Clinicians should be prepared to identify and support goal change as an unexceptional part of the treatment process that need not jeopardize good outcome.

Cited by 109 publications

References 24 publications

Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment

Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment

Alcohol Use Disorder Treatment: The Association of Pretreatment Use and the Role of Drinking Goal

Muutoksen polku alkoholin käytössä alkoholihaimatulehduksen jälkeen – yhdeksän vuoden seurantatutkimus

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