Is Controlled Drinking an Acceptable Goal in the Treatment of Alcohol Dependence? A Survey of French Alcohol Specialists

Luquiens, Amandine; Reynaud, Michel; Aubin, Henri‐Jean

doi:10.1093/alcalc/agr083

Cited by 56 publications

(33 citation statements)

References 21 publications

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“…This finding further supports the clinical relevance of the once controversial treatment goal of reducing consumption in alcohol-dependent patients [28], a concept which in recent years has gained increased acceptance [6,29,30]. …”

Section: Discussionsupporting

confidence: 73%

Clinical Relevance of As-Needed Treatment with Nalmefene in Alcohol-Dependent Patients

Aubin¹,

Reimer²,

Nutt³

et al. 2015

Eur Addict Res

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Nalmefene is the first drug approved for reduction of alcohol consumption. The aim of this study was to evaluate the clinical relevance of treatment with nalmefene in alcohol-dependent patients with a high drinking risk level from two randomised placebo-controlled 6-month studies (NCT00811720 and NCT00812461). Response criteria were based on alcohol consumption, Clinical Global Impression, and Short Form Health Survey mental component summary scores at month 6, analysed using logistic regression. The proportion of responders was higher in the nalmefene group than in the placebo group with odds ratios significantly in favour of nalmefene for all responder criteria; numbers-needed-to-treat ranged from 6 to 10. Significant differences from placebo in clinician-rated and patient-reported outcomes, and liver enzymes further supported the clinical relevance of the treatment effect. In conclusion, this study supports the clinical relevance of nalmefene treatment in patients with alcohol dependence. Nalmefene may help to reduce the alcohol-related burden and the large treatment gap, with currently less than 10% of alcohol-dependent patients in Europe receiving treatment.

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Section: Discussionsupporting

confidence: 73%

Clinical Relevance of As-Needed Treatment with Nalmefene in Alcohol-Dependent Patients

Aubin¹,

Reimer²,

Nutt³

et al. 2015

Eur Addict Res

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“…Furthermore, it should be noted that the literature does not offer consensus on the operational definition of drinking goal (Luquiens et al, 2011). Instead, the authors categorized responses to the Commitment to Abstinence item based largely on clinical judgment and prior research using this measure.…”

Section: Discussionmentioning

confidence: 99%

The effects of drinking goal on treatment outcome for alcoholism.

Bujarski¹,

O’Malley²,

Lunny³

et al. 2013

Journal of Consulting and Clinical Psychology

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Objective It is well known to clinicians and researchers in the field of alcoholism that patients vary with respect to drinking goal. The objective of this study is to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions. Method Participants were 1226 alcohol dependent individuals enrolled in a large, multi-site trial of Combined Behavioral Intervention (CBI), acamprosate, and naltrexone. Drinking goal was coded as follows: (a) controlled drinking, (b) conditional abstinence, and (c) complete abstinence. Results Analysis revealed a main effect of drinking goal on percent days abstinent (p < .0001), days to relapse to heavy drinking (p < 0.0001), and global clinical outcome (p < .001). These results were such that a goal of complete abstinence was associated with the best outcomes, followed by conditional abstinence; controlled drinking was associated with the poorest outcomes. Conversely, a main effect of drinking goal was observed on drinks per drinking day (p < .01), such that controlled drinking was associated with fewer drinks per drinking day whereas complete abstinence was associated with the highest drinks per drinking day. CBI performed better than medical management alone for participants whose drinking goal was not complete abstinence. Conclusion These results suggest that drinking goal represents a highly predictive clinical variable and should be an integral part of the clinical assessment of patients with alcohol dependence. Assessment of patients' drinking goals may also help match patients to interventions best suited to address their goals and clinical needs.

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“…It is reported that 78.1% of persons abusing alcohol or being dependent to alcohol are not seeking any kind of therapy (154,155). One of the reasons for avoiding therapy is that some people may want to reduce the amount of alcohol used but are not inclined towards total abstinence (156). To choose harm reduction as a treatment goal can be a important step that may lead to an internalization of consuming less alcohol, possibly leading towards total abstinence (157).…”

Section: Reduction Of Heavy Drinking (Harm Reduction)mentioning

confidence: 99%

Pharmacological treatment options for alcohol use disorder

Evren¹,

Bozkurt²

2015

Dusunen Adam

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Is Controlled Drinking an Acceptable Goal in the Treatment of Alcohol Dependence? A Survey of French Alcohol Specialists

Abstract: Half of French alcohol specialists accept CD as a goal. Acceptance was associated with specialists' personal and professional characteristics. The criteria for success specialists use in their clinical practice differ from those they expect to be used in clinical trials.

Cited by 56 publications

References 21 publications

Clinical Relevance of As-Needed Treatment with Nalmefene in Alcohol-Dependent Patients

Clinical Relevance of As-Needed Treatment with Nalmefene in Alcohol-Dependent Patients

The effects of drinking goal on treatment outcome for alcoholism.

Pharmacological treatment options for alcohol use disorder

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