Stability of Successful Long-Term Adjustment in Alcohol Dependence: A Follow-Up Study 15 Years after the First Long-Term Follow-Up

Nordström, G; Berglund, Mats; Frank, Arne

doi:10.1159/000077701

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…Even among those who receive treatment, many individuals with AD are able to achieve “low level,” “social,” and “normal” levels of drinking (with exact amounts of drinking defined differently across studies) [39,40,41,42]. The US Project MATCH ( n = 1,726) compared 3 forms of psychotherapy, cognitive-behavioral treatment, motivation enhancement treatment, and 12-step facilitation treatment, in patients with AD.…”

Section: Examining Reduced Alcohol Consumption In Treatment Trials Anmentioning

confidence: 99%

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

2017

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Abstinence from alcohol has been the prevailing treatment goal for individuals with alcohol dependence (AD) within the context of specialty alcohol treatment. Yet, alcohol use has been conceptualized as existing on a continuum. Importantly, most people who meet criteria for AD and could benefit from treatment never receive treatment. About half of these individuals do not seek treatment because they report a desire to continue drinking. To increase acceptability of treatment, reductions in alcohol consumption have been examined as alternative outcomes in treatment trials for AD. The current study reviews data which indicate that long-term reduction in alcohol consumption among patients with AD is possible. Controlled studies have tested reduced alcohol consumption and show sustained improvements in drinking reductions for many patients following behavioral treatments and pharmacotherapy. Evidence-based treatment guidelines and medicines development guidance authorities have taken note of these developments and accept “intermediate harm reduction” (European Medicines Agency) or “low-risk drinking limits” (US Federal Drug Administration) as optional trial endpoints. In conclusion, while abstinence remains the safest treatment goal for individuals with AD, evidence supports that reduced drinking approaches may be an important extension in the treatment of AD.

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Section: Examining Reduced Alcohol Consumption In Treatment Trials Anmentioning

confidence: 99%

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

2017

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“…Estudios como el de McCabe (1986), ilustran cómo una muestra inicial de 57 pacientes limita los hallazgos al análisis de casos, dado que con una mortalidad del 42% en 16 años, al final sólo dispone de 31 pacientes clasificados en cuatro categorías de consumo. Una muestra aproximada a 100 pacientes, típica en esta revisión, produce una situación ligeramente mejor, pero igualmente plantea limitaciones a la hora de analizar los resultados (Edwards, Duckitt, Oppenheimer, Sheehan y Taylor, 1983;Mann et al 2005;Nordström, Berglund y Frank, 2004;Vaillant, 1988).…”

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Investigación longitudinal del alcoholismo tratado: Una revisión sistemática de los seguimientos a largo plazo

2010

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Aims:To analyze the methodological design of long-term longitudinal studies of alcoholics who have undergone treatment. Methods: Systematic review of prospective longitudinal studies of treated alcoholics with follow-up periods of at least 8 years, and published in English, during the period 1983-2009. The review includes 9 studies which analyzed: follow-up evaluations, information sources, the period of reference in the final assessment, the measurement of alcohol use, the operationalization of drinking patterns, and data analysis. Results: 2434 patients (ranging between 57 and 850 per study) were studied on average for a period of 15.3 (D.T. = 3.2) years (range 8-20 years). Studies differ in the number of intermediate evaluations (0, 1, 3, 4) and the length of the period considered for the final evaluation (the whole period, the last 3 years, the last year, last 6 months, last month or present situation). Drinking patterns tend to be used as the main outcome variable, but they are operationalized in non-equivalent forms and the analysis is performed using classical cross-sectional statistical techniques. Alcoholism evolution is studied by analyzing the evolution of drinking patterns and patients' life situation during the period under study. Conclusions:The scarce amount of data available on the evolution of treated alcoholism cannot be compared across studies due to considerable methodological differences. There is a need to promote common methodological criteria in relation to follow-up strategies. New statistical methods that permit longitudinal analysis for non-balanced and correlated data should also be incorporated. Key words: alcoholism, longitudinal studies, methodology RESUMEN ABSTRACTObjetivo: Analizar el diseño metodológico de los estudios longitudinales a largo plazo en el campo del alcoholismo tratado. Método: Revisión sistemática de los estudios longitudinales prospectivos de pacientes alcohólicos con seguimiento de al menos 8 años y publicados en inglés entre 1983-2009. La revisión incluye 9 estudios en los que se analizan: Las evaluaciones de seguimiento, las fuentes de información, el periodo de referencia en la evaluación final, la medición del consumo de alcohol, la categorización del patrón de consumo y el análisis de los datos. Resultados: 2.434 pacientes (rango 57 -850 por estudio) tratados por alcoholismo fueron seguidos en promedio 15.3 (D.T. =. 3.2) años (rango 8 -20 años). Los estudios se diferencian en el número de evaluaciones intermedias (0, 1, 3 y 4) y en el periodo de referencia usado en la evaluación final (todo el seguimiento, últimos 3 años, último año, últimos 6 meses, último mes y actual). Los patrones de consumo (principal resultado de tratamiento) se definen de manera no equivalente y los datos se analizan principalmente de manera transversal usando técnicas estadísticas clásicas. La evolución del alcoholismo se estudia analizando la trayectoria de los patrones de consumo y del estado vital de los pacientes durante los seguimientos. Conclusiones: Los escasos datos disponi...

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“…Langzeitkatamnesen zeigen denn auch, dass langfristig sowohl nach selbstinitiierten Veränderungen (self-change; vgl. [4]) wie nach abstinenzorientierter Behandlung [5] viele ehemals Abhängige einen moderaten bzw. kontrollierten Konsum betreiben.…”

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Die Akzeptanz von kontrolliertem Konsum als Behandlungsziel unter Suchthilfefachkräften in Bayern

Drinkmann

Lettl

2014

Suchttherapie

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Zusammenfassung ▼ Fragestellung: Die Akzeptanz unter Suchtfachkräften gegenüber kontroll-statt abstinenzorientierten Behandlungszielen ist international wiederholt untersucht worden, unter anderem von Davis und Rosenberg (2012) in den USA. Auch in Deutschland wird die Diskussion um kontrollierten Konsum seit geraumer Zeit geführt, Daten zur Akzeptanz innerhalb des Suchthilfesystems fehlen jedoch bislang. Methodik: Mithilfe eines international eingeführten Itempools wurden in einer Online-Befragung alle bayerischen Suchtberatungsstellen um Stellungnahmen zur Akzeptanz oder Ablehnung gegenüber Nicht-Abstinenz-Zielen für 12 verschiedene Therapiebedingungen gebeten: kontrollierter Konsum als Zwischen-oder Endziel der Behandlung von Klienten mit Missbrauch oder Abhängigkeit von Alkohol, illegalen Drogen oder Tabak. Ergebnisse: Generell überwiegt die Akzeptanz die Ablehnung. Es finden sich jedoch Unterschiede je nach in Frage stehender Therapiebedingung: Die Akzeptanz für kontrollierten Konsum als Zwischenziel ist deutlich größer als die als Endziel der Behandlung. Bei Missbrauch ist sie größer als bei Vorliegen einer Abhängigkeit und bei Alkoholproblemen größer als bei Problemen mit illegalen Drogen. Schlussfolgerungen: Diese Ergebnisstruktur bestätigt internationale Befunde. In Bayern ist die durchschnittliche Akzeptanz aber deutlich größer als in den USA und geringer als in Groß-britannien. Abstract ▼

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Stability of Successful Long-Term Adjustment in Alcohol Dependence: A Follow-Up Study 15 Years after the First Long-Term Follow-Up

Cited by 8 publications

References 23 publications

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

Reduced Drinking in Alcohol Dependence Treatment, What Is the Evidence?

Investigación longitudinal del alcoholismo tratado: Una revisión sistemática de los seguimientos a largo plazo

Die Akzeptanz von kontrolliertem Konsum als Behandlungsziel unter Suchthilfefachkräften in Bayern

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