Who achieves low risk drinking during alcohol treatment? An analysis of patients in three alcohol clinical trials

Witkiewitz, Katie, Pearson, Matthew, Hallgren, Kevin, Maisto, Stephen, Roos, Corey, Kirouac, Megan, Wilson, Adam, Montes, Kevin and Heather, Nick (2017) Who achieves low risk drinking during alcohol treatment? An analysis of patients in three alcohol clinical trials. Addiction, 112 (12). pp. 2112-2121. ISSN 0965-2140

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Abstract

Background and aims
There is evidence that low-risk drinking is possible during the course of alcohol treatment and can be maintained following treatment. Our aim was to identify characteristics associated with low-risk drinking during treatment in a large sample of individuals as they received treatment for alcohol dependence.

Design
Integrated analysis of data from the Combined Pharmacotherapies and Behavioral Intervention (COMBINE) study, Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) and the United Kingdom Alcohol Treatment Trial (UKATT) using repeated-measures latent class analysis to identify patterns of drinking and predictors of low-risk drinking patterns during treatment.

Setting
United States and United Kingdom.

Participants
Patients (n = 3589) with alcohol dependence receiving treatment in an alcohol clinical trial were primarily male (73.0%), white (82.0%) and non-married (41.7%), with an average age of 42.0 (standard deviation = 10.7).

Measurements
Self-reported weekly alcohol consumption during treatment was assessed using the Form-90 [1] and validated with biological verification or collateral informants.
Findings

Seven patterns of drinking during treatment were identified: persistent heavy drinking (18.7% of the sample), increasing heavy drinking (9.6%), heavy and low-risk drinking (6.7%), heavy drinking alternating with abstinence (7.9%), low-risk drinking (6.8%), increasing low-risk drinking (10.5%) and abstinence (39.8%). Lower alcohol dependence severity and fewer drinks per day at baseline significantly predicted low-risk drinking patterns [e.g. each additional drink prior to baseline predicted a 27% increase in the odds of expected classification in heavy drinking versus low-risk drinking patterns; odds ratio = 1.27 (95% confidence interval (CI) = 1.10, 1.47, P = 0.002]. Greater negative mood and more heavy drinkers in the social network were significant predictors of expected membership in heavier drinking patterns.

Conclusions
Low-risk drinking is achievable for some individuals as they undergo treatment for alcohol dependence. Individuals with lower dependence severity, less baseline drinking, fewer negative mood symptoms and fewer heavy drinkers in their social networks have a higher probability of achieving low-risk drinking during treatment.

Item Type:	Article
Uncontrolled Keywords:	alcohol dependence, alcohol treatment, controlled drinking, dependence severity, low-risk drinking, moderation, repeated-measures latent class analysis
Subjects:	B200 Pharmacology, Toxicology and Pharmacy B900 Others in Subjects allied to Medicine
Department:	Faculties > Health and Life Sciences > Psychology
Depositing User:	Ay Okpokam
Date Deposited:	27 Nov 2017 15:39
Last Modified:	12 Oct 2019 12:00
URI:	http://nrl.northumbria.ac.uk/id/eprint/32656

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