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

Abstract

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.

CONCLUSIONS:

Patients with an alcohol use disorder who have a drinking goal of abstinence, in particular consistent daily drinkers, may maximally benefit from alcohol use disorder treatment, including the use of medication, in a primary care setting.

• Authors: Lisa Berger, Michael Brondino, Michael Fisher, Robert Gwyther, James C Garbutt
• Journal: Journal of the American Board of Family Medicine : JABFM (J Am Board Fam Med) 2016 Jan-Feb Vol. 29 Issue 1 Pg. 37-49 ISSN: 1558-7118 [Electronic] United States
• PMID: 26769876 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Copyright 2016 by the American Board of Family Medicine.

Chemical References

• Alcohol Deterrents
• Taurine
• Acamprosate

Topics

• Acamprosate
• Adult
• Aged
• Alcohol Abstinence (psychology, statistics & numerical data)
• Alcohol Deterrents (administration & dosage, therapeutic use)
• Alcohol-Related Disorders (drug therapy, prevention & control, psychology)
• Cognitive Behavioral Therapy
• Controlled Before-After Studies (statistics & numerical data)
• Counseling (methods)
• Female
• Goals
• Humans
• Male
• Middle Aged
• North Carolina
• Primary Health Care (methods, statistics & numerical data)
• Randomized Controlled Trials as Topic (statistics & numerical data)
• Taurine (administration & dosage, analogs & derivatives, therapeutic use)
• Treatment Outcome
• Wisconsin
• Young Adult