title: Drinking behavior and motivation for treatment among alcohol-dependent liver transplant candidates.
abstract: Alcohol misuse is the second most common indication for liver transplantation in the United States. Our post-transplant alcoholism treatment trial suggested that current interventions might not be transferable to liver transplantees. We sought to identify differences between patients awaiting liver transplantation and alcoholics entering treatment without severe liver disease. Thirty transplant patients were compared to thirty naltrexone study patients on medical status, alcohol and drug use, alcohol craving, motivation for treatment, psychiatric symptoms, and psychosocial problems. Lifetime alcohol consumption was greater for transplant patients compared to naltrexone patients. In contrast to the naltrexone group, transplant patients denied craving for alcohol and showed little motivation for alcoholism treatment. Groups did not differ on other psychosocial measures. Liver transplant patients differ from patients in alcoholism treatment trials on measures of alcohol consumption, alcohol craving and motivation for treatment. Alcoholism interventions should accommodate their medical condition and boost motivation for continued abstinence.
authors.affiliation: Department of Psychiatry, The University of Pennsylvania School of Medicine and the Philadelphia Veterans Affairs Medical Center, USA. weinrieb_b@mall.trc.upenn.edu
authors.forename: R M
authors.initials: RM
authors.lastname: Weinrieb
authors.forename: D H
authors.initials: DH
authors.lastname: Van Horn
authors.forename: A T
authors.initials: AT
authors.lastname: McLellan
authors.forename: J R
authors.initials: JR
authors.lastname: Volpicelli
authors.forename: J S
authors.initials: JS
authors.lastname: Calarco
authors.forename: M R
authors.initials: MR
authors.lastname: Lucey
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000523:psychology*
chemical_list: D000418:Albumins; D009292:Narcotic Antagonists; D009271:Naltrexone