Problem-free drinking over 16 years among individuals with alcohol use disorders.
BACKGROUND
Limited data exist on the rates and long-term stability of non-problem drinking in individuals who sought help for an alcohol use disorder.


METHODS
A sample of initially untreated individuals with alcohol use disorders (n=420) was surveyed at baseline and 1 year and was re-assessed at 8 and 16 years.


RESULTS
In the 6 months prior to the 1-year assessment, 36% (n=152) of participants reported abstinence from alcohol, 48% (n=200) reported drinking with problems, and 16% (n=68) reported non-problem drinking. At each follow up, 16-21% of the sample reported non-problem drinking. Compared to individuals in the abstinent and problem-drinking groups, individuals who were drinking in a problem-free manner at 1 year had reported, at baseline, fewer days of intoxication, drinks per drinking day, alcohol dependence symptoms, and alcohol-related problems, less depression, and more adaptive coping mechanisms. Over time, 48% of participants who engaged in non-problem drinking at 1 year continued to report positive outcomes (either non-problem drinking or abstinence) throughout the long-term follow-up, whereas 77% of those abstaining at 1 year reported positive outcomes throughout the same time period. Additionally, 43% of individuals with problematic alcohol consumption at 1 year reported positive outcomes over the remaining follow-up interval, a rate that was not significantly different from the rate of positive outcomes of 48% observed in those with initial problem-free drinking.


CONCLUSIONS
Although some individuals report non-problem drinking a year after initially seeking help, this pattern of alcohol use is relatively infrequent and is less stable over time than is abstinence. An accurate understanding of the long-term course of alcohol use and problems could help shape expectations about the realistic probability of positive outcomes for individuals considering moderate drinking as a treatment goal.
Ilgen
Mark A
MA
Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, CA 94025, USA. mark.ilgen@va.gov
Wilbourne
Paula L
PL
Moos
Bernice S
BS
Moos
Rudolf H
RH
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology*; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012919:Social Behavior; D013695:Temperance / Q000706:statistics & numerical data
J Stud Alcohol. 1997 Jan;58(1):7-29
8979210
Addict Behav. 1995 Jul-Aug;20(4):427-41
7484324
Addiction. 2006 Feb;101(2):212-22
16445550
Addiction. 2006 Nov;101(11):1540-2
17034432
Psychiatr Serv. 2003 May;54(5):621-2
12719491
J Stud Alcohol. 1981 Jan;42(1):94-105
7230825
Drug Alcohol Depend. 1987 Nov 30;20(3):173-201
3325253
Can J Psychiatry. 2005 Apr;50(5):266-8
15968842
Addiction. 1995 Sep;90(9):1223-40
7580820
N Engl J Med. 1985 Jun 27;312(26):1678-82
4000215
Psychol Bull. 1993 Jan;113(1):129-39
8426872
Drug Alcohol Rev. 2005 May;24(3):209-16
16096124
J Abnorm Psychol. 1982 Jun;91(3):199-209
7096790
Addiction. 2006 Jun;101(6):824-34
16696626
J Stud Alcohol. 2001 Mar;62(2):211-20
11327187
J Stud Alcohol. 1994 Mar;55(2):167-72
8189737
J Consult Clin Psychol. 1984 Jun;52(3):390-403
6747058
Psychol Addict Behav. 2003 Sep;17(3):203-10
14498814
J Stud Alcohol. 1992 May;53(3):249-61
1583904
Addiction. 2002 Mar;97(3):265-77
11964100