title: Problem-free drinking over 16 years among individuals with alcohol use disorders.
abstract: 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.
authors: 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
authors: Mark A
authors: MA
authors: Ilgen
authors: Paula L
authors: PL
authors: Wilbourne
authors: Bernice S
authors: BS
authors: Moos
authors: Rudolf H
authors: RH
authors: Moos
mesh_terms: 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
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