Brief intervention in alcohol-dependent versus nondependent individuals.
OBJECTIVE
Randomized trials examining the effects of brief alcohol interventions by primary care providers have consistently excluded individuals with alcohol dependence. The purpose of this study was to examine whether a diagnosis of alcohol dependence, according to the criteria in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, predicted differential effectiveness of a brief intervention (BI).


METHODS
Retrospective analyses were performed on participants (N = 326) enrolled in a randomized trial designed to examine the impact of interactive voice response following BI. All participants had received a BI from their primary care provider before enrolling in the study. Daily consumption data were collected using the Timeline Followback for the period before the BI (mean = 71 days) and for 6 months following the BI. We compared nondependent and dependent participants on a number of consumption-based outcomes.


RESULTS
Dependent participants had significantly higher pre-BI consumption. At the index assessment (median =15 days after BI), both dependent and nondependent participants reported significant reductions in total drinks per week and drinking days per week after BI. Dependent participants significantly reduced their drinks per drinking day. After BI, dependent participants no longer differed significantly from nondependent participants on these measures. Similar decreases from before BI were observed in both groups through 6 months, although dependent participants drank on fewer days and significantly more on days on which they drank than did nondependent participants. Regression analyses showed that baseline consumption was the only significant predictor of post-BI consumption.


CONCLUSIONS
We found no evidence that dependent participants realized less benefit on measures of alcohol consumption following a BI than nondependent participants.
Guth
Sarah
S
University of Vermont, College of Medicine, Health Behavior Research Center, UHC #4570H3, 1 South Prospect Street, Burlington, Vermont 05401, USA.
Lindberg
Sarah A
SA
Badger
Gary J
GJ
Thomas
Colleen S
CS
Rose
Gail L
GL
Helzer
John E
JE
D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000534:rehabilitation*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors