title: Posttreatment low-risk drinking as a predictor of future drinking and problem outcomes among individuals with alcohol use disorders.
abstract: BACKGROUND
  Treatment for alcohol disorders has traditionally been abstinence-oriented, but evaluating the merits of a low-risk drinking outcome as part of a primary treatment endpoint is a timely issue given new pertinent regulatory guidelines. This study explores a posttreatment low-risk drinking outcome as a predictor of future drinking and problem severity outcomes among individuals with alcohol use disorders in a large private, not for profit, integrated care health plan.
  
  
  METHODS
  Study participants include adults with alcohol use disorders at 6 months (N = 995) from 2 large randomized studies. Logistic regression models were used to explore the relationship between past 30-day drinker status at 6 months posttreatment (abstinent [66%], low-risk drinking [14%] defined as nonabstinence and no days of 5+ drinking, and heavy drinking [20%] defined as 1 or more days of 5+ drinking) and 12-month outcomes, including drinking status and Addiction Severity Index measures of medical, psychiatric, family/social, and employment severity, controlling for baseline covariates.
  
  
  RESULTS
  Compared to heavy drinkers, abstinent individuals and low-risk drinkers at 6 months were more likely to be abstinent or low-risk drinkers at 12 months (adj. ORs = 16.7 and 3.4, respectively; p < 0.0001); though, the benefit of abstinence was much greater than that of low-risk drinking. Compared to heavy drinkers, abstinent and low-risk drinkers were similarly associated with lower 12-month psychiatric severity (adj. ORs = 1.8 and 2.2, respectively, p < 0.01) and family/social problem severity (adj. OR = 2.2; p < 0.01). While abstinent individuals had lower 12-month employment severity than heavy drinkers (adj. OR = 1.9; p < 0.01), low-risk drinkers did not differ from heavy drinkers. The drinking groups did not differ on 12-month medical problem severity.
  
  
  CONCLUSIONS
  Compared to heavy drinkers, low-risk drinkers did as well as abstinent individuals for many of the outcomes important to health and addiction policy. Thus, an endpoint that allows low-risk drinking may be tenable for individuals undergoing alcohol specialty treatment.
authors: Division of Research, Kaiser Permanente Northern California, Oakland, California 94612, USA. andrea.h.kline-simon@kp.org
authors: Andrea H
authors: AH
authors: Kline-Simon
authors: Daniel E
authors: DE
authors: Falk
authors: Raye Z
authors: RZ
authors: Litten
authors: Jennifer R
authors: JR
authors: Mertens
authors: Joanne
authors: J
authors: Fertig
authors: Megan
authors: M
authors: Ryan
authors: Constance M
authors: CM
authors: Weisner
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends*; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013695:Temperance / Q000639:trends*; D016896:Treatment Outcome