title: Continuous Abstinence During Early Alcohol Treatment is Significantly Associated with Positive Treatment Outcomes, Independent of Duration of Abstinence.
abstract: OBJECTIVE
  Neither the predictive value of early continuous abstinence in alcohol use disorder (AUD) or the point at which this effect may emerge has been evaluated. This analysis of the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) clinical trial evaluated whether abstinence early in treatment was a predictor of longer term abstinence.
  
  
  METHODS
  Participants who stated a goal of total abstinence (N = 954) were dichotomized into Early Abstainer vs. Nonabstainers and were compared on a variety of drinking outcome measures that are frequently used in clinical trial evaluations of alcohol treatment strategies, as a function of duration of early continuous abstinence.
  
  
  RESULTS
  Significant differences existed for every outcome. Early Abstinence was significantly associated with fewer drinks per drinking day, number of drinking and number of heavy drinking days, and longer time to first drinking and first heavy drinking day. Effects were evident within the first week. The magnitude of all effects increased as the duration of early abstinence (1-4 weeks) increased, though the size of increase varied across the outcomes.
  
  
  CONCLUSIONS
  These data provide evidence that drinking at the beginning of alcohol treatment is significantly and robustly associated with drinking throughout and at the end of a clinical trial treatment for AUD. Early drinking may be a useful early index to identify whether patients are responding positively to a treatment strategy, and provides a useful method for tailoring treatment to patients that is consistent with a personalized medicine approach.
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, Baltimore, MD, USA kdunn9@jhmi.edu.
authors: Kelly E
authors: KE
authors: Dunn
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, Baltimore, MD, USA.
authors: Joseph A
authors: JA
authors: Harrison
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, Baltimore, MD, USA.
authors: Jeannie-Marie
authors: JM
authors: Leoutsakos
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, Baltimore, MD, USA.
authors: Dingfen
authors: D
authors: Han
authors: Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, Baltimore, MD, USA.
authors: Eric C
authors: EC
authors: Strain
mesh_terms: D000077443:Acamprosate; D000328:Adult; D064829:Alcohol Abstinence / Q000523:psychology / Q000639:trends*; D000427:Alcohol Deterrents / Q000008:administration & dosage; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods / Q000639:trends*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage; D013654:Taurine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D013654:Taurine; D009270:Naloxone; D000077443:Acamprosate