title: Posttreatment Low-Risk Drinking as a Predictor of Future Drinking and Problem Outcomes Among Individuals with Alcohol Use Disorders: A 9-Year Follow-Up.
abstract: Treatment for alcohol use disorders (AUDs) has traditionally been abstinence oriented, but new research and regulatory guidelines suggest that low-risk drinking may also be an acceptable treatment outcome. However, little is known about long-term outcomes for patients who become low-risk drinkers posttreatment. This study explores a posttreatment low-risk drinking outcome as a predictor of future drinking and psychosocial outcomes over 9 years.
  
  
  
  Study participants were adults with AUDs at treatment entry who received follow-up interviews 6 months posttreatment intake (N = 1,061) in 2 large randomized studies conducted at Kaiser Permanente Northern California, a large private, nonprofit, integrated health system. Six-month drinking status was defined as abstinent, low-risk (nonabstinent, no 5+ drinking days), or heavy drinking (1 or more days of 5+ drinks). Using logistic regression models, we explored the relationship between past 30-day drinking status at 6 months and odds of being abstinent or a low-risk drinker (compared to heavy drinking), and positive Addiction Severity Index psychosocial outcomes over 9 years (9-year follow-up rate of 73%).
  
  
  
  Abstainers and low-risk drinkers at 6 months had higher odds of recent abstinence/low-risk drinking over 9 years than heavy drinkers; abstainers had better drinking outcomes than low-risk drinkers. Additionally, among those with interview data, 95% of abstainers and 94% of low-risk drinkers at 6 months were abstinent/low-risk drinkers at 9 years; surprisingly, 89% of heavy drinkers at 6 months were also abstinent/low-risk drinkers although still significantly fewer than the other groups. Abstainers and low-risk drinkers at 6 months had better psychiatric outcomes, and abstainers had better family/social outcomes than heavy drinkers; medical outcomes did not differ. Low-risk drinkers and abstainers showed no reliable differences across psychosocial measures.
  
  
  
  The findings suggest that a low-risk drinking outcome may be reasonable over the long-term for some alcohol-dependent individuals receiving addiction treatment.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Kline-Simon
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism (NIAAA), Bethesda, Maryland.
authors.forename: Raye Z
authors.initials: RZ
authors.lastname: Litten
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California.|Department of Psychiatry, University of California, San Francisco, San Francisco, California.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Weisner
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism (NIAAA), Bethesda, Maryland.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Falk
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence / Q000523:psychology / Q000639:trends*; D000428:Alcohol Drinking / Q000523:psychology / Q000628:therapy* / Q000639:trends*; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Alcohol; Long-Term Outcomes; Long-Term Psychosocial Functioning; Low-Risk Drinking