Maisto Stephen A, Clifford Patrick R, Stout Robert L, Davis Christine M
Department of Psychology, Center for Health and Behavior, Syracuse University, Syracuse, NY 13244, USA.
J Stud Alcohol Drugs. 2007 May;68(3):419-27. doi: 10.15288/jsad.2007.68.419.
The relationship between moderate alcohol consumption in the first year following alcohol treatment admission and longer-term functioning is clinically important and pertains to the clinical course of alcohol-use disorders. This study investigated these relationships, focusing on the first year posttreatment admission and 3 years later.
Analyses were conducted on the outpatient Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) sample (n = 952 at baseline, and n = 802 at Months 37-39). Participants were classified as first-year "abstainer," "moderate drinker," or "heavy drinker."
Drinker classification predicted percentage of days abstinent from alcohol, drinks per drinking day, and alcohol-related negative consequences at 3 years. The abstainers had better drinking outcomes than either of the other two groups, and the moderate drinkers' outcomes were better than those of the heavy drinkers. The heavy drinkers had a higher rate of negative consequences at 3 years than did the abstainers and the moderate drinkers, who did not differ from each other. Analyses of change in drinker status between 1 and 3 years explored variability in clinical course.
First-year posttreatment alcohol use on the group level predicts longer-term alcohol use and related functioning, and moderate drinking may be considered a treatment goal option for some individuals. The data also reaffirm the variability among individuals in clinical course following alcohol treatment. Future research should aim to understand the factors that determine the maintenance of patterns of alcohol use that are not associated with the occurrence of alcohol-related negative consequences.
酒精治疗入院后第一年适度饮酒与长期功能之间的关系具有临床重要性,且与酒精使用障碍的临床病程相关。本研究调查了这些关系,重点关注治疗入院后的第一年和三年后。
对门诊“匹配酒精成瘾治疗与患者异质性”项目(MATCH)样本进行分析(基线时n = 952,第37 - 39个月时n = 802)。参与者被分类为第一年的“戒酒者”“适度饮酒者”或“重度饮酒者”。
饮酒者分类可预测三年时的戒酒天数百分比、每日饮酒量以及与酒精相关的负面后果。戒酒者的饮酒结果优于其他两组中的任何一组,适度饮酒者的结果优于重度饮酒者。重度饮酒者在三年时的负面后果发生率高于戒酒者和适度饮酒者,而后两者之间无差异。对1年至3年饮酒者状态变化的分析探讨了临床病程的变异性。
治疗后第一年群体层面的酒精使用情况可预测长期酒精使用及相关功能,对于某些个体,适度饮酒可被视为一种治疗目标选择。数据还再次证实了酒精治疗后个体临床病程的变异性。未来研究应旨在了解决定维持与酒精相关负面后果发生无关的酒精使用模式的因素。