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患有酒精使用障碍的个体能否维持非戒酒的康复状态?酒精使用障碍治疗 10 年后的非戒酒结果。

Can Individuals With Alcohol Use Disorder Sustain Non-abstinent Recovery? Non-abstinent Outcomes 10 Years After Alcohol Use Disorder Treatment.

机构信息

University of New Mexico, Albuquerque, NM (KW, ADW, JES, VRV, ERS, MRP, KAE, JST), Yale University, New Haven, CT (CRR), University of Washington, Seattle, WA (KAH), California State University Dominquez Hills, Carson, CA (KSM), Syracuse University, Syracuse, NY (SAM), University of Florida, Gainesville, FL (JAT).

出版信息

J Addict Med. 2021;15(4):303-310. doi: 10.1097/ADM.0000000000000760.

Abstract

OBJECTIVE

Four decades ago, the "controlled drinking" controversy roiled the alcohol field. Data have subsequently accumulated indicating that nonabstinent alcohol use disorder (AUD) recovery is achievable, but questions remain whether it is sustainable long-term. This study examined whether nonabstinent recovery at 3 years after AUD treatment is associated with better functioning at 10 years after treatment.

METHODS

Data were from the 10-year follow-up of Project MATCH (New Mexico site only, n  = 146; 30.1% female, 58.6% non-White). Recovery was defined by latent profile analyses based on psychosocial functioning and alcohol consumption 3 years after treatment. Drinking practices and consequences, depression, purpose in life, and anger were assessed 10 years after treatment. Distal outcome analyses examined differences in drinking and functional outcomes at 10 years as a function of the 3-year latent profiles. Analyses were preregistered at https://osf.io/3hbxr.

RESULTS

Four latent profiles identified at 3 years after treatment (ie, low functioning frequent heavy drinkers, low functioning infrequent heavy drinkers, high functioning heavy drinkers, and high functioning infrequent nonheavy drinkers) were significantly associated with outcomes 10 years after treatment. The 2 high functioning profiles at 3 years had the highest level of psychological functioning at 10 years posttreatment, regardless of alcohol consumption level. Abstinence at 3 years did not predict better psychological functioning at 10 years.

CONCLUSIONS

Nonabstinent AUD recovery is possible and is sustainable for up to 10 years after treatment. The current findings align with recent proposals to move beyond relying on alcohol consumption as a central defining feature of AUD recovery.

摘要

目的

四十年前,“控制饮酒”争议席卷了酒精领域。此后的数据积累表明,非戒酒性酒精使用障碍(AUD)的康复是可以实现的,但仍存在疑问,即这种康复是否能够长期持续。本研究考察了 AUD 治疗后 3 年非戒酒康复是否与治疗后 10 年功能更好相关。

方法

数据来自 MATCH 项目的 10 年随访(仅新墨西哥州站点,n=146;女性占 30.1%,非白人占 58.6%)。康复是根据治疗后 3 年的心理社会功能和酒精消费情况进行潜在剖面分析定义的。在治疗后 10 年评估饮酒实践和后果、抑郁、生活目的和愤怒。远端结果分析考察了 3 年潜在特征与 10 年饮酒和功能结果之间的差异。分析已在 https://osf.io/3hbxr 上预先注册。

结果

治疗后 3 年确定的 4 个潜在特征(即低功能频繁重度饮酒者、低功能非频繁重度饮酒者、高功能重度饮酒者和高功能非频繁非重度饮酒者)与治疗后 10 年的结果显著相关。治疗后 3 年的 2 个高功能特征,无论饮酒水平如何,在治疗后 10 年具有最高的心理功能水平。治疗后 3 年的戒酒并不能预测 10 年后的心理功能更好。

结论

非戒酒性 AUD 康复是可能的,并且可以在治疗后持续长达 10 年。目前的研究结果与最近提出的超越以酒精消费作为 AUD 康复的核心特征的建议一致。

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