Ramasubramanian Chellamuthu, Tirupati Srinivasan, Muthukumaraswamy Anand, Kannan Mahalingam, Rajangam Kuduman
Alcohol and Drug Deaddiction Services, MS Chellamuthu Trust and Research Foundation, Madurai, Tamil Nadu, India.
Faculty of Health, School of Medicine and Public Health, The University of Newcastle, Callaghan Campus, NSW 2308, Australia.
Indian J Psychiatry. 2025 Jul;67(7):659-665. doi: 10.4103/indianjpsychiatry_86_25. Epub 2025 Jul 15.
Alcohol use disorder (AUD) is a major health issue in developing countries, posing a significant economic burden with limited access to comprehensive treatment and follow-up services. AUD treatment services are limited in India, especially in regional and rural areas.
This retrospective study assessed outcomes in patients with AUD from a rural and regional part of India admitted to a voluntary treatment program with a 2-year follow-up after initial detoxification. The primary outcome measures were the extent and duration of abstinence achieved at the end of 2 years. The secondary outcome measures were quality of life, psychological wellbeing, and family burden.
One hundred sixty-nine out of 180 patients (93.9%) completed the 2-year program. Sustained abstinence was achieved by 81.1% of patients and sustained low-risk drinking by 14.8% in an uncontrolled environment. There was a significant improvement in the quality of life and psychological wellbeing and a reduction in the total family burden. Patients sustaining total abstinence experienced a higher family burden at intake than those with low-risk drinking.
The majority of patients with AUD achieved total abstinence in communities with limited specialist health services with appropriate treatment and follow-up services. Factors influencing such positive outcomes could be the voluntary nature of the program, setting up total abstinence as the treatment goal, collaborative support of the family, access to low-cost treatment and extended follow-up, and use of disulfiram. A future prospective study using a control group addressing this study's limitations is required to confirm the observed outcomes.
酒精使用障碍(AUD)是发展中国家的一个主要健康问题,由于获得全面治疗和后续服务的机会有限,造成了重大经济负担。AUD治疗服务在印度很有限,特别是在地区和农村地区。
这项回顾性研究评估了来自印度农村和地区、参加自愿治疗项目且在初次戒毒后进行了2年随访的AUD患者的治疗结果。主要结局指标是2年结束时实现戒酒的程度和持续时间。次要结局指标是生活质量、心理健康和家庭负担。
180名患者中有169名(93.9%)完成了2年项目。在无对照环境中,81.1%的患者实现了持续戒酒,14.8%的患者实现了持续低风险饮酒。生活质量和心理健康有显著改善,家庭总负担减轻。持续完全戒酒的患者在入院时的家庭负担高于低风险饮酒的患者。
大多数AUD患者在专科医疗服务有限的社区中,通过适当的治疗和后续服务实现了完全戒酒。影响这些积极结果的因素可能是该项目的自愿性质、将完全戒酒设定为治疗目标、家庭的协作支持、获得低成本治疗和延长随访以及使用双硫仑。需要未来进行一项使用对照组解决本研究局限性的前瞻性研究来证实观察到的结果。