Abstinence not required: Individuals with alcohol dependence may benefit from less drinking

Newswise Nov 08, 2018

Individuals who seek help for an alcohol use disorder (AUD) may be presented with either of two treatment goals: abstinence or no heavy-drinking days, which are approved by the Food and Drug Administration for use in testing medications to treat AUD. However, these goals may fail to work for individuals who seek to reduce their drinking. An alternative approach uses the World Health Organization (WHO) drinking risk levels—very high, high, moderate, and low—which are defined in terms of average alcohol consumption in grams per day. A reduction in these levels may provide a useful third option in assessing the success of AUD treatment. This study examined the association between reductions in WHO drinking risk levels and improvements in physical health and quality of life among individuals with alcohol dependence.

Researchers analyzed data on 1,142 individuals (786 men, 356 women) participating in the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study, the largest known controlled pharmacotherapy trial for treating AUDs. The researchers examined the associations between reductions in WHO drinking risk levels and changes in blood pressure, liver enzyme levels, and self-reported quality of life following treatment for alcohol dependence.

Reductions of one or two WHO drinking risk levels during treatment were associated with significant improvements in physical health—reduced systolic blood pressure and liver enzyme levels—and quality of life. Improvements in health and quality of life were observed even when abstainers were excluded from the analysis. The study authors suggested that WHO drinking risk levels are a marker of improvements in how a person “feels and functions” following treatment for alcohol dependence. These findings add to growing support for using a reduction in WHO drinking risk levels as an alternative to abstinence or no heavy drinking as goals of alcohol treatment.


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