Christine Timko1, Anna Debenedetti, Bernice S Moos, Rudolf H Moos. 1. Center for Health Care Evaluation, Department of Veterans Affairs Health Care System and Stanford University Medical Center, Menlo Park, California 94025, USA. ctimko@stanford.edu
Abstract
BACKGROUND AND METHODS: We examined rates and predictors of mortality in individuals (47% women) who had just initiated help-seeking for their alcohol use disorders (AUDs) at the start of the study (n=628) and were followed for 16 years. RESULTS: For both women and men, the observed-to-expected mortality ratio (1.4) was lower than rates found in samples of treated individuals with AUDs, suggesting that those initiating help-seeking careers have better chances of long-term survival. Of the individuals for whom cause of death was known, 68% died of alcohol-related causes. Men were more likely to die than were women. When gender was controlled, individuals who were older and unmarried and had more alcohol dependence symptoms at baseline were more likely to die over the 16-year period. When these baseline characteristics were controlled, better drinking outcomes at 1 year were associated with a lower likelihood of subsequent death. The combination of a shorter duration of inpatient/residential care and better drinking outcomes at 1 year was related to a lower probability of death, as was the combination of a longer duration of outpatient care or Alcoholics Anonymous attendance and better drinking outcomes at 1 year. CONCLUSIONS: Efforts should be made to help providers identify individuals who are not responding positively to inpatient or residential treatment and intervene to motivate participation in continuing outpatient care and community 12-step self-help groups to reduce the likelihood of a chronic and fatal AUD course.
BACKGROUND AND METHODS: We examined rates and predictors of mortality in individuals (47% women) who had just initiated help-seeking for their alcohol use disorders (AUDs) at the start of the study (n=628) and were followed for 16 years. RESULTS: For both women and men, the observed-to-expected mortality ratio (1.4) was lower than rates found in samples of treated individuals with AUDs, suggesting that those initiating help-seeking careers have better chances of long-term survival. Of the individuals for whom cause of death was known, 68% died of alcohol-related causes. Men were more likely to die than were women. When gender was controlled, individuals who were older and unmarried and had more alcohol dependence symptoms at baseline were more likely to die over the 16-year period. When these baseline characteristics were controlled, better drinking outcomes at 1 year were associated with a lower likelihood of subsequent death. The combination of a shorter duration of inpatient/residential care and better drinking outcomes at 1 year was related to a lower probability of death, as was the combination of a longer duration of outpatient care or Alcoholics Anonymous attendance and better drinking outcomes at 1 year. CONCLUSIONS: Efforts should be made to help providers identify individuals who are not responding positively to inpatient or residential treatment and intervene to motivate participation in continuing outpatient care and community 12-step self-help groups to reduce the likelihood of a chronic and fatal AUD course.
Authors: Marc A Schuckit; Tom L Smith; George Danko; John Kramer; Kathleen K Bucholz; Vivia McCutcheon; Grace Chan; Samuel Kuperman; Victor Hesselbrock; Danielle M Dick; Michie Hesselbrock; Bernice Porjesz; Howard J Edenberg; John I Nureberger; Marcy Gregg; Lara Schoen; Mari Kawamura; Lee Anne Mendoza Journal: Alcohol Clin Exp Res Date: 2018-07-05 Impact factor: 3.455
Authors: Jack R Cornelius; Maureen Reynolds; Barry M Martz; Duncan B Clark; Levent Kirisci; Ralph Tarter Journal: Addict Behav Date: 2007-05-08 Impact factor: 3.913