Reconsidering alcohol treatment non-responders: psychosocial functioning among heavy drinkers 3 years following treatment.

BACKGROUND AND AIMS: Psychosocial functioning among individuals who exceed low-risk drinking limits (exceed three to four standard drinks for women/men) is heterogeneous. Among those who receive treatment for alcohol use disorder (AUD), recent research found that more than one-half of those who exceeded low-risk limits (i.e. treatment non-responders) reported good psychosocial functioning, commensurate with those who were abstinent or low-risk drinkers (i.e. treatment responders) up to 1 year following treatment. This study aimed to determine if good levels of psychosocial functioning are maintained beyond 1 year.
DESIGN: Secondary analysis of 3-year follow-up data from Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) and the Combined Pharmacotherapies and Behavioral Interventions study (COMBINE), multi-site alcohol clinical trials conducted in the United States.
SETTING: Eleven sites in COMBINE and nine sites in Project MATCH. PARTICIPANTS: Individuals with AUD from COMBINE and Project MATCH (n = 1383 and n = 1726) characterized in terms of drinking/functioning at 1-year follow-up and retained at 3-year (n = 641 and n = 790) post-treatment follow-ups. MEASUREMENTS: Alcohol consumption measured by Form-90 and psychosocial functioning assessed by various instruments at 3 years post-treatment
FINDINGS: High-functioning non-responders at 1 year post-treatment maintained a high level of functioning 2 years later and were not significantly different from the abstainers/low-risk drinkers on any functional outcomes (e.g. SF12 Mental Health Mean difference: -1.38 [95% confidence interval (CI) = -4.34, 1.57), SF12 Physical Health Mean difference: -0.43 (95% CI = -2.28, 3.13)].
CONCLUSIONS: Approximately one-half of those who engage in some heavy drinking in the year following treatment for alcohol use disorder appear to maintain high levels of psychosocial functioning up to 3 years following treatment. © 2020 Society for the Study of Addiction.