Within-AUD outpatient treatment heavy drinking transitions and associations with long-term outcomes. (1st November 2021)

• Record Type: Journal Article
• Authors: Maisto, Stephen A.; Hallgren, Kevin A.; Swan, Julia E.; Roos, Corey; Witkiewitz, Katie
• Is Part Of: Drug and alcohol dependence. Volume 228(2021)
• Publication Date: 2021-11-01
• Subjects: Alcohol use disorder -- Clinical course -- Within-treatment drinking status -- Transition pattern -- Latent profile analysis -- Long-term outcomes; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108968
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Alcohol use disorder clinical course is dynamic and heterogeneous. Posttreatment transitions between periods of heavy and nonheavy drinking predict long-term alcohol use and psychosocial functioning. Drinking episode transitions occurring within outpatient treatment have good stability and predict long-term functioning. Abstract: Objectives: The purpose of this study was to examine whether changes in heavy drinking occurring within alcohol treatment predict long-term functioning. Method: Latent profile analyses were conducted using data from Project MATCH and COMBINE. Observed changes in heavy and nonheavy drinking within consecutive 2-week periods over the respective treatment durations were characterized for each participant and were used to identify latent profiles. Results: Both data sets revealed 6 profiles: (1) continuous "remission" (nonheavy drinking); (2) transition from heavy drinking ("relapse") to remission; (3) mostly remission, limited relapse; (4) numerous short transitions between relapse and remission; (5) transition to relapse; and (6) continuous relapse. Profiles 1 and 2 had the best long-term outcomes, Profiles 5 and 6 had the worst, and Profiles 3 and 4 fell between these groups. Within-treatment patterns of heavy drinking and nonheavy drinking were also associated with post-treatment patterns of relapse and remission. Conclusions: Patterns of transition between episodes that respectively include heavy and nonheavy drinking predict long-term alcohol use and psychosocial outcomes and seem essential for clinicians to discuss with their patients. Relapses during outpatient treatment do not necessarily indicate treatment failure, provided they are relatively brief and/or infrequent. In addition, some individuals can and do change from transition patterns of heavy drinking within treatment that are predictive of poorer long-term functioning to transition patterns that predict better functioning within the first year post-treatment.