Predictors of moderated drinking in a primarily alcohol-dependent sample of men who have sex with men

Abstract

Understanding for whom moderated drinking is a viable, achievable, and sustainable goal among those with a range of alcohol use disorders (AUD) remains an important public health question. Despite common acceptance as severe risk factors, there is little empirical evidence to conclude whether co-occurring mental health disorders or drug dependence contribute to an individual's inability to successfully moderate his drinking. Utilizing secondary data analysis, the purpose of this study was to identify predictors of moderation among both treatment-seeking and non-treatment-seeking, primarily alcohol-dependent, problem-drinking men who have sex with men (MSM), with an emphasis on the high risk factors psychiatric comorbidity and drug dependence. Problem drinkers (N=187) were assessed, provided feedback about their drinking, given the option to receive brief AUD treatment or change their drinking on their own, and then followed for 15 months. Findings revealed that neither psychiatric comorbidity or drug dependence predicted ability to achieve moderation when controlling for alcohol dependence severity. Those who were younger, more highly educated, and had more mild alcohol dependence were more likely to achieve moderated drinking. Impact of treatment on predictors is explored. Limitations of this study and arenas for future research are discussed.

Figure 1

Proportion achieved moderation and/or abstinence by three definitions of moderation. Each of the definitions includes individuals who achieved abstinence that month. Actual moderation proportion of individuals moderating their active drinking is the difference between abstinence and the respective lines. For those who received treatment, treatment ended at month four.

Figure 2

Proportion achieved moderation at NIAAA defined level, abstinence, or remained an at-risk drinker (drank more than NIAAA level).