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Randomized Controlled Trial
. 2017 Oct;26(7):673-675.
doi: 10.1111/ajad.12558. Epub 2017 Aug 18.

Pretreatment ethyl glucuronide levels predict response to a contingency management intervention for alcohol use disorders among adults with serious mental illness

Michael Gerard McDonell  1   2   3   4 , Emily Leickly  1   3 , Sterling McPherson  2   3   5 , Jordan Skalisky  1   3 , Katherine Hirchak  1   3 , Oladunni Oluwoye  1   3 , Debra Srebnik  4 , John Michael Roll  2   3 , Richard Kirkland Ries  4
Affiliations
Randomized Controlled Trial

Pretreatment ethyl glucuronide levels predict response to a contingency management intervention for alcohol use disorders among adults with serious mental illness

Michael Gerard McDonell et al. Am J Addict. 2017 Oct.

Abstract

Background and objectives: This study investigated if pretreatment ethyl glucuronide (EtG) levels corresponding to light (100 ng/mL), heavy (500 ng/mL), and very heavy (1,000 ng/mL) drinking predicted longest duration of alcohol abstinence (LDA) and proportion of EtG-negative urine tests in outpatients receiving a 12-week EtG-based contingency management (CM) intervention for alcohol dependence.

Methods: Participants were 40 adults diagnosed with alcohol use disorders and serious mental illness who submitted up to 12 urine samples for EtG analysis during a 4-week observation period and were then randomized to 12-weeks of CM for alcohol abstinence and addiction treatment attendance. Alcohol use outcomes during CM as assessed by EtG and self-report were compared across those who did and did not attain a pre-treatment average EtG level of 500 ng/mL-a level that equates to frequent heavy drinking.

Results: Only the 500 ng/mL cutoff was associated with significant differences in LDA and proportion of EtG-negative samples during CM. Those with a pre-treatment EtG < 500 ng/mL attained a LDA 2.3 (alcohol) to 2.9 (drugs) weeks longer than pre-treatment heavy drinkers.

Discussion and conclusions: The EtG biomarker can be used to determine who will respond to a CM intervention for alcohol use disorders and could inform future trials that are designed to be tailored to individual patients.

Scientific significance: Results suggest pre-treatment EtG cutoffs equivalent to heavy and very heavy drinking predict outcomes in CM. (Am J Addict 2017;26:673-675).

Keywords: alcohol treatment; contingency management; ethyl glucuronide; predicting treatment outcomes; serious mental illness.

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Conflict of interest statement

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Figures

Figure 1
Figure 1
Predicting Longest Duration of Abstinence from Alcohol
See this image and copyright information in PMC

References

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    1. McDonell M, Leickly E, McPherson S, et al. A randomized controlled trial of ethyl glucuronide-based contingency management for outpatients with co-occurring alcohol use disorders and serious mental illness. Am J Psychiat. 2017 - PMC - PubMed
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