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Randomized Controlled Trial
. 2023 Aug;37(5):713-722.
doi: 10.1037/adb0000895. Epub 2022 Dec 8.

World Health Organization (WHO) risk level reductions in inpatients with alcohol use disorder and comorbid anxiety disorders

Brittany L Stevenson  1 , Justin Anker  1 , Paul Thuras  2 , Linda Rinehart  1 , Matt G Kushner  1
Affiliations
Randomized Controlled Trial

World Health Organization (WHO) risk level reductions in inpatients with alcohol use disorder and comorbid anxiety disorders

Brittany L Stevenson et al. Psychol Addict Behav. 2023 Aug.

Abstract

Objective: Studies have demonstrated that reduced drinking without total abstinence is associated with improved outcomes in outpatients with alcohol use disorder (AUD). We sought to examine this question in AUD inpatients who have comorbid anxiety disorders, a common presentation in AUD.

Method: This is a secondary analysis of data from a randomized controlled trial for N = 241 inpatients with AUD and comorbid anxiety disorders. Change from baseline drinking level was measured at 1-, 4-, and 12-months postdischarge, and psychological and functional outcomes were measured at 4- and 12-months postdischarge. Three groups were compared: abstinent, reduced (reduced drinking by 1-3 World Health Organization drinking risk levels without abstinence), or nonreduced (maintained or increased drinking risk level).

Results: At 1-, 4-, and 12-months posttreatment, most patients reported abstinence (83, 63, and 60%), and 11, 25, and 26% reported drinking at a reduced level. Drinking reductions achieved at 1-month posttreatment were maintained at 12-month posttreatment by 74% of participants. Overall, the abstinent group reported the best psychological and functional outcomes at follow-ups, followed by the reduced group. Few differences were observed between reducers and nonreducers, but reducers reported significantly better alcohol dependence severity and alcohol-related problems than nonreducers.

Conclusions: Though abstinence was associated with the best outcomes in this abstinence-based treatment sample, we conclude that reduced drinking is also associated with significant improvements in alcohol-related outcomes in inpatients with AUD and comorbid anxiety disorders.At 1-, 4-, and 12-months posttreatment, most patients reported abstinence (83, 63, and 60%), and 11, 25, and 26% reported drinking at a reduced level. Drinking reductions achieved at 1-month posttreatment were maintained at 12-month posttreatment by 74% of participants. Overall, the abstinent group reported the best psychological and functional outcomes at follow-ups, followed by the reduced group. Few differences were observed between reducers and nonreducers, but reducers reported significantly (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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Conflict of interest statement

Declarations of interest: none

Figures

Figure 1.
Figure 1.
Flow of participants between drinking groups at all follow-up time points. Graphic made using SankeyMATIC.com.
Figure 2.
Figure 2.
Legal Problems by Drinking Group and Baseline Severity (Month 4). Bars are 95% confidence intervals.
See this image and copyright information in PMC

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