Two-year outcome of a treatment program for alcohol use disorder in regional and rural India

Abstract

Background: Alcohol use disorder (AUD) is a major health issue in developing countries, posing a significant economic burden with limited access to comprehensive treatment and follow-up services. AUD treatment services are limited in India, especially in regional and rural areas.

Methods: This retrospective study assessed outcomes in patients with AUD from a rural and regional part of India admitted to a voluntary treatment program with a 2-year follow-up after initial detoxification. The primary outcome measures were the extent and duration of abstinence achieved at the end of 2 years. The secondary outcome measures were quality of life, psychological wellbeing, and family burden.

Results: One hundred sixty-nine out of 180 patients (93.9%) completed the 2-year program. Sustained abstinence was achieved by 81.1% of patients and sustained low-risk drinking by 14.8% in an uncontrolled environment. There was a significant improvement in the quality of life and psychological wellbeing and a reduction in the total family burden. Patients sustaining total abstinence experienced a higher family burden at intake than those with low-risk drinking.

Conclusion: The majority of patients with AUD achieved total abstinence in communities with limited specialist health services with appropriate treatment and follow-up services. Factors influencing such positive outcomes could be the voluntary nature of the program, setting up total abstinence as the treatment goal, collaborative support of the family, access to low-cost treatment and extended follow-up, and use of disulfiram. A future prospective study using a control group addressing this study's limitations is required to confirm the observed outcomes.

Keywords: Alcohol use disorder; India; social capital; treatment outcome.