Can Individuals With Alcohol Use Disorder Sustain Non-abstinent Recovery? Non-abstinent Outcomes 10 Years After Alcohol Use Disorder Treatment.
Can Individuals With Alcohol Use Disorder Sustain Non-abstinent Recovery? Non-abstinent Outcomes 10 Years After Alcohol Use Disorder Treatment.
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DOI：
10.1097/adm.0000000000000760
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发表时间：
2021-07-01
影响因子：
5.5
通讯作者：
Tucker JA
中科院分区：
文献类型：
--
作者：
Witkiewitz K;Wilson AD;Roos CR;Swan JE;Votaw VR;Stein ER;Pearson MR;Edwards KA;Tonigan JS;Hallgren KA;Montes KS;Maisto SA;Tucker JA
四十年前，“控制饮酒”的争议搅动了酒类领域。随后积累的数据表明，非戒酒使用障碍(AUD)的恢复是可以实现的，但长期是否可持续的问题仍然存在。这项研究调查了AUD治疗后三年未戒断的恢复与治疗后10年的功能改善是否相关。数据来自Project Match的10年随访(仅限新墨西哥州，n=146；30.1%为女性，58.6%为非白人)。康复的定义是基于治疗三年后的心理社会功能和饮酒情况的潜伏期分析。在治疗10年后，对饮酒习惯和后果、抑郁、生活目标和愤怒进行评估。远端结局分析检查了饮酒和功能结局在10年时的差异，作为3年潜伏期的函数。分析是在https://osf.io/3hbxr.上预先注册的在治疗后三年发现的四种潜在特征(即低功能经常酗酒者、低功能不经常饮酒者、高功能重度饮酒者和高功能不频繁非重度饮酒者)与治疗十年后的结果显著相关。无论饮酒水平如何，三年后的两组高功能患者在治疗后十年的心理功能水平最高。禁欲三年并不能预示十年后心理功能会更好。非戒断性AUD的恢复是可能的，并且在治疗后可持续长达10年。目前的发现与最近的建议一致，即超越依赖酒精消费作为AUD恢复的核心定义特征。
Four decades ago the “controlled drinking” controversy roiled the alcohol field. Data have subsequently accumulated indicating that non-abstinent alcohol use disorder (AUD) recovery is achievable, but questions remain whether it is sustainable long-term. This study examined whether non-abstinent recovery at three years following AUD treatment is associated with better functioning at 10 years following treatment. Data were from the 10-year follow-up of Project MATCH (New Mexico site only, n=146; 30.1% female, 58.6% non-White). Recovery was defined by latent profile analyses based on psychosocial functioning and alcohol consumption three years following treatment. Drinking practices and consequences, depression, purpose in life, and anger were assessed 10 years following treatment. Distal outcome analyses examined differences in drinking and functional outcomes at 10 years as a function of the 3-year latent profiles. Analyses were pre-registered at https://osf.io/3hbxr. Four latent profiles identified at three years following treatment (i.e., low functioning frequent heavy drinkers, low functioning infrequent heavy drinkers, high functioning heavy drinkers, and high functioning infrequent non-heavy drinkers) were significantly associated with outcomes ten years following treatment. The two high functioning profiles at three years had the highest level of psychological functioning at ten years post-treatment, regardless of alcohol consumption level. Abstinence at three years did not predict better psychological functioning at ten years. Non-abstinent AUD recovery is possible and is sustainable for up to 10 years following treatment. The current findings align with recent proposals to move beyond relying on alcohol consumption as a central defining feature of AUD recovery.