Commentary on Henssler et al.: The public health case for promoting and valuing drinking reductions in the treatment of alcohol use disorder.
Commentary on Henssler et al.: The public health case for promoting and valuing drinking reductions in the treatment of alcohol use disorder.
复制标题
Henssler 等人的评论：在酒精使用障碍治疗中促进和重视减少饮酒的公共卫生案例。
DOI：
10.1111/add.15429
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Tucker,JalieA
中科院分区：
文献类型：
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作者：
Witkiewitz,Katie;Morris,James;Tucker,JalieA
Drinking reductions short of abstinence are achievable, sustainable and associated with improvements in how some individuals with alcohol use disorder (AUD) feel and function. The public health burden of AUD could be lessened if drinking reductions were more widely accepted and promoted as a treatment goal in addition to abstinence.Sustained abstinence from alcohol has been the primary target in the treatment of alcohol use disorder (AUD) for the past century. More than 40 years ago, research showing the possibility of controlled drinking outcomes among some individuals with AUD was swiftly condemned and criticized [1]. Despite pushback from the alcohol field during ‘the controlled drinking controversy’[1], a few research groups continued to examine controlled (ie moderate or low-risk) drinking as a potential treatment goal and outcome. This body of work comprises a limited number of randomized clinical trials and a larger number of non-randomized treatment evaluations that compared non-abstinent and abstinence-based treatment strategies, including a subset of studies that allowed patients to choose their drinking goals and provided goal-specific interventions. The recent systematic review and meta-analysis by Henssler and colleagues [2] examined this research using modern review methods and replicated earlier reviews [3] that provided compelling evidence that controlled drinking is possible, even among some individuals with severe AUD. Moreover, for the first time, Henssler and colleagues [2] rigorously showed that treatments focused on abstinence goals did not significantly differ from treatments that allowed controlled drinking with respect to patient psychosocial functioning and successful maintenance of drinking reductions. These meta-analysis and meta-regression [2] findings are aligned with other recent empirical research showing that drinking reductions, short of complete abstinence from alcohol, are achievable, sustainable and associated with improvements in how individuals with AUD feel and function for several years or more after treatment [4–6]. These results provide further support for considering non-abstinent recovery from AUD as a potential treatment target that could expand the scope and reach of AUD treatment in the population with problems [7, 8]. They are also consistent with drinking reductions and positive functional outcomes achieved by the majority of the population with alcohol-related problems who recover on
