Participating in at least two sessions of a telephone-delivered intervention may help reduce total alcohol consumption, alcohol problem severity, and risky drinking patterns among patients with alcohol use problems, according to a study published yesterday in JAMA Psychiatry.
“Alcohol use disorders are estimated to affect 5.1% of the adult population worldwide,” wrote Dan Lubman, Ph.D., of Monash Addiction Research Centre in Victoria, Australia, and colleagues. “Yet, the magnitude of alcohol consumption and attributable harms remains in sharp contrast to the low rates of treatment use.”
Lubman and colleagues recruited participants aged 18 and older with problem alcohol use from across Australia via social media and clinician referrals. Problem alcohol use was defined as a score of more than 6 for females and more than 7 for males on the Alcohol Use Disorders Identification Test (AUDIT). Possible scores on the AUDIT range from zero to 40. AUDIT also measures hazardous use, harmful use, and dependence symptoms. Participants’ AUDIT scores were assessed at baseline and again three months later.
Participants were randomly assigned to either the intervention group or the active control group. Those in the intervention group received four to six 30- to 50-minute sessions of a telephone-delivered cognitive and behavioral intervention called Ready2Change. After receiving a clinical assessment in the first session, trained counselors introduced the participants in the intervention group to the following practices in session two: keeping a daily alcohol diary; identifying participants’ triggers; assistance managing urges with SOBER breathing (a mindfulness-based practice that includes five steps: stop, observe, breathe, expand, and respond); and establishing a helpful routine. The counselors tailored the remainder of the sessions (offered weekly) to individual participants, based on their reasons for engaging in treatment and challenges they faced. The active control group received alcohol consumption guidelines, stress management pamphlets, and four telephone check-ins that were five minutes or less.
Among 344 participants, two-thirds had AUDIT scores corresponding to the highest category of probable dependence, and only one-third had previously sought treatment for their alcohol use. Sixty-five percent of participants randomized to the intervention group completed the program (defined as participating in at least four sessions), and 80% of participants in the control group completed the program.
The AUDIT scores decreased significantly from baseline to three months in both groups, falling from 21 to 12.8 in the intervention group, and from 22.1 to 14.9 in the active control group. The intervention group showed a significantly greater reduction in hazardous use. When adjusting for exposure to two or more sessions, the researchers found that the intervention group had a greater reduction in their total AUDIT scores compared with the control group.
“The results of this clinical trial support [the] benefits of a telephone-delivered intervention in a general population sample of individuals who do not typically seek treatment for alcohol use problems, despite experiencing high problem severity,” the authors concluded. The “[f]indings demonstrate the potential benefits of this highly scalable telehealth model of alcohol treatment, with potential to reduce the treatment gap for problem alcohol use.”
For related information, see the Psychiatric News article “Pandemic May Be Accelerating Problematic Trends in Alcohol Use.”
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