For people seeking treatment for alcohol dependence, drink reduction goals are achievable and sustainable, according to new study findings.
Sustained abstinence has long been considered the optimal treatment outcome for those with a clinically diagnosed alcohol use disorder (AUD). However, most people who seek treatment would prefer to reduce their drinking, rather than quit completely. Interest in drinking reduction as a treatment goal is growing, although whether reductions can be maintained over time, and improve patients' function, is uncertain.
The large COMBINE clinical trial examined combinations of medications and behavioral interventions, used over 4 months, for treating alcohol dependence. One measure of alcohol intake was the World Health Organization (WHO) drinking risk level, which defines five risk levels based on a standard drink containing .6 fluid ounces (oz) or 14 grams (g) of ethanol per day (equivalent to 1.5 oz of 80 proof liquor, 12 oz of 5% beer, or 5 oz of 12% wine): abstinence(no intake), low risk(1-40 g/up to ~3 standard drinks in persons who are biologically male, 1-20 g/~1.5 drinks in persons who are biologically female), medium risk(41-60 g/up to ~4 drinks in males, 21-40 g/up to ~3 drinks in females), high risk(61-100 g/up to ~7 drinks in males, 41-60 g/~4 drinks in females), and very highrisk (101 g/+7 drinks in males, 61 g/+4 females). Most participants were in the 'very high risk' category before treatment, but reduced their drinking by at least two levels during treatment.
These new data show that a reduction in WHO risk drinking level is a meaningful and sustainable measure, and appropriate for use in future clinical trials of new treatment approaches and in clinical care.