Psychological Interventions on Abstinence in Patients with Alcohol Use Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials PMC

Guided-self change is a relatively new and brief cognitive-behavioral intervention that has demonstrated efficacy with problem drinkers. Interventions based on harm reduction principles have decreased alcohol use in various student populations. Finally, Moderation Management is the only self-help program that supports non-abstinence goals, a feature that makes it popular with problem drinkers who are avoidant of traditional treatment services. In 1990, Marlatt was introduced to the philosophy of harm reduction during a trip to the Netherlands (Marlatt, 1998). He adopted the language and framework of harm reduction in his own research, and in 1998 published a seminal book on harm reduction strategies for a range of substances and behaviors (Marlatt, 1998). Marlatt’s work inspired the development of multiple nonabstinence treatment models, including harm reduction psychotherapy (Blume, 2012; Denning, 2000; Tatarsky, 2002).

Even moderate drinking can lead to long-term health problems such as liver disease, heart disease, and increased risk of certain cancers. Besides, alcohol affects your sleep quality and mental health too; it’s not uncommon for people who drink regularly to struggle with anxiety or depression. Your thoughts, feelings, and behaviours all play a role in how you manage your alcohol consumption. It’s important to acknowledge any emotional ties you might have to alcohol as these could make both moderation and complete abstinence more challenging.

How Successful Are Controlled Drinking Programmes?

In its original form, RP aims to reduce risk of relapse by teaching participants cognitive and behavioral skills for coping in high-risk situations (Marlatt & Gordon, 1985). More recent versions of RP have included mindfulness-based techniques (Bowen, Chawla, & Marlatt, 2010; Witkiewitz et al., 2014). The RP model has been studied among individuals with both AUD and DUD (especially Cocaine Use https://ecosoberhouse.com/ Disorder, e.g., Carroll, Rounsaville, & Gawin, 1991); with the largest effect sizes identified in the treatment of AUD (Irvin, Bowers, Dunn, & Wang, 1999). As a newer iteration of RP, Mindfulness-Based Relapse Prevention (MBRP) has a less extensive research base, though it has been tested in samples with a range of SUDs (e.g., Bowen et al., 2009; Bowen et al., 2014; Witkiewitz et al., 2014).

Indeed, the participants in the study are what I would consider very heavy drinkers and are likely more representative of common drinking problem behavior than the really severe, chronic, poly-substance dependent patients that often present to residential treatment. The ability to control drinking varies significantly from person to person and is influenced by a range of factors including genetics, environment, emotional state, and individual psychology. For people suffering from alcohol use disorders, trying to moderate drinking isn’t advised and total abstinence is always recommended. This means addressing not just the physical symptoms of addiction but also the psychological, emotional, social, and spiritual aspects as well. Such approaches could include cognitive behavioural therapy to address mental health issues that may contribute to excessive drinking; yoga or meditation for stress relief; art therapy for expressing emotions; faith-based support groups for spiritual growth among others. While you may see the appeal in a programme that allows for some level of drink intake, it’s crucial to consider the potential drawbacks that could come with this approach.

How Do You Practice Controlled Drinking?

The outcomes included percentage of days abstinent (PDA), change in drinks per drinking day (change in DDD), and change in craving compared among individuals accepting various psychotherapies. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered on the International Prospective Register of Systematic Reviews (PROSPERO). Alcohol moderation management isn’t just about cutting back and reducing your blood alcohol concentration, it’s a deeply personal journey that can empower you to regain control of your life and reconnect with those who matter most. This strategy is not about total abstinence but involves setting moderate drinking goals that are safe and sensible for you, paying attention to social influences that may sway your decisions, and developing self-awareness around your triggers.

We considered over one hundred baseline predictors in COMBINE that had less than 15% missing values. When I first set about writing this article, many of the issues I was going to bring up had to do with research on alcohol relapse patterns, my own story, and other evidence I’ve already introduced on All About Addiction. It’s not an easy road to lasting recovery, but with the right support and resources, it can definitely be a journey worth taking. The crucial factor here isn’t necessarily which path you choose but having a supportive network around you who respects and understands your decision. Rethinking life stages and intergenerational relations of Italian youth”, Societies, Vol. Some interview person (IP) were former polydrug users and altered between AA and NA meetings.

2. Relationship between goal choice and treatment outcomes

The top four most likely to be accepted were naltrexone+MET (55.4%), naltrexone+CBT (37.8%), PLC+MET (16.5%), and PLC+CBT (18.7%). Among the SUCRA rankings, naltrexone+MET, sertraline+CBT, and naltrexone+CBT were ranked 2.6, 5.1, and 5.2, respectively. The results of the NMA indicate that no treatment showed a significantly better effect than TAU or TAU plus PLC on the change in DDD (Figure S9Ba–c), and (d)). All of the significant evidence from controlled drinking vs abstinence active intervention comparisons were with low certainty (Figure S11B and Table S12A). PDA was used to measure the self-control and was assessed by Timeline Followback Interviews (TLFBs) or Form-90.25 To some extent, the higher the PDA is, the better the patient’s ability to control drinking is. Change in DDD was assessed by TLFBs or Form-90 to evaluate the change in average drinking on a drinking day, using a “standard drink” as a measure.