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Risk factors for nonremission among initially untreated individuals with alcohol use disorders
Rudolf H Moos1, Bernice S Moos
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto, California 94025, USA. bmoos@stanford.edu
Objective:
This study identified risk factors for 1-year and 8-year nonremission among initially untreated individuals with alcohol use disorders and examined whether a longer duration of professional treatment or Alcoholics Anonymous (AA) increased the likelihood of remission, moderated the influence of risk factors on remission status and reduced modifiable risk factors.
Method:
A sample of individuals with alcohol use disorders (N = 473) was recruited at alcoholism information and referral centers and detoxification units and was surveyed at baseline and 1 year, 3 years and 8 years later. At each contact, participants completed an inventory that assessed their alcohol-related problems and personal characteristics and their participation in treatment and AA since the last assessment.
Results:
An 11-item baseline risk index was associated with 1-year nonremission. Longer duration of treatment and AA in the first year predicted remission and a decline in modifiable risk factors. In addition, longer duration of AA increased the likelihood of remission more among high-risk than among low-risk individuals. The risk factors at 1 year were associated with 8-year nonremission; longer duration of additional treatment or AA was associated with a higher likelihood of 8-year remission and further reductions in modifiable risk factors.
Conclusions:
Referral counselors and treatment providers can identify high-risk individuals early in their help-seeking career and intervene to reduce the likelihood of a chronic course of their alcohol use disorder.