[One drink, one drunk--controlled drinking by alcoholics? 3-year-outcome after intensive outpatient treatment]

Up to now, controlled drinking as an alternative to abstinence for alcohol-dependents has been discussed controversially. In the present study we examined in a sample of alcohol-dependent patients whether or not controlled drinking is possible during a three years period following treatment.

103 consecutively recruited alcohol-dependent participants (ICD-10) which took part in an abstinence-orientated outpatient treatment were re-interviewed 6, 12, 24, 36 months following treatment (follow-up ratio ca. 90 %).

Analysis revealed that 43 % of patients were abstinent during total follow-up period and 12 % of patients were classified as improved at follow-up using the classification proposed by Feuerlein and Küfner. Of these patients, no patient at all was able to practise self-controlled drinking alcohol during the entire follow-up period.

Only four patients had a drinking pattern similar to controlled drinking during a maximum period of 24 months. Though the primary aim of the evaluated outpatient clinic was to achieve abstinence and not controlled drinking, controlled drinking in alcohol-dependent patients nevertheless seems to be a rare phenomenon, which cannot be recommended. Moreover, recent animal models for alcoholism indicate alcoholism being an irreversible pattern.