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Published on: April 28, 2022
Two-year outcome of a treatment program for alcohol use disorder in regional and rural India
Chellamuthu Ramasubramanian1, Srinivasan Tirupati2, Anand Muthukumaraswamy2,3
1Alcohol and Drug Deaddiction Services, MS Chellamuthu Trust and Research Foundation, Madurai, Tamil Nadu, India.
Background:
Alcohol use disorder (AUD) is a major health issue in developing countries, posing a significant economic burden with limited access to comprehensive treatment and follow-up services. AUD treatment services are limited in India, especially in regional and rural areas.
Methods:
This retrospective study assessed outcomes in patients with AUD from a rural and regional part of India admitted to a voluntary treatment program with a 2-year follow-up after initial detoxification. The primary outcome measures were the extent and duration of abstinence achieved at the end of 2 years. The secondary outcome measures were quality of life, psychological wellbeing, and family burden.
Results:
One hundred sixty-nine out of 180 patients (93.9%) completed the 2-year program. Sustained abstinence was achieved by 81.1% of patients and sustained low-risk drinking by 14.8% in an uncontrolled environment. There was a significant improvement in the quality of life and psychological wellbeing and a reduction in the total family burden. Patients sustaining total abstinence experienced a higher family burden at intake than those with low-risk drinking.
Conclusion:
The majority of patients with AUD achieved total abstinence in communities with limited specialist health services with appropriate treatment and follow-up services. Factors influencing such positive outcomes could be the voluntary nature of the program, setting up total abstinence as the treatment goal, collaborative support of the family, access to low-cost treatment and extended follow-up, and use of disulfiram. A future prospective study using a control group addressing this study's limitations is required to confirm the observed outcomes.
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