Individualized assignment to short-term alcohol abstinence: A proof-of-concept human laboratory study using...

Alcohol risk prevention strategies have recently incorporated temporary, short-term abstinence to reduce overall alcohol risk and health and social impacts on both individuals and society. However, experimental research in animals and humans has shown that, for some, short-term abstinence followed by reinstatement of drinking escalates, instead of reduces, subsequent alcohol use. The goal of this project was to conduct a proof-of-concept study using a novel precision approach to optimize assignment to short-term abstinence.

The sample consisted of 48 healthy adults aged 21-35 (Median=24.5, Interquartile Range (IQR)= 6, 67% female, 83% White) who endorsed moderate-to-heavy alcohol use. Participants completed two counterbalanced intravenous alcohol self-administration sessions, one following a two-week period of alcohol abstinence and one during usual drinking. Crossover generalized outcome weighted learning was used to estimate an optimal individualized assignment rule for short-term abstinence, based on relevant psychopathology dimensions and other individual characteristics as prescriptive factors.

Findings showed that an estimated rule with higher granularity - higher-specificity traits and demographics - led to lower overall alcohol consumption compared to one-size-fits-all rules. The effect sizes of the difference were small-to-medium but did not reach statistical significance, likely due to the small sample size.

Results provide preliminary evidence that individualized assignment rules based on simple, accessible characteristics warrant further examination as an approach to identify individuals who could benefit from short-term alcohol abstinence. This line of research has significant long-term implications for tailoring interventions to individual needs, thereby enhancing outcomes. Further research steps are necessary to realize its full impact.