Influence of temperance on short-term mortality among alcohol-dependent men in Sri Lanka

The influence of temperance on short-term mortality was assessed in a group of alcohol-dependent men admitted to a rehabilitation unit in Sri Lanka. Of the 234 men initially admitted to the programme, 188 were followed up for at least 3 years (mean +/- SD 49.5 +/- 12.6 months) or until death. All 188 were totally abstinent from alcohol on leaving the 6 week residential module of the programme. During follow-up, 115 relapsed to continued heavy drinking, whereas 73 remained either totally abstinent or drank infrequently. There were no significant differences in the age, duration of dependence, number of previous interventions, duration of follow-up or smoking habits between the two groups of patients. The overall mortality for the whole sample population was 9.6%. The mortality among those who relapsed to heavy drinking (13.9%) was more than five times that of those who were abstinent or drank infrequently (2.7%) (P < 0.04). Fifteen of the 16 deaths (93.8%) among those who relapsed to heavy drinking were alcohol-related, and included five suicides and accidents whilst under the influence of alcohol. Temperance significantly reduces short-term mortality in alcohol-dependent men when compared to those who relapse to continued heavy drinking. This difference was primarily due to reduction in the risk of alcohol-related deaths.