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IMPROVING ABSTINENCE IN ALCOHOLICS.

Evidence that helping alcohol abusers stop drinking may improve their prognosis is supplied by two cohort studies. In the first, researchers evaluated 234 alcoholic men enrolled in another study who had achieved stable abstinence. Follow-up data at 1 to 11 years were available for 199 subjects, of whom 101 had relapsed. U.S. life-table data suggested that just 4 deaths would be expected among the relapsed alcoholics, but 19 had died. Excess mortality was particularly marked among men 20 to 45 years old (standardized mortality ratio, 9.6). The most common causes of death were neoplasms and hepatic cirrhosis (four cases of each). In contrast, mortality among the subjects who continued to abstain was similar to that predicted.

In the second study, 200 problem drinkers identified through a company-union employee assistance program were interviewed at 2-year intervals. These subjects averaged 6.3 drinks per day, and 21 percent were drunk daily. Even though 74 percent had seen physicians during the preceding year, only 22 percent of these recalled warnings from physicians about the dangers of alcohol. Factors associated with an increased likelihood of warnings included older age and the presence of liver disease. Two years later, those who had received warnings were significantly more likely to be abstinent than those who had not been warned (64 versus 32 percent).

Although these two studies are observational, the findings are consistent with the possibility that efforts aimed at helping alcoholics quit can increase alcohol abstinence and improve prognosis.

— THL

Published in Journal Watch General Medicine February 11, 1992

Citation(s):

Bullock KD et al. Reduced mortality risk in alcoholics who achieve long- term abstinence. JAMA 1992 Feb 5 267 668-672.

• Medline abstract (Free)

Walsh DC et al. The impact of a physician's warning on recovery after alcoholism treatment. JAMA 1992 Feb 5 267 663-667.

• Medline abstract (Free)