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Profiles of Recovery from Alcohol Use Disorder at Three Years Following Treatment: Can the Definition of Recovery be Extended to Include High Functioning Heavy Drinkers?

Research paper by Katie K Witkiewitz, Adam D AD Wilson, Matthew R MR Pearson, Kevin S KS Montes, Megan M Kirouac, Corey R CR Roos, Kevin A KA Hallgren, Stephen A SA Maisto

Indexed on: 01 Aug '18Published on: 01 Aug '18Published in: Addiction



Abstract

Recovery from alcohol use disorder (AUD) is often narrowly defined by abstinence from alcohol and improvements in functioning (e.g., mental health, social functioning, employment). This study used latent profile analysis to examine variability in recovery outcomes, defined by alcohol use, alcohol-related problems, and psychosocial functioning at three years following treatment. Secondary analysis investigated pre-treatment, post-treatment, and one- and three-year post-treatment covariate predictors of the latent profiles. Secondary analysis of data from a randomized clinical trial. USA PARTICIPANTS: We used data from the outpatient arm of Project MATCH (n=805; 29.7% female, 22.2% non-White). Recovery was defined by latent profile analyses including measures of psychosocial functioning and life satisfaction (Psychosocial Functioning Inventory), unemployment and mental health (Addiction Severity Index), alcohol and other drug use (Form 90), and alcohol-related consequences (Drinker Inventory of Consequences) three years following treatment. Mixture modeling was used to examine correlates of profiles. We identified four profiles at three years following treatment: 1) poor functioning frequent heavy drinkers, 2) poor functioning infrequent heavy drinkers, 3) high functioning occasional heavy drinkers, and 4) high functioning infrequent non-heavy drinkers. There were relatively few differences on indicators of functioning and treatment-related variables between the high functioning infrequent non-heavy drinkers and the high functioning occasional heavy drinkers, other than high functioning occasional heavy drinkers having lower alcohol dependence severity (OR=0.94, 95% CI: 0.90, 0.98), fewer post-treatment coping skills (OR=0.54, 95% CI: 0.27, 0.81), and lower three-year post-treatment abstinence self-efficacy (OR=0.37, 95% CI: 0.27, 0.47), and AA involvement (OR=0.87, 95% CI: 0.74, 0.99). The two high functioning profiles showed the greatest improvements in functioning from baseline through the 3-year follow-up, whereas the low functioning profiles showed the least amount of improvement. High functioning occasional heavy drinkers had higher purpose in life than the poor functioning profiles. Some individuals who engage in heavy drinking following treatment for alcohol use disorder may function as well as those who are mostly abstinent with respect to psychosocial functioning, employment, life satisfaction, and mental health. This article is protected by copyright. All rights reserved.

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