Background Alcohol dependence often goes untreated. Although abstinence is often the aim of alcohol treatment, many drinkers prefer drinking-reduction goals. Therefore, if supported by evidence of benefit, drinking-reduction goals could broaden the appeal of treatment. Regulatory agencies are considering non-abstinent outcomes as clinical trial efficacy indicators, including reduction in the World Health Organization (WHO) drinking risk levels: very high, high, moderate and low, defined in terms of average grams of ethanol per day. Little is known about the relationship between reductions in WHO risk levels and subsequent reduction in the risk for alcohol dependence. Methods In a U.S. national sample, 22 005 drinkers participated in Wave 1 interviews in 2001–2002 and Wave 2 follow-ups 3 years later. Alcohol consumption and alcohol dependence were assessed at both waves. Logistic regression tested the relationship between change in WHO drinking risk levels between Waves 1 and 2, and Wave 2 alcohol dependence. Findings Reductions of 1, 2 or 3 WHO risk levels predicted significantly lower odds of alcohol dependence at Wave 2, particularly among very high and high risk drinkers at Wave 1, and among those with alcohol dependence at Wave 1. Interpretation Results support the use of reductions in WHO drinking risk levels as clinical trial efficacy indicators. Because the levels can readily be translated into average drinks per day using the standard drink equivalents of different countries, the WHO risk levels could also be used internationally to guide treatment goals and clinical recommendations on drinking reduction.

Background: Non-abstinent drinking reductions that predict improvement in how individuals feel or function, such as the World Health Organization (WHO) drinking risk levels, may be useful outcomes in clinical trials for alcohol use disorders (AUD). Methods: Current drinkers in a U.S. national survey (n=22,005) were interviewed in 2001-02 (Wave 1) and re-interviewed 3 years later (Wave 2). WHO drinking risk levels, a 4-level categorization system (very-high-risk, high-risk, moderate-risk, and low-risk drinkers) defined using estimated mean ethanol consumption (grams) per day in the prior 12 months, and DSM-IV depressive and anxiety disorders were assessed at both waves. Logistic regression was used to

Interventions targeting these disparities should be explored, as women may face complicated treatment initiation, retention, and recovery. (Am J Addict 2018;27:465-470).

In the highest-risk drinkers, reductions in WHO drinking risk levels predicted lower likelihood of liver disease and positive AUDIT-C scores. Results add to findings that reductions in the 4-category WHO drinking risk levels are a meaningful indicator of how individuals feel and function, and could serve as nonabstinent end points in clinical trials. Results also connect the WHO risk drinking levels to commonly used alcohol screening questions, which may be more familiar to healthcare providers.

Individuals with early psychosis receiving CSC achieved significant improvements in education and employment and experienced a decrease in hospitalization rate. Demographic variables and baseline education predicted education and employment outcomes. CSC teams should make particular effort to support the occupational goals of individuals at increased risk of not engaging in work or school, including male participants and participants from racial and ethnic minority groups.