A Randomized Trial of Two Behavioral Interventions to Improve Outcomes Following Inpatient Detoxification for Alcohol Dependence

Abstract

To determine if the addition of a behavioral intervention during alcohol detoxification would facilitate initiation of subsequent care, we randomized 150 detoxification patients to receive: treatment as usual (TAU), a Motivation Enhancement Therapy (MET) intervention, or a Peer-delivered Twelve Step Facilitation (P-TSF) intervention. The main outcome was the initiation of any type of subsequent care (i.e., professional treatment or self-help) within 30 and 90 days of discharge. Other outcomes included: alcohol and drug use, completion of subsequent professional treatment, and readmission for detoxification. The mean age of the participants was 45 years; 65% were men, and 84% were white. At the 30-day follow-up, there was no significant difference among the groups in the rate of initiation of any type of subsequent care (82%, 74%, and 82% respectively, p = 0.617); however, the MET group had significantly more patients initiate subsequent inpatient treatment by the 90-day follow-up compared to the P-TSF group (31% and 61%, p = 0.007) and a greater proportion of MET participants completed subsequent inpatient treatment compared to both TAU and P-TSF. There were no differences in drinking-related outcomes (e.g., number of days before first drink, percent days abstinent) between the groups. We conclude that MET during detoxification may provide additional benefits in terms of initiating and maintaining patients in aftercare inpatient treatment programs.

Efficacy and Safety of the Glycine Transporter‐1 Inhibitor Org 25935 for the Prevention of Relapse in Alcohol‐Dependent Patients: A Randomized, Double‐Blind, Placebo‐Controlled Trial

“…Relapse curves usually tend to be exponential and steeper in the early phase after detoxification (Blondell et al, 2011;Paparrigopoulos et al, 2011). However, for 90% of subjects in the present study, a typical drinking day was a heavy drinking day, and 70% reported 4 or more drinking day per week, before detoxification.…”

Psychometric properties of a Spanish-language version of the Short Inventory of Problems.

“…Overall however, results of factor analysis, coupled with the high internal reliability for the total score, support the notion of one overall construct of adverse consequences, consistent with prior interpretations of the SIP (Allensworth-Davies, Cheng, Smith, Samet, & Saitz, 2012; Alterman et al, 2009; Bender et al, 2007; Blanchard et al, 2003a). These findings support the use of the SIP total score when reporting results, as is most common in the literature (e.g., Blondell, et al, 2011; Brower, Krentzman, & Robinson, 2011; Clark, et al, 2012), with limited use of the three-item subscale scores.…”

Predischarge Injectable Versus Oral Naltrexone to Improve Postdischarge Treatment Engagement Among Hospitalized Veterans with Alcohol Use Disorder: A Randomized Pilot Proof‐of‐Concept Study

“…Given prior literature indicating that many inpatients with AUDs forgo follow‐up treatment (Blondell et al., ; Saitz et al., ), we were surprised that the vast majority of veterans in both study groups saw an addiction treatment specialist in the last 14 days after hospital discharge. In light of these findings, and because inpatients in need of alcohol detoxification are likely to have extensive treatment needs, our findings indicate that the most optimal measure of follow‐up care would be a measure based on continued engagement in substance‐use disorder treatment, rather than the initiation of any treatment.…”