Benefits of temporary alcohol restriction: a feasibility randomized trial

Abstract

Background Participation in temporary alcohol abstinence campaigns such as ‘Dry January’ may prompt enduring reductions in alcohol consumption. A randomized controlled trial (RCT) is required to establish any long-term benefits or negative consequences of temporary abstinence. In the present study, we randomized heavy drinkers to complete or intermittent alcohol abstinence for 4 weeks, in order to evaluate the feasibility of conducting a large-scale RCT. Methods This was a mixed methods feasibility study in which we explored recruitment and retention to a randomized trial, compliance with alcohol abstinence instructions and barriers to compliance, and acceptability of study procedures (primary feasibility outcomes). A community sample of women aged between 40 and 60 who drank in excess of 28 alcohol units per week were randomized to abstain from alcohol for 4 weeks either completely or intermittently (at least four abstinent days per week). To monitor compliance, both groups provided regular breath samples on a cellular breathalyser. A subsample completed a semi-structured interview that probed barriers to compliance with abstinence instructions and acceptability of study procedures. Results Within 5 months, we recruited, screened and randomized 25 participants (20% of participants who responded to advertisements: 14 in the complete abstinence group, 11 in the intermittent abstinence group), 24 of whom were retained throughout the 28-day intervention period. Participants in both groups tended to comply with the instructions: the median number of breathalyser-verified abstinent days was 24 (IQR = 15.5–25.0; 86% of target) in the complete abstinence group versus 12 (IQR = 10–15; 75% of target) in the intermittent abstinence group. Semi-structured interviews identified some barriers to compliance and methodological issues that should be considered in future research. No adverse events were reported. Conclusions It is feasible to recruit heavy drinking women from community settings and randomize them to either complete or intermittent abstinence from alcohol for 4 weeks. The majority of participants were retained in the study and compliance with the abstinence instructions was good, albeit imperfect. A comprehensive RCT to compare temporary alcohol abstinence with other alcohol reduction strategies on long-term alcohol consumption is feasible. Findings from such a trial would inform implementation of alcohol campaigns and interventions.

Experiences of alcohol-dependent elderly: grounded theory

“…According to the results of the present study, the alcohol-dependent elderly, when they start treatment and maintain abstinence, can experience its benefits. Individuals in abstinence from alcohol, show improvement in health conditions and ability to work, financial situation, concentration and energy levels, and confidence in resisting alcohol (17) .…”

Behavioral economic and value-based decision-making constructs that discriminate current heavy drinkers versus people who reduced their drinking without treatment

“…We also administered the following self-report questionnaires: the 10-item Alcohol Use Disorders Identification Test (AUDIT; Saunders et al, 1993, McDonald's ω = .82 (McDonald, 1970, 1999) to examine alcohol use and related problems, the 10-item Meaning in Life Questionnaire (MLQ; Steger et al, 2006, presence, ω = .93, search, ω = .92) to measure presence of meaning and search for meaning in life, the 13-item Brief Self-Control Scale (BSCS; Tangney et al, 2004, ω = .85) to measure self-control, the 4-item Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; Miller & Tonigan, 1996, ω = .89) as used in other research (Morris et al, 2020(Morris et al, , 2021 to measure alcohol problem recognition, and the 9-item Drinking Refusal Self-Efficacy Questionnaire (Young et al, 1991) as used in other research (Field, Puddephatt, et al, 2020) to measure drinking refusal self-efficacy across three subscales (social pressure, ω = .84, emotional relief, ω = .91, opportunistic, ω = .85). Finally, we measured participant demographics, duration of current and previous (prior to moderation) level of alcohol consumption, and questions about COVID-19 (see supplementary materials for a detailed description of all questionnaire measures and the participant demographic breakdown).…”

“…Drinking Refusal Self-Efficacy Questionnaire (Young et al, 1991): In line with previous research (Field, Puddephatt, et al, 2020), we used a 9-item version of the original 31-item measure to assess participants' belief in their ability to resist alcohol. This measures selfefficacy across three subscales: social pressure (e.g., "When I am with friends"), emotional relief (e.g., "When I am worried"), and opportunistic (e.g., "When I am watching TV").…”

Development of the motivational thought frequency scale for alcohol abstinence (MTF‐A)

“…Most pharmacological medications for AUD treatment have been validated with the primary outcome of abstinence, and in many international jurisdictions can only be prescribed for that purpose (Connor et al, 2016). Better understanding of baseline motivation may also allow more pragmatic approaches to engage patients in AUD treatment for those who initially reject, or have weaker motivation, in abstinence as a treatment goal (De Visser & Piper, 2020; Field et al, 2020; Leggio & Lee, 2017).…”