Early successful alcohol treatment pays dividends

By Anne Harding

NEW YORK (Reuters Health) - People with alcohol problems who remain abstinent within a year of first seeking treatment are more likely to be alive fifteen years later than those who don't fare as well early in treatment, a new study shows.

The findings confirm that "if you think you have a drinking problem, then it's important to get help, and it's important to get help early," Dr. Christine Timko of the Veterans Affairs Health Care System in Menlo Park , California , the study's lead author, told Reuters Health.

Some studies have found a nearly five-fold greater risk of death for alcoholics compared to people without drinking problems, Timko and her colleagues note in the medical journal Alcoholism: Clinical and Experimental Research. However, it's not clear whether getting help early might reduce this risk.

To investigate, the team followed up on 628 people who had entered treatment 16 years previously.

Sixty-eight percent had died of alcohol-related causes in that time. Overall, the researchers found, study participants were 40% more likely to die over the course of follow-up than would have been expected in the general population.

Older people, those with more symptoms of alcohol dependence, and those who were unmarried had an even greater mortality risk.

Among those who were not drinking one year after they started treatment, the likelihood of dying was much lower, the researchers found. Risk of death also was reduced for those who spent eight weeks or longer in outpatient treatment during that year and also did not have drinking problems at one year. Spending more than four months attending Alcoholics Anonymous meetings, along with better drinking outcomes at one year, also cut death risk.

However, people who spent three weeks or longer in inpatient treatment were more likely to die. This is probably because they had more serious alcohol problems, or may have not had the social support of people who were able to get care without being hospitalized, Timko noted.

The findings show how important it is for health care providers who work with people with alcohol problems to find them treatment that will help them, even if they don't succeed in their first attempts at quitting, Timko added.

"Our data indicate that treatment will reduce the chances of dying from alcohol-related problems, but it's up to the programs to measure how well the patients are doing in treatment, and if they're not responding, they need to continue to try to help those people," Timko said.

SOURCE: Alcoholism: Clinical and Experimental Research, October 2006.

The Answer May Be More Simple Than You Think

The short answer is if you have to ask, chances are you have a problem. If others in your life have told you that you have a problem, you probably do. If you have continued to drink in spite of negative consequences, that could be an indication of a serious problem.

Most people who experience problems with drinking, simply quit. They have one particularly painful or embarrassing drinking incident, wake up the next morning and tell themselves, "Never again!" and that's it. They stop drinking; just like that, no problem.

If you have done the same thing -- told yourself you would never get that drunk again, or even drink again -- but found yourself a few days later doing exactly what you swore to yourself you would never do, chances are your drinking falls into the category of alcohol abuse, at the very least, and alcohol dependence at worse.

Alcohol abuse is described as any "harmful use" of alcohol and that by definition is a "drinking problem." Whether or not you have become alcohol dependent is another question -- and whether or not you come to believe that you are an alcoholic, is yet another question.

If you think that you have a drinking problem, you should seek a full evaluation by a healthcare professional.

Alcohol Abuse Screening Quiz
Answering these 20 questions will give you an idea if your drinking patterns are safe, risky or harmful. The test is completely confidential and anonymous; your results are not recorded; and are available only to you. You will not be asked for any personal identifying information.

AlcoholScreening.org
AlcoholScreening.org is a service of Join Together as part of its Demand Treatment! initiative. The interactive test is based on the Alcohol Use Disorders Identification Test (AUDIT), developed by the World Health Organization and is completely confidential and anonymous.

AA's 12 Questions
This yes-or-no 12-question test is used to determine if A.A. might be helpful to you, but it can also be used to help you determine if you are in "deep trouble" with your drinking.

CAGE Questionnaire
Developed by the American Psychiatric Association, this four-question test is usually used by healthcare professionals to quickly determine if the need for further evaluation of a patient's alcohol use is indicated.

Michigan Alcohol Screening Test (MAST)
This 25-question test has been around for many years. Answers are weighted on a point system and a score of three points or less is considered non-alcoholic, four points is suggestive of alcoholism, a score of five points or more indicates alcoholism.

The Johns Hopkins Test
Another yes-or-no test, this famous 20-question test was developed by Johns Hopkins University .

If you have decided that you do have a drinking problem and you want to do something about it there is a world of help available, but the first step should be to contact your healthcare provider and be totally honest about your use of alcohol. Quiting alcohol suddenly can result in alcohol withdrawal symptoms that can range from mild to life-threatening.

Updated: June 11, 2006