Treating Alcoholics with a Co-Occurring Anxiety Disorder

Abstract

Objectives: Psychiatric comorbidity likely complicates the treatment of alcoholism. Studies of alcoholics with and without co-occurring anxiety disorders suggest that the presence of an anxiety disorder can significantly impact alcoholism treatment efficacy and can increase subsequent alcohol relapse rates. The objective of this study was to estimate the long-term relapse rates and costs associated with treating an alcoholic with an anxiety disorder. Methods: We have used a Markov model to create a virtual clinical trial to predict and compare long-term outcomes in alcoholics with and without a co-occurring anxiety disorder. We have also incorporated the subsequent associated costs of the two subject groups. Results: In our model, at the end of five years, 34% of our hypothetical group of 100 alcoholics with an ameliorated anxiety disorder remained abstinent compared to only 8% of the 100 alcoholics with an untreated anxiety disorder. Furthermore, the costs associated with these relapses are greater for the untreated group, after factoring in the costs of anxiety treatment in the treated group, even if only 50% of the anxiety treated group gets amelioration of their anxiety disorder. Conclusion: Our results suggest that addressing co-occurring anxiety disorders in an alcohol treatment setting may have a dramatic impact on alcohol relapse and its associated costs.