Early Stage Problem Drinkers Research Articles

Interest in different forms of self-help in a general population sample of drinkers.

The study investigates: (1) the level of interest in self-help services for drinkers, and (2) the predictors of interest in these services. A representative sample of 1,557 Ontario respondents participated in a telephone survey. Current drinkers (n=1,247) were asked about their interest in getting: (a) a telephone call from a therapist to help them evaluate their drinking, (b) a self-help book, and (c) a computerized summary comparing their drinking to that of other Canadians. Bivariate comparisons of demographic and drinking-related variables were made between those interested and not interested in each of the offered services. Logistic regression analysis was used to find the best predictors of interest. The results revealed that 16% were interested in a telephone call, 26% in a self-help book, and 39% in computerized normative feedback. Negative consequences of drinking and indicators of lower societal resources increased interest in self-help services. Computerized feedback and self-help books serve as cheap and nonintrusive ways to provide incentive for change to early-stage problem drinkers due to the interest they raise in the intended target population.

Fluvoxamine and Alcoholism

There has been much recent interest in the pharmacological manipulation of alcohol intake and alcohol seeking behaviour. An effective drug treatment could form an important part of a multi-modal treatment programme and could make controlled drinking more of a reality. In animal models the serotonin reuptake inhibitors, including fluvoxamine, have been consistently shown to reduce alcohol consumption, even in alcohol-preferring rat strains. Clinical studies have shown that these specific serotonin reuptake inhibitors may also be useful in significantly reducing the alcohol intake of a group of early stage problem drinkers. Although there are many possible mechanisms, the most likely mechanism to explain this mode of action of these specific serotonin antidepressants is that the serotonin enhancement they produce reduces the positive reinforcement properties of alcohol and thereby produces an anti-craving effect. These studies now need to be replicated, with particular attention being given to those patients who fulfil the criteria of the alcohol dependence syndrome. Such an ongoing study with fluvoxamine will be described.

Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers

The effects of fluoxetine, a relatively selective long-acting serotonin uptake inhibitor, on the consumption of alcoholic and nonalcoholic drinks, cigarette smoking, and body weight were assessed in 29 men who were early stage problem drinkers. After a 2-week baseline, subjects were randomly assigned to receive 40 mg/day fluoxetine (n = 8), 60 mg/day fluoxetine (n = 11), or placebo (n = 10) for 4 weeks. Fluoxetine 60 mg/day decreased mean daily alcoholic drinks from (X +/- SEM) 8.3 +/- 0.7 during baseline to 6.9 +/- 0.7 and decreased total drinks per 14 days from 115.8 +/- 9.3 to 96.5 +/- 9.5 (p less than 0.01; 17.3% decrease from baseline), with no significant increase in days of abstinence. Neither 40 mg/day fluoxetine nor placebo had effects on intake of alcohol. Fluoxetine 60 mg/day decreased total and mean daily alcoholic drinks compared with 40 mg/day fluoxetine (ANCOVA, both p less than 0.02), but neither dose of fluoxetine was different from placebo. Compared with placebo, both 40 mg/day fluoxetine and 60 mg/day fluoxetine no differences were detected between treatment groups, 60 mg/day fluoxetine increased mean daily nonalcoholic beverages from baseline (5.0 +/- 0.4 to 5.6 +/- 0.3, p less than 0.01) and increased daily cigarettes smoked (from 25.1 +/- 4.6 to 26.9 +/- 4.5, p less than 0.05), whereas no significant changes from baseline were observed with 40 mg/day fluoxetine or placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

A Randomized Study of Secondary Prevention of Early Stage Problem Drinkers in Primary Health Care

British Journal of AddictionVolume 85, Issue 3 p. 431-431 Free Access A Randomized Study of Secondary Prevention of Early Stage Problem Drinkers in Primary Health Care First published: March 1990 https://doi.org/10.1111/j.1360-0443.1990.tb00661.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume85, Issue3March 1990Pages 431-431 RelatedInformation

Current Trends in the Pharmacological Treatment of Alcohol‐related Problems

Abstract: Since alcohol‐related problems affect almost 20% of the adult population, effective therapies are needed. Newly developed pharmacological strategies have been tested experimentally in animals and humans and progress is apparent. For example, an imidazobenzodiazepine (Ro15–4513) has recently been found to antagonize ethanol intoxication in rats selectively. However, testing in humans may be prevented by toxicity and ethical concerns. Abrupt discontinuation of ethanol intake in dependent subjects results in a withdrawal syndrome (AWS). With the recently developed benzodiazepine loading dose technique, practically all patients can be effectively treated with oral diazepam. Recent studies in rats suggest that non‐sedative calcium channel blockers (e.g. nitrendipine, nifendipine) may also attenuate the AWS. New pharmacological strategies for decreasing alcohol consumption have also been developed. In three randomized, double‐blind, controlled studies, serotonin uptake inhibitors (zimelidine, citalopram and viqualine) have consistently attenuated alcohol consumption in early stage problem drinkers. Effects on ethanol intake are distinct from the antidepressant properties of these drugs and they are most likely explained by a facilitation of satiety signals. Recently, new pharmacological approaches for attenuating neurological and hepatic alcohol‐related problems have been described. Examples illustrate how the integration of basic and clinical pharmacological strategies may lead to improved pharmacotherapy for alcoholism within the foreseeable future.

Serotonin Uptake Inhibitors Attenuate Ethanol Intake in Humans

Abstract: There are several problems with the drugs currently used to decrease alcohol consumption (i.e. alcohol‐sensitizing drugs). Their efficacy is unproven, they are associated with toxicity and there are several contraindications for use. New therapies are needed because alcohol‐related problems affect almost 20% of the adult population. A new strategy was developed that involves attenuation of alcohol intake via serotonin uptake inhibitors. Since several experiments showed that serotonin uptake inhibitors consistently attenuated ethanol intake in rats, we tested their effects in humans. In three randomized, double‐blind, cross‐over studies, the ethanol intake of early stage problem drinkers was significantly attenuated by the serotonin uptake inhibitors (zimelidine, citalopram and viqualine). Although marked variations in the pattern of response to serotonin uptake inhibitors were observed, 63% to 92% of the subjects responded to the drug treatments. Effects on ethanol intake are distinct from the antidepressant properties of these drugs and most likely can be explained by a facilitation of satiety signals. Our results suggest an innovative approach for moderating ethanol intake in problem drinkers.

Training in controlled drinking for early-stage problem drinkers.

SummaryForty‐eight early‐stage problem drinkers were recruited through a newspaper announcement and randomly assigned to one of four outpatient treatment groups: (1) Bibliotherapy‐ Behavioral Self‐Control Training (BSCT), (2) BSCT‐therapist directed, (3) Training in Coping Skills and (4) a combination of BSCT and Coping Skill Training. The weekly alcohol consumption in all groups decreased significantly from intake to 3, 6 and 12 month follow‐up. There were no significant differences among the groups. At the same time the number of life problems decreased significantly. The majority of the clients reduced their alcohol consumption during the assessment period, before treatment started. The absence of a non‐treatment control group means that we cannot be sure about the reasons for this early change. Theoretical implications of these results are discussed.

Pattern of alcohol use associated with self-identified problem drinking.

To estimate the pattern and level of alcohol consumption leading to problem drinking, the drinking histories of 70 early stage problem drinkers were examined. An average consumption of four drinks (54 g/ethanol), on an average of three days/week, was the pattern that best separated the phase when patients were problem free from the phase when their drinking led to problems.

Group behavior therapy for problem drinkers.

Twenty-eight problem drinkers participated in behavioral training groups designed to teach moderate drinking. Both at termination and at follow-up, 70% were considered successful, showing significant reduction in alcohol consumption and in weekly peak blood alcohol concentration. Indices of severity of problem drinking were found to best predict outcome. Results are consistent with previous data regarding behavioral self-control training as a therapeutic intervention for early stage problem drinkers.