Treatment Settings for Those With an Alcohol Problem

Study Overview
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Brief Summary
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A prior study in a tightly controlled clinical research environment found individuals with an alcohol use disorder (AUD) benefited more from inpatient (IP) than outpatient (OP) care, if they presented with high alcohol involvement and/or low cognitive functioning. This study sought to: (a) validate and extend these findings within the uncontrolled environment of a community-based treatment center, and (b) test whether inpatients had fewer days of involuntary abstinence (e.g., incarcerations) relative to outpatients. Based on their need for inpatient treatment, using prior cut-points for alcohol involvement and cognitive functioning, participants were randomly assigned within inpatient need group (No Need for IP; Needs IP) to either 21-days of inpatient substance misuse treatment or 21-days of outpatient treatment, all followed by 6 months of continuing outpatient care. Follow-up were conducted an 90-day intervals across 18 months.

Official Title
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Treatment Settings for Alcoholics: A Field Extension

Conditions
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Alcohol Abuse, Alcohol-dependence

Intervention / Treatment
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* Behavioral: Inpatient Care
* Behavioral: Outpatient Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligible for treatment through the Chemical Dependency treatment programs of a large, community-based healthcare network Drank alcoholic beverages within the last 90 days Have a current address (not homeless) Free of legal stipulations that would affect treatment decisions Have a past 3 months Alcohol Use Disorder Primary alcohol, or alcohol and drug problem Exclusion Criteria: Homeless Drug problem only

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Inpatient Care + Needs Inpatient<br>Individuals with high alcohol involvement or low cognitive functioning receiving inpatient treatment | Behavioral: Inpatient Care<br>* 21 days of inpatient substance misuse treatment<br>|
| Active Comparator: Inpatient Care + No Need for Inpatient<br>Individuals with low alcohol involvement or mid-high cognitive functioning receiving inpatient treatment | Behavioral: Inpatient Care<br>* 21 days of inpatient substance misuse treatment<br>|
| Active Comparator: Outpatient Care + Needs Inpatient<br>Individuals with high alcohol involvement or low cognitive functioning receiving outpatient treatment | Behavioral: Outpatient Care<br>* 21 days of outpatient substance misuse treatment<br>|
| Active Comparator: Outpatient Care + No Need for Inpatient<br>Individuals with low alcohol involvement and or mid-high cognitive functioning receiving outpatient treatment | Behavioral: Outpatient Care<br>* 21 days of outpatient substance misuse treatment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Monthly Percentage of Voluntary Abstinent Days (from Timeline Followback Interview) | Percentage of Days Abstinent of those in which drinking was not restricted | Change up to 18 months | 
| Monthly Point Prevalence of Abstinent Days (from Timeline Followback Interview) | Monthly percentage of participants abstinent throughout a month | Change up to 18 months | 
| Monthly Drinks per Drinking Day (from Timeline Followback Interview) | For those drinking in a month, average drinks per drinking day | Change up to 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Monthly percentage of Involuntary abstinent days (from Timeline Followback Interview) | Monthly percentage of days in which the participant was incarcerated, hospitalized, or in residential treatment | Up to 18 months |