Moderate drinking in the first year after treatment as a predictor of three-year outcomes

Objective: The relationship between moderate alcohol consumption in the first year following alcohol treatment admission and longer-term functioning is clinically important and pertains to the clinical course of alcohol-use disorders. This study investigated these relationships, focusing on the first year posttreatment admission and 3 years later. Method: Analyses were conducted on the outpatient Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) sample (n = 952 at baseline, and n = 802 at Months 37-39). Participants were classified as first-year "abstainer," "moderate drinker," or "heavy drinker." Results: Drinker classification predicted percentage of days abstinent from alcohol, drinks per drinking day, and alcohol-related negative consequences at 3 years. The abstainers had better drinking outcomes than either of the other two groups, and the moderate drinkers' outcomes were better than those of the heavy drinkers. The heavy drinkers had a higher rate of negative consequences at 3 years than did the abstainers and the moderate drinkers, who did not differ from each other. Analyses of change in drinker status between 1 and 3 years explored variability in clinical course. Conclusions: First-year posttreatment alcohol use on the group level predicts longer-term alcohol use and related functioning, and moderate drinking may be considered a treatment goal option for some individuals. The data also reaffirm the variability among individuals in clinical course following alcohol treatment. Future research should aim to understand the factors that determine the maintenance of patterns of alcohol use that are not associated with the occurrence of alcohol-related negative consequences.