Impaired Control Scale Predicts Outcome of Alcohol Moderation
Current guidelines for brief alcohol intervention recommend that physicians advise abstinence for patients with alcohol dependence. However, some patients with dependence are able to moderate their drinking.
To examine whether certain measures can identify patients who may or may not drink moderate amounts without consequences, researchers analyzed data from 154 subjects in Britain and Australia who had participated in a randomized trial of a moderation-oriented treatment for alcohol problems. They compared the performances of the Impaired Control Scale (ICS, which measures the degree of impaired control over drinking) with the widely used Severity of Alcohol Dependence Questionnaire (SADQ) to predict the outcomes of abstinence or drinking without self-reported problems.
- Over 6-8 months of follow-up, 5% of subjects became abstinent and 13% drank but reported no problems.
- The ICS correctly classified 62% of successful* cases (subjects reporting abstinence or drinking without problems) and 68% of unsuccessful cases. The SADQ correctly classified 75% of successful cases but only 17% of unsuccessful cases.
This study suggests that the ICS performs better than the SADQ at identifying patients who may not benefit from moderation-oriented treatment. If validated in future studies, the Impaired Control Scale might prove useful to help determine whether moderation is an appropriate goal for certain problem drinkers; however, its ability to predict outcomes with a great deal of certainty is unlikely.Peter D. Friedmann, MD, MPH