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.

Comments:

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

Reference:

Heather
N, Dawe S. Level of impaired control predicts outcome
of moderation-oriented treatment for alcohol problems. Addiction. 2005;100(7):945-952.