This trial is evaluating whether Phosphatidylethanol-based Contingency Management will improve 5 primary outcomes, 4 secondary outcomes, and 13 other outcomes in patients with Alcohol Use Disorders (AUD). Measurement will happen over the course of 26 weeks of treatment (repeated measure) through study completion.
This trial requires 17 total participants across 2 different treatment groups
This trial involves 2 different treatments. Phosphatidylethanol-based Contingency Management is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
The causes of AUD are manifold and are likely multifactorial depending on the definition utilized. They seem to occur due to an interaction of biologically determined vulnerability and environmental factors. Thus, factors included in the DSM-IV AUD definition may not be sufficient to predict progression to alcohol dependence. Nevertheless, this suggests we are insufficiently skilled as clinicians to fully understand the complex aetiology of AUD.
The number of alcohol use disorders (aud) in the United States may be around 100,000 per year. The frequency and severity of alcohol use disorders (aud) among adults might be underestimated since it varies by demographic and socioeconomic status. The high frequency of alcohol use disorders (aud) in some communities where high levels of alcohol use are associated with negative social consequences has been reported.
It is feasible to treat AUD in a structured environment with a success rate of 80-99%. The recovery rate depended on how long AUD had been present, and whether the alcohol use disorder had recurred. A high number of patients were attracted to follow-up assessment because they found recovery to be a very positive experience and wanted to remain in treatment long after the treatment ended.
AUD occurs in approximately half of patients with AUDC. AUD is the second foremost cause of hospitalization in those with AUDC, following CAD. AUD should be looked for in all patients when they are admitted to the hospital.
There is no single symptom to signify AUD; the symptoms vary between individuals. The main issue with AUD screening is to determine the need for intervention.
The most common treatment for alcohol use disorders is psychoeducation, but psychoeducation alone tends not to be sufficient and may not be the most successful type of treatment for patients with AUD.
While medications are the most common interventions used in clinical practice, recent advances in the treatments for AUD have expanded our understanding and capabilities in the treatment of AUD. However, there are gaps in our current understanding of how to develop more sophisticated and effective treatment modalities and how to manage comorbid psychiatric disorders. Additional research in this area is warranted.
There was some evidence of a modest benefit for participants. The potential benefit (approximately 7% decrease in AUD and 2% decrease in lifetime misuse) would be small and the sample size of participants would have to be larger than the current study in order for any benefit to be considered clinically significant.
PHCM is an effective intervention for treating patients with AUD and improving adherence. Although the effectiveness of PHCM over a short time period remains to be determined, continued research on this intervention is warranted.
PHECM has led to significant increases in the use of PE to treat AD and AUD problems. PHECM appears to work through a social learning"model"of change. Copyright © 2016 John Wiley & Sons, Ltd.
While the COMS group did demonstrate sustained abstinence, the COMS+ATD group did not. The lack of abstinence in this group could be due to greater number of relapse-related drinking-days in untreated AUD and/or to the COMS+ATD's failure to promote long-term abstinence. Future research should further assess these issues. While COMS could prove effective in the short term by decreasing drinking days, it may also cause relapse and, thus, ineffective over the long-term.
A significant proportion of PDE-based CM patients have persistent substance use and are usually referred to an AUDT. As these patients show high levels of symptom severity and substance withdrawal symptoms, immediate and targeted interventions addressing these problems should be used with caution.