Alcohol Cue Reactivity Personalized Feedback Intervention for Problem Drinking

One in five adults drink to intoxication at some point in a year. When heavy drinking is defined as alcohol consumption in excess of four standard drinks on one occasion, one in 5 adults is a heavy drinker. If heavy drinking is defined as consumption of more alcohol than four standard drinks on one occasion, then about 8% of adults are heavy drinkers. People with problem drinking, defined as drinking more than seven drinks on one occasion per week, have more than double the prevalence of heavy drinking.

There is no single pharmacological treatment that can cure alcohol dependence. Rather, good pharmacotherapy combined with personal change, behavioral skills training, relapse prevention strategies and education of peers have important roles. The effectiveness of alcohol counseling and relapse prevention varies among studies. Therefore, more rigorous studies are needed. Until good evidence is available, it would be inappropriate to assume that problem drinking is curable.

According to epidemiological and clinical evidence, problem drinking constitutes a substantial proportion of the alcohol dependence syndromes. In contrast to many other drug dependencies, problem drinking is highly correlated to serious social, legal, or medical consequences. The occurrence of problem drinking is not limited to heavy drinkers as such, but has a far broader spectrum of pathological patterns and consequences, with a much wider impact on the well-being of society. The need for intervention of non-medical treatment for problem drinking should be further explored.

The most common treatments for problem drinking are counseling and individual or family support. There is no cure for alcohol dependence; treatment is focused on minimizing negative consequences and making a permanent change.

Sudden onset of problem drinking may be a sign of alcoholism. Symptoms of frequent drinking may include headache, anxiety and insomnia. Symptoms of binge drinking may include confusion, dizziness, memory problems and/or a drunken disposition. If those symptoms are present, this could be a sign of problem drinking rather than alcoholism.

The factors that contribute to problem drinking are complex and are related to many issues around the world. Interventions that aim to reduce these risks must be multiple and address diverse factors.

Problem drinking is a leading public health concern. This article discusses the research on problem drinkers over the last 20 years and the latest developments in prevention and treatment.

A personalized feedback intervention was shown to increase alcohol use behaviors in treatment-seeking, substance abusing adolescents with problems with high risk of developing alcohol use disorders. These preliminary data warrant additional attention to the development of tailored FBT interventions in clinical settings.

There is some variability in common ARFI outcome measures, but the most commonly reported common ARFI side effects among those with ARFI scores ≥1 (≥1% of patients) were (1) tired/slightly fatigued; (2) anxious/nervous; (3) depressed mood; (4) dry mouth; (5) dry eyes; (6) sweating; and (7) unpleasant taste in the mouth (distinctive taste of alcohol).

When patients want to try clinical trials of help with problem drinking, they are likely to be of low socioeconomic status and more likely to have a history of alcohol problems. Trial professionals and clinicians may not be communicating the full scope of potential trial participation, particularly amongst less educated and/or more socially vulnerable people.

Results from a recent clinical trial suggest that the presence of an increased alcohol cue reactivity may help people recognize the importance of decreasing alcohol. Participants in the intervention showed statistically significant reductions in alcohol intake, craving levels and urge values after treatment. The study therefore provides evidence that cue reactivity influences alcohol use in humans. The personalized intervention resulted in higher alcohol outcomes compared to a control group.