Evaluation of Guanfacine as a Potential Medication for Alcohol Use Disorder in Long-Term Drinking Rats: Behavioral and Electrophysiological Findings

Abstract Background The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. Objective The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Design and Participants Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Measures Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. Key Results One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. Conclusion AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.

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The Impact of Comorbid Conditions on Long-Term Patient-Reported Outcomes From Burn Survivors

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa090 ◽

2020 ◽

Vol 41 (5) ◽

pp. 956-962

Author(s):

Clifford C Sheckter ◽

Kevin Li ◽

Gretchen J Carrougher ◽

Tam N Pham ◽

Nicole S Gibran ◽

...

Keyword(s):

Mental Illness ◽

Alcohol Use ◽

Mental Component Summary ◽

Patient Reported Outcomes ◽

Alcohol Use Disorder ◽

Negatively Associated ◽

Risk Of Death ◽

Patient Reported ◽

The Impact

Abstract Preburn comorbidities increase the risk of death in the acute phase, and negatively impact quality of life among survivors. Investigations to date have only evaluated comorbidities as indices, limiting the ability to target conditions and develop strategies for risk reduction. Therefore, we aimed to evaluate the differential effects of specific conditions on long-term, patient-reported outcomes after burn injury. A prospectively maintained trauma registry was merged with a longitudinal database of patient-reported outcomes from a regional burn center from 2007 to 2018. Demographic data, injury-specific information, and the prevalence of 20 comorbidities were systematically documented. The impact of comorbidities on responses to Short Form-12/Veterans RAND 12 (SF/VR-12) health surveys at 6, 12, and 24 months postinjury was evaluated with generalized linear models. The merged dataset included 493 adult participants. Median age was 46 years (interquartile range, IQR 32–57 years), and 72% were male. Median burn size was 14% TBSA (IQR 5–28%). Seventy percent of participants had ≥1 comorbidity (median 1 comorbidity/participant; IQR 0–2 comorbidities). SF/VR-12 mental component summary scores at 6 and 12 months postinjury were negatively associated with mental illness (P < .001, P = .013). SF/VR-12 physical component summary (PCS) scores were negatively associated with smoking (P = .019), diabetes (P = .001), and alcohol use disorder (P = .001) at 6-month follow-up. Twelve-month SF/VR-12 PCS scores were negatively associated with prior trauma admission (P = .001) and diabetes (P = .042). Twenty-four-month SF/VR-12 PCS scores were negatively associated with mental illness (P = .003). Smoking, alcohol use disorder, and diabetes were associated with lower PCS scores 6 months after injury; diabetes persisted as a negatively associated covariate at 12 months. Mental component summary scores were negatively associated with mental illness 6 and 12 months postinjury. Integrated models of postdischarge comorbidity management need to be tested in burn patients.

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Do Alcohol Relapse Episodes During Treatment Predict Long-Term Outcomes? Investigating the Validity of Existing Definitions of Alcohol Use Disorder Relapse

Alcoholism Clinical and Experimental Research ◽

10.1111/acer.13173 ◽

2016 ◽

Vol 40 (10) ◽

pp. 2180-2189 ◽

Cited By ~ 11

Author(s):

Stephen A. Maisto ◽

Corey R. Roos ◽

Kevin A. Hallgren ◽

Dezarie Moskal ◽

Adam D. Wilson ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Long Term Outcomes ◽

Alcohol Relapse

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Long Term Pharmacotherapy for Alcohol Use Disorder

Bengal Journal of Psychiatry ◽

10.51332/bjp.2020.v25.i1.80 ◽

2020 ◽

pp. 1-12

Author(s):

Indranil Saha ◽

Supartha Barua ◽

Arijit Mondal

Keyword(s):

Cost Effectiveness ◽

Alcohol Use ◽

Alcohol Dependence ◽

Alcohol Use Disorder ◽

Chronic Alcoholism ◽

Psychosocial Treatment ◽

Pharmacological Management ◽

Meta Analyses ◽

Drug Studies

The psychopharmacology of alcohol dependence is today poised at interesting crossroads. Three major drugs Naltrexone, Disulfiram and Acamprosate have been tried and tested in various trials and have many meta-analyses each to support them. While Naltrexone may reduce craving, Acamprosate scores on cost effectiveness worldwide with Disulfiram being an alcohol deterrent drug. Studies support, refute and criticize the use of each of these drugs. Combining one or more of them is also a trend seen. The most important factor in efficacy has been the combination of psychosocial treatment with medication. In this article, we are going to discuss about long term pharmacological management of chronic alcoholism.

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Assessing the Safety and Tolerability of Long‐Term Multi Day IVM Treatment for Alcohol Use Disorder

The FASEB Journal ◽

10.1096/fasebj.29.1_supplement.lb476 ◽

2015 ◽

Vol 29 (S1) ◽

Author(s):

Natalie Arabian ◽

Nhat Huynh ◽

Dustin Lieu ◽

Jamie Thuy ◽

Neel Patel ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder

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Problem Alcohol Use in Young Australian Adults

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670701264784 ◽

2007 ◽

Vol 41 (5) ◽

pp. 436-441 ◽

Cited By ~ 8

Author(s):

Sophie C. Reid ◽

Obioha C. Ukoumunne ◽

Carolyn Coffey ◽

Maree Teesson ◽

John B. Carlin ◽

...

Keyword(s):

High Risk ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Abuse ◽

Alcohol Use Disorder ◽

Short Term ◽

Cross Sectional ◽

Drinking Status ◽

High Risk Drinking

Objective: To examine the extent to which excessive drinking in young adults is associated with alcohol abuse and dependence. Method: Cross-sectional analyses were conducted using data from the eighth wave of the Victorian Adolescent Health Cohort Study, which comprised 1943 Victorians currently aged 24–25 years drawn from 44 secondary schools across the state in 1992. The main outcome measures of interest were short-term risk drinking status (based on daily alcohol consumption) and long-term risk drinking status (based on total weekly alcohol consumption). Results: Two out of 5 participants drank at moderate to high risk levels for short-term harm. Yet, because young people tend to drink on only 1–2 days a week, fewer (22%) were at moderate to high risk for long-term harm. Although 20% of the participants met criteria for a diagnosis of alcohol abuse or dependence, most of those in the moderate- to high-risk drinking categories were not diagnosed with either alcohol disorder. Conclusion: Excessive alcohol use in one or two sessions a week appears to be common in young Australian adults. While short- and long-term risky drinking is more common in those with an alcohol use disorder, the majority of moderate- and high-risk drinking is done by those who do not meet criteria for an alcohol use disorder.

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