Facilitating Aftercare for Alcohol Detox Patients

University at Buffalo (UB)

Status: Completed

Conditions: Alcohol Abuse; Alcohol Dependence

Treatments: Behavioral: Peer-Twelve Step Facilitation (P-TSF); Behavioral: Motivation Enhancement Therapy (MET)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00513708

BLO-NIAAA-015616

K23AA015616 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study is to determine whether peer visits (known as "12th Step Calls") and professional counselors (using "Motivational Enhancement Therapy") are effective helping alcoholics link to substance abuse treatment programs after being in the hospital for detox.

Full description

For those with an alcohol use disorder, the decision to seek detoxification treatment often represents a desire or willingness to change drinking behavior. This gives clinicians with the opportunity to intervene and improve the lives of these individuals. Even patients admitted involuntarily or who have been coerced may be amenable to change. Therefore, inpatient alcohol detoxification treatment offers an opportunity to prepare these patients for and link them with aftercare treatment.

Unfortunately, clinicians have little to guide them on how the current standard of care for alcohol detoxification might be improved. Improvement in clinical practice is ideally driven by clinical research, but there is little recent published information to guide the development of evidence-based pharmacological or psychological practices or interventions in detoxification settings. As a result, alcohol detoxification treatment has changed little over the past 25 years.

Taken as a whole, the literature suggests that the outcomes of inpatient detoxification are less than optimal. A limited number of published studies suggest that a majority of these patients are not linked to any aftercare following inpatient detoxification treatment and return to drinking within a few weeks of hospital discharge. However, there is some evidence to suggest that interventions, performed while the patient is hospitalized, could encourage patients to initiate involvement in aftercare (i.e., professional treatment and/or mutual self-help following hospitalization) and to decrease drinking or initiate abstinence. Motivational Enhancement Therapy and Twelve-Step Facilitation are two interventions that show promise.

The study proposed in this study addresses this issue by testing two brief interventions, Motivation Enhancement Therapy (MET) and Peer-Twelve Step Facilitation (P-TSF, also known as "12th Step Calls"), which have shown potential to enhance initiation of a period of abstinence and engagement in treatment and/or self-help programs among alcohol detoxification patients.

Enrollment: 150 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female inpatients 18 years of age or older.
• Participants will have a current DSM-IV diagnosis of alcohol abuse or dependence.
• Able to understand/speak English
• Participants will have signed a witnessed informed consent.

Exclusion criteria

• Cognitive impairment (e.g., mental retardation)
• Participants who meet current DSM-IV criteria for bipolar disorder, schizophrenia, or dementia
• Participants who are homeless, without contact person
• Participants enrolled in a methadone maintenance treatment program.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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150 participants in 3 patient groups

Treatment As Usual (TAU)

No Intervention group

Description:

Treatment as Usual (TAU): Participants randomized to this arm will receive "usual care" (i.e., pharmacotherapy to manage alcohol withdrawal, counseling and referral to treatment or self-help) during medically managed inpatient detoxification.

Motivational Enhancement Therapy (MET)

Experimental group

Description:

Participants randomized to this arm will receive "usual care" (i.e., pharmacotherapy to manage alcohol withdrawal, counseling and referral to treatment or self-help) during inpatient detoxification plus a 60-minute Motivational Enhancement Therapy (MET) session delivered by a trained professional.

Treatment:

Behavioral: Motivation Enhancement Therapy (MET)

Peer-delivered Twelve Step Facilitation

Experimental group

Description:

Participants randomized to this arm will receive "usual care" (i.e., pharmacotherapy to manage alcohol withdrawal, counseling and referral to treatment or self-help) during inpatient detoxification plus a 60-minute Peer-delivered Twelve Step Facilitation (P-TSF)session delivered by individuals from a common self-help program.

Treatment:

Behavioral: Peer-Twelve Step Facilitation (P-TSF)