Do talking treatments help problem drinkers who also use illicit drugs? We’re still guessing

Alcohol Awareness Week starts today, with the theme ‘It’s time to talk about drinking’, so I thought we’d kick-start the week in this bit of the woodland by doing just that. Alcohol Concern’s Hair of the Dog campaign poster displays facts which may well achieve their aim of prompting conversation on this subject, including the surprising information that around 200,000 people will have turned up to work with a hangover today (and people who work are more likely to drink alcohol than unemployed people).

Talking treatments were the focus for a new Cochrane review, published last week, which looked at different psychosocial interventions to reduce alcohol consumption in people with problem alcohol and drug use. Four studies with 594 people were included, comparing cognitive-behavioural coping skills training with 12-step facilitation, a brief intervention with treatment as usual, motivational interviewing with hepatitis health promotion and brief motivational interviewing with assessment only.

Here’s what they found:

  • The only study finding a significant difference found that people in the control group receiving ‘treatment as usual’ drank less alcohol at three and nine months than those receiving a brief intervention.
  • The evidence is weak, coming from low quality studies
  • Studies differed too much for their results to be combined

I was rather surprised to read a positive result favouring the control group, until I discovered that the only additional intervention for the intervention group was a single one-hour talking session. Otherwise, everyone in the trial received ‘treatment as usual’ which included a barrage of things including drugs, medical and psychiatric follow-up AND, wait for it, psychosocial interventions…

The reviewers, not surprisingly, said that

 no conclusion can be made because of the paucity of the data and the low quality of the retrieved studies.

So targeting drug and alcohol use together may be a logical approach, given the high rate of these problems occuring together, but one that still lacks an evidence base. If you want to talk about drinking this week, check-out the drinkaware website for some facts about alcohol and you could use the MyDrinkaware feature to track or cut down your drinking. I’m off now to grab a glass of water, something I definitely don’t drink enough.

Links:

Klimas J, Field CA, Cullen W, O’Gorman CSM, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD009269. DOI: 10.1002/14651858.CD009269.pub2. Cochrane summary 

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Sarah Chapman

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My name is Sarah Chapman. I have worked on systematic reviews and other types of research in many areas of health for the past 17 years, for the Cochrane Collaboration and for several UK higher education institutions including the University of Oxford and the Royal College of Nursing Institute. I also have a background in nursing and in the study of the History of Medicine.

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