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Addiction, Pain, and Public Health Website
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Medline references: 'Controlled Drinking,' 'Moderate Drinking,' 'Moderation Management' as Title Words |
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Last Updated: 11/2001 - 139 references, sorted by Date, Descending |
1 AU - Ogborne AC AU - Smart RG AD - Centre for Addiction and Mental Health, London and Toronto, Ontario, Canada. ogborne@julian.uwo.ca TI - Public opinion on the health benefits of moderate drinking: results from a Canadian National Population Health Survey AB - AIMS: To explore beliefs about the health benefits of drinking alcohol in the Canadian population. DESIGN: Secondary analysis of data from a national population health survey. PARTICIPANTS: Canadians age 12 or older (weighted n = 72375) in all provinces but Alberta excluding those living in remote regions, native reserves and armed forces bases. MEASURES: Responses to questions concerning the definition of moderate drinking and the belief that moderate drinking can be good for health. Self-reports of age, gender, province of residence, quantity and frequency of drinking, health problems and indicators of alcohol dependence. FINDINGS: Fifty-seven per cent of respondents believed that moderate drinking has health benefits. Forty-seven per cent defined moderate drinking as drinking less than one drink a day and believed this to be good for health. Twelve per cent defined moderate drinking as one or more drinks a day and believed this is good for health. Belief in the health benefits of moderate drinking was more common among men, those age 45 or older, residents of Ontario and Quebec, more frequent drinkers and those with ischaemic heart disease. Those who believed in the health benefits of at least one drink a day were more often males, older persons and frequent, heavy drinkers. CONCLUSIONS: Belief in the health benefits of moderate drinking is generally associated with a conservative definition of moderate drinking. However, some drinkers at risk for alcohol problems may be influenced to drink by the belief that this can have health benefits or use this belief as an excuse for drinking UR - PM:11300968 SO - Addiction 2001 Apr ;96(4):641-649 2 TI - Women and moderate drinking: health in the balance UR - PM:11063549 SO - Harv Womens Health Watch 2000 Nov ;8(3):2-3 3 TI - Moderate drinking protects against diabetes UR - PM:0010903296 SO - West J Med 2000 Jul ;173(1):47 4 TI - No support for moderate drinking improving health UR - PM:0010381747 SO - BMJ 1999 Jun 26 ;318(7200):C 5 AU - Chick J AD - Department of Psychiatry, University of Edinburgh, UK. jchick@compuserve.com TI - Can light or moderate drinking benefit mental health? AB - Observational studies in several cultures show light and moderate drinking to be associated with better emotional and social adjustment than abstinence. However, adjustments for pre-existing personality characteristics and socialisation need to be made, and abstainers who are ex-drinkers must be excluded. There is still insufficient evidence to suggest that emotional health can be improved by light or moderate drinking. For cognition, consumption of up to 65 g/day is not associated with chronic inefficiencies. With regard to cognitive decline in older people, emerging evidence suggests the possibility that such decline may be reduced by light drinking. The elderly in institutions probably benefit from a 'social hour' when alcoholic beverage is available. Doctors considering giving advice to drink to improve health should be very cautious and note a number of caveats UR - PM:10394037 SO - Eur Addict Res 1999 Jun ;5(2):74-81 6 AU - Dufour MC AD - National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA TI - What is moderate drinking? Defining "drinks" and drinking levels AB - Although the benefits and risks associated with moderate drinking have gained increasing attention in recent years from both researchers and the general public, no universal definition of moderate drinking exists. Most currently used definitions are based on a certain number of drinks consumed in a specific time period. Defining a "drink," however, also is difficult because alcoholic beverages can differ substantially in their alcohol content, even within the same beverage category (e.g., beer, wine, or distilled spirits). Because international differences in drink definitions also exist, comparing studies from different countries is difficult. The development of a universal definition of moderate drinking is hampered further by variations in the way alcohol consumption levels and drinking patterns are being assessed (i.e., the survey methods and assessment modes used). Despite these problems, definitions of moderate drinking and drinking guidelines have been developed in the United States and other countries UR - PM:10890793 SO - Alcohol Res Health 1999 ;23(1):5-14 7 AU - Fagrell B AU - De Faire U AU - Bondy S AU - Criqui M AU - Gaziano M AU - Gronbaek M AU - Jackson R AU - Klatsky A AU - Salonen J AU - Shaper AG AD - Department of Medicine, Karolinksa Hospital, Stockholm, Sweden. befa@divmed.ks.se TI - The effects of light to moderate drinking on cardiovascular diseases UR - PM:10583704 SO - J Intern Med 1999 Oct ;246(4):331-340 8 AU - Klatsky AL AD - Department of Medicine, Kaiser Permanente Medical Center, Oakland, California, USA TI - Moderate drinking and reduced risk of heart disease AB - Although heavier drinkers are at increased risk for some heart diseases, moderate drinkers are at lower risk for the most common form of heart disease, coronary artery disease (CAD) than are either heavier drinkers or abstainers. This association has been demonstrated in large-scale epidemiological studies from many countries. Abstainers may share traits potentially related to CAD risk, such as psychological characteristics, dietary habits, and physical exercise patterns. However, evidence supports a direct protective effect of alcohol, even after data have been adjusted for the presence of these factors. The alcohol-CAD relationship is also independent of the hypothetically increased risk status among abstainers who stopped drinking for medical reasons. All alcoholic beverages protect against CAD, although some additional protection may be attributable to personal traits or drinking patterns among people who share some beverage preferences or to nonalcohol ingredients in specific beverages. Alcohol's protective effect may result from favorable alterations in blood chemistry and the prevention of clot formation in arteries that deliver blood to the heart muscle. Because CAD accounts for a large proportion of total mortality, the risk of death from all causes is slightly lower among moderate drinkers than among abstainers, but heavier drinkers are at considerably higher total mortality risk UR - PM:10890794 SO - Alcohol Res Health 1999 ;23(1):15-23 9 AU - Mumenthaler MS AU - Taylor JL AU - O'Hara R AU - Yesavage JA AD - Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA TI - Gender differences in moderate drinking effects AB - Women appear to become more impaired than men after drinking equivalent amounts of alcohol, achieving higher blood alcohol concentrations even when doses are adjusted for body weight. This finding may be attributable in part to gender differences in total body water content. Men and women appear to eliminate approximately the same total amount of alcohol per unit body weight per hour. However, women seem to eliminate significantly more alcohol per unit of lean body mass per hour than men. Some studies report that women are more susceptible than men to alcohol-related impairment of cognitive performance, especially in tasks involving delayed memory or divided attention functions. Psychomotor performance impairment, however, does not appear to be affected by gender. This article provides an overview of alcohol metabolism (pharmacokinetics) and reviews recent studies on gender differences in alcohol absorption, distribution, elimination, and impairment. Speculation that gender differences in alcohol pharmacokinetics or alcohol-induced performance impairment may be caused by the menstrual cycle and variations in female sex hormones are discussed. It is concluded that the menstrual cycle is unlikely to influence alcohol pharmacokinetics UR - PM:10890798 SO - Alcohol Res Health 1999 ;23(1):55-64 10 AU - Zacny JP AU - Janiszewski D AU - Sadeghi P AU - Black ML AD - Department of Anesthesia and Critical Care, University of Chicago, USA. zacn@midway.uchicago.edu TI - Reinforcing, subjective, and psychomotor effects of sevoflurane and nitrous oxide in moderate-drinking healthy volunteers AB - AIMS: To characterize the reinforcing, subjective and psychomotor effects of sevoflurane, a volatile anesthetic, across a range of subanesthetic concentrations in non-drug-abusing humans. In addition, a concentration of nitrous oxide was included in the design in order to compare and contrast behavioral effects of a gaseous to a volatile anesthesic. DESIGN: Repeated measures, double-blind, placebo control experiment. SETTING: Human psychopharmacology laboratory. PARTICIPANTS: Fourteen moderate-drinking healthy volunteers. INTERVENTION: In each of four sessions, subjects first sampled placebo-oxygen and an active drug (end-tidal concentrations of 0.2, 0.4, 0.6% sevoflurane and 30% nitrous oxide in oxygen) and then chose between the two MEASUREMENTS: Mood and psychomotor performance during the sampling trials, and choice of drug or placebo-oxygen during choice trial. FINDINGS: Nitrous oxide was chosen by 71% of the subjects, and 0.2, 0.4 and 0.6% sevoflurane were chosen by 50%, 57% and 50% of the subjects, respectively. Neither drug was chosen at levels that exceeded that of chance. Sevoflurane and nitrous oxide both impaired psychomotor performance and produced changes in mood. There were several differences in subjective effects between sevoflurane and nitrous oxide at concentrations which were considered to be equivalent in anesthetic effect. Finally, although sevoflurane did not function as a reinforcer in the majority of individuals tested, there was evidence that sevoflurane functioned as a reinforcer in some volunteers: subjects who chose to inhale sevoflurane over placebo-oxygen tended to report a positive spectrum of subjective effects during the sevoflurane sampling trial, relative to those subjects who chose placebo-oxygen over sevoflurane. CONCLUSIONS: Although sevoflurane did not function as a reinforcer in the majority of subjects tested, the correspondence between positive subjective effects of sevoflurane and subsequent sevoflurane choice suggests that the volatile anesthetic drug can function as a reinforcer in some moderate drinkers UR - PM:10717960 SO - Addiction 1999 Dec ;94(12):1817-1828 11 AU - Zakhari S AU - Gordis E AD - Division of Basic Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-7003, USA TI - Moderate drinking and cardiovascular health AB - Moderate alcohol consumption (1-2 drinks a day) can be beneficial in reducing the risk of coronary artery disease. This article focuses on cellular and molecular mechanisms underlying the beneficial effect of moderate drinking, including increased plasma high-density lipoprotein levels, changes in cellular signaling, reduction in platelet function, stimulation of fibrinolysis, and reduction in ischemia-reperfusion injury. While moderate drinking may be protective against coronary artery disease for some individuals, populations such as pregnant women and individuals who are about to operate motor vehicles or heavy machinery should not drink alcoholic beverages. People with family histories of alcoholism should exercise extreme caution in their decision to drink UR - PM:10220810 SO - Proc Assoc Am Physicians 1999 Mar ;111(2):148-158 12 AU - Conduit E AU - Appels A AU - Lewis A AD - Clinical Psychology Practice, Stourbridge, West Midlands, UK TI - Cardioprotective effect of moderate drinking: possible mediation by vital exhaustion AB - A curvilinear relationship between alcohol consumption and heart disease risk has often been demonstrated. A similar relationship was found between vital exhaustion (VE) and alcohol intake in 62 Japanese and 53 British healthy males. Vital exhaustion is a prodromal state for cardiac events. A possible connection between moderate social drinking, VE and heart disease is suggested UR - PM:9811206 SO - Alcohol Alcohol 1998 Sep ;33(5):528-532 13 TI - Moderate drinking reduces chest pain UR - PM:9429950 SO - J Adv Nurs 1997 Dec ;26(6):1060-1061 14 AU - Ashley MJ AU - Ferrence R AU - Room R AU - Bondy S AU - Rehm J AU - Single E AD - Department of Preventive Medicine and Biostatistics, Faculty of Medicine, University of Toronto, ON. ashley@pmb.med.utoronto.ca TI - Moderate drinking and health. Implications of recent evidence AB - OBJECTIVE: To address three questions (Is moderate drinking good for health? Should people drink to prevent heart disease? What is moderate drinking?) and to examine and compare two recent Canadian guidelines on low-risk drinking in the context of counseling patients. DATA SOURCES: English-language data sources were searched, particularly peer-reviewed health and social science literature and recent expert reports. STUDY SELECTION: Studies and reports were selected for their scientific merit and direct relevance to the three questions addressed and to the formulation of guidelines on low-risk drinking. SYNTHESIS: While moderate drinking might protect some older people against coronary heart disease, it is associated with increased risk of hemorrhagic stroke, certain cancers, accidents and injuries, and a range of social problems. For most health outcomes, risk increases as consumption of alcohol increases. CONCLUSIONS: While the data have limitations, they provide a basis for formulating guidelines on low-risk drinking. The two Canadian guidelines, one developed from the perspective of health recovery, the other from the perspective of health promotion, complement each other in the context of counseling patients UR - PM:9111985 SO - Can Fam Physician 1997 Apr ;43():687-694 15 AU - Dawe S AU - Richmond R AD - School of Applied Psychology, Griffith University, Brisbane, Qld, Australia TI - Controlled drinking as a treatment goal in Australian alcohol treatment agencies AB - Under the broad umbrella of harm minimisation, the Australian National Drug Strategy has emphasised the development of services aimed at reducing hazardous alcohol consumption in problem drinkers thereby shifting the focus of treatment from abstinence to moderation goals. The objective of the present study was to determine the extent to which alcohol treatment agencies offered advice and treatment aimed at moderation of alcohol consumption (i.e., controlled drinking). Of the 179 agencies (40% of identified treatment agencies across Australia) approached, 66% (115) reported giving advice about controlled drinking as a treatment goal. The reported therapeutic strategies used to assist in the attainment of a controlled drinking goal are empirically supported. Thus, controlled drinking as a treatment goal is widely offered by Australian treatment agencies, by workers who appear well versed in validated strategies and techniques used to obtain such a goal. This finding is discussed in relation to comparison studies conducted in the UK and the USA UR - PM:9218241 SO - J Subst Abuse Treat 1997 Jan ;14(1):81-86 16 AU - Donovan M AU - Heather N AD - Waverley Drug and Alcohol Centre, Bondi Junction, NSW, Australia TI - Acceptability of the controlled-drinking goal among alcohol treatment agencies in New South Wales, Australia AB - OBJECTIVE: A survey was conducted to estimate the acceptability of the controlled drinking goal among treatment services in New South Wales (NSW), Australia, and to compare results with similar surveys carried out elsewhere. METHOD: Of all identified alcohol treatment services (N = 295) in NSW, 179 (61%) responded to a mailed questionnaire with useable returns. RESULTS: Nearly three-quarters of respondents endorsed controlled drinking but half of these reported allocating less than 25% of their clients to this goal. Community-based services and alcohol treatment units were significantly more likely to endorse controlled drinking than were residential or private facilities. Community-based services and alcohol treatment units were also more likely to base the appropriateness of controlled drinking on professional experience and research evidence, whereas residential and private facilities relied more on the disease model or agency policy in making this determination. Respondents with tertiary qualifications were more likely to endorse controlled drinking than those without such qualifications, and these respondents were more likely to be found in community-based services and alcohol treatment units. CONCLUSIONS: The results show widespread support for the controlled drinking goal among NSW alcohol treatment services. This is similar to the reported status of controlled drinking in Britain and Norway and stands in marked contrast to the comparative reluctance of treatment services in North America to endorse the controlled drinking goal UR - PM:9130216 SO - J Stud Alcohol 1997 May ;58(3):253-256 17 AU - Knapik-Smith M AU - Bennett G AD - School of Nursing, Medical College of Georgia, Augusta, USA TI - Moderate drinking in women: a concept analysis AB - This analysis clarifies the concept of moderate drinking in women. The literature reflects a variety of definitions of moderate drinking and refers largely to drinking in men. Several strategies for concept analysis suggested by Walker and Avant (1995) resulted in the formulation of a theoretical definition of moderate drinking in women applicable to practice and research. The defining attributes of women's moderate drinking in contemporary U.S. culture include (1) minimization of risks of alcohol-related problems, (2) a desire for any potential health benefits, (3) deliberate adoption of personal drinking guidelines based on some knowledge of the effects of alcohol, (4) control of when and how much alcohol is consumed, (5) sensitization to special drinking considerations faced by women, and (6) having at least one interpersonal relationship with another moderate drinker UR - PM:9233168 SO - Issues Ment Health Nurs 1997 Jul ;18(4):285-301 18 AU - Wilson L TI - Moderate drinking UR - PM:9111972 SO - Can Fam Physician 1997 Apr ;43():592-592 19 AU - Abel EL AD - Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA TI - "Moderate" drinking during pregnancy: cause for concern? AB - The effects of "moderate" drinking have been exaggerated. The greatest danger to the unborn child from moderate drinking is the danger of abortion that misguided alarmism about such drinking has engendered UR - PM:8814963 SO - Clin Chim Acta 1996 Mar 15 ;246(1-2):149-154 20 AU - Kavanagh DJ AU - Sitharthan T AU - Sayer GP AD - Department of Psychology, University of Sydney, Australia TI - Prediction of results from correspondence treatment for controlled drinking AB - Identification of people who will benefit most from brief interventions is an important research challenge in the study of addictive disorders. The current study investigated predictors of response to correspondence interventions for alcohol abuse. We examined both subject retention and alcohol intake over a 12-month period. The primary focus was on the predictive utility of self-efficacy, stages of change and alcohol dependence. Self-efficacy performed relatively well in the study, predicting both retention and later consumption. When predicting 12-month consumption from pretest assessments or examining subject retention over the last 6 months, self-efficacy offered a significant contribution to multivariate analyses. However, in some other predictions a significant effect of self-efficacy was eliminated after the entry of other variables. Stages of change significantly predicted mid-way through treatment, but did not provide an independent prediction of overall retention or treatment response. Neither the degree of alcohol dependence nor level of alcohol problems figured in any of the predictions. Older subjects stayed longer in the study, and those with lower intake and higher pretest self-efficacy had the lowest consumption at 12 months. Results are compared with previous research on prediction of outcomes in addictive disorders UR - PM:8917921 SO - Addiction 1996 Oct ;91(10):1539-1545 21 AU - Rosenberg H AU - Devine EG AU - Rothrock N AD - Psychology Department, Bowling Green State University, Ohio 43403, USA TI - Acceptance of moderate drinking by alcoholism treatment services in Canada AB - OBJECTIVE: The present study was conducted to provide a nationwide survey of acceptance of nonabstinence goals and related alcoholism treatment practices by Canadian alcoholism treatment services. METHOD: A random sample of 335 Canadian alcoholism treatment service agencies were mailed a 4-page questionnaire designed to assess acceptance of moderate drinking as a drinking goal and related alcoholism treatment practices. RESULTS: Acceptance varied by type of service, with considerably more acceptance by outpatient programs (62%) and mixed inpatient/outpatient programs (43%) than inpatient/detoxification/ correctional facilities (27%) and halfway houses (16%). Two-thirds of the respondents who reported moderate drinking as unacceptable in their own agencies categorically rejected moderation for all alcoholism clients. CONCLUSIONS: Individuals seeking services in Canadian alcoholism treatment agencies are more likely to have a choice of drinking goals if they present to an outpatient program than a residential institution, and Canadian agencies appear more accepting of moderation goals than American programs, but less accepting than British and Norwegian service agencies UR - PM:8858554 SO - J Stud Alcohol 1996 Sep ;57(5):559-562 22 AU - Ryder D TI - Shades of grey: some observations on Sobell & Sobell's "Controlled drinking after 25 years: how important was the great debate?" UR - PM:8857385 SO - Addiction 1996 Apr ;91(4):603-604 23 AU - Ferrence R AU - Kozlowski LT AD - Addiction Research Foundation, Toronto, Canada TI - Moderate drinking and health: being confounded by confounders UR - PM:7773109 SO - Addiction 1995 Apr ;90(4):485-488 24 AU - Lyons RA AU - Lo SV AU - Monaghan S AU - Littlepage BN TI - Mortality and alcohol consumption. Moderate drinking also improves health UR - PM:7866182 SO - BMJ 1995 Feb 4 ;310(6975):326 25 AU - Monheit B TI - Controlled drinking program in general practice AB - Controlled drinking programs are feasible to run in general practice. They add another important dimension to health promotion activities. Adapting the program to the clinic's time and budget resources is the main challenge facing clinics wishing to set up such a program UR - PM:7625937 SO - Aust Fam Physician 1995 Jun ;24(6):1031-4, 1036 26 AU - Sanchez-Craig M AU - Wilkinson DA AU - Davila R AD - Addiction Research Foundation, Toronto, Ontario, Canada TI - Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers AB - OBJECTIVES. The study was conducted to refine guidelines on moderate drinking for problem drinkers, persons whose alcohol use is hazardous or harmful. Information on levels of alcohol intake unlikely to cause problems is useful for health professionals, educators, and policymakers. METHODS. Based on their reports of alcohol-related problems, participants in three studies assessing interventions to reduce heavy drinking (114 men, 91 women) were categorized as "problem-free" or "problem" drinkers at follow-up. Drinking measures were examined to identify patterns separating these outcome categories. RESULTS. Analyses using 95% confidence intervals for means on drinking measures showed that guidelines should be sex-specific. Based on analyses of positive and negative predictive value, sensitivity, and specificity, it is recommended that men consume no more than 4 standard drinks in any day and 16 drinks in any week, and that women consume no more than 3 drinks in any day and 12 drinks in any week. CONCLUSIONS. These guidelines are consistent with those from several official bodies and should be useful for advising problem drinkers when moderation is a valid treatment goal. Their applicability to the general population is unevaluated UR - PM:7762717 SO - Am J Public Health 1995 Jun ;85(6):823-828 27 AU - Sobell MB AU - Sobell LC TI - Controlled drinking after 25 years: how important was the great debate? UR - PM:7580815 SO - Addiction 1995 Sep ;90(9):1149-1153 28 AU - Ashley MJ AU - Ferrence R AU - Room R AU - Rankin J AU - Single E AD - Department of Preventive Medicine and Biostatistics, University of Toronto TI - Moderate drinking and health: report of an international symposium UR - PM:8087756 SO - CMAJ 1994 Sep 15 ;151(6):809-828 29 AU - Garlick R TI - Abstinence or controlled drinking? UR - PM:8313256 SO - CMAJ 1994 Feb 15 ;150(4):462-463 30 AU - Jacyk WR TI - Abstinence or controlled drinking? UR - PM:8313254 SO - CMAJ 1994 Feb 15 ;150(4):461-462 31 AU - Jacyk WR TI - Moderate drinking and health: proceedings of an international conference UR - PM:8087751 SO - CMAJ 1994 Sep 15 ;151(6):748-749 32 AU - Jessen-Petersen B AU - Vendsborg PB AD - Afdeling A, Sankt Hans Hospital, Roskilde TI - [Controlled alcohol intake. Is it possible to predict which alcohol abusers can manage a more controlled drinking?] AB - The purpose of this investigation was to identify parameters of predictive value as to which alcohol abusers can manage controlled alcohol intake. Of 72 patients admitted during one year with alcohol abuse as a major diagnosis 27 attempted controlled drinking in a total of 64 events. Socio-demographic data and history of alcohol abuse had no predictive value in identifying patients who could achieve a controlled alcohol intake. However, it appears that a desire and hope for an improved psychological well-being can increase alcohol-abusers' control of alcohol intake. We also found a good correlation between the opinion of an experienced clinician as to which patients should attempt controlled drinking and the patients' own estimation of their possibilities, but neither evaluation had predictive value for the outcome of attempts at drinking. We conclude that it is difficult to predict the outcome of attempted controlled alcohol intake during and after treatment for alcohol abuse UR - PM:8009752 SO - Ugeskr Laeger 1994 Feb 28 ;156(9):1293-1296 33 AU - Mackenzie A AU - Funderburk FR AU - Allen RP AD - Johns Hopkins University School of Medicine, Baltimore, Maryland 21205 TI - Controlled drinking and abstinence in alcoholic men: beliefs influence actions AB - A group of alcoholic men were asked 8 years postdischarge from hospital if they could drink alcohol with control. Subjects who said "no" (the NCD group) were compared to those who said "yes" (the CD group). A majority of the NCD group had been abstinent during the year preceding the 8-year evaluation, whereas none of the CD group had been. In the model developed, troubles resulting from drinking are seen as instrumental in changes from a CD to a NCD belief. The clinical relevance of our results is discussed UR - PM:7829276 SO - Int J Addict 1994 Sep ;29(11):1377-1392 34 AU - Pond RA AU - Wilkinson DA AU - Simpson RI TI - Abstinence or controlled drinking? UR - PM:8155153 SO - CMAJ 1994 Feb 15 ;150(4):460-461 35 AU - Rosenberg H AU - Davis LA AD - Department of Psychology, Bowling Green State University, Ohio 43403-0228 TI - Acceptance of moderate drinking by alcohol treatment services in the United States AB - This study was designed to survey the acceptance of moderate drinking as an outcome goal by alcohol treatment services in the United States. Of a sample of 330 randomly selected services, there were 312 potential respondents of whom 196 (63%) returned surveys that were usable. Three-quarters of respondents reported that nonabstinence was not an acceptable outcome goal for patients in their program; however, 17% of these respondents endorsed the statement that nonabstinence was acceptable for patients in other alcohol programs or for their own patients after discharge. Of the remaining one-quarter of respondents who found moderate drinking acceptable for their patients, 80% worked in outpatient programs and 70% reported moderate drinking as appropriate for only 1-25% of their clientele. Respondents endorsing moderate drinking rated the following factors as important when selecting outcome goals: severity of physiological dependence, drinking history, psychological dependence, previous treatment, criminal behavior and liver function test results UR - PM:8189737 SO - J Stud Alcohol 1994 Mar ;55(2):167-172 36 AU - Sobell MB AU - Sobell LC TI - Controlled drinking research UR - PM:8025509 SO - Addiction 1994 Apr ;89(4):483-484 37 AU - Tattersall ML AU - White S TI - Moderate drinking and loss of brain cells. Factor converting imperial to metric measures was wrong UR - PM:7819911 SO - BMJ 1994 Dec 10 ;309(6968):1581 38 AU - Taylor M TI - Abstinence or controlled drinking? UR - PM:8313255 SO - CMAJ 1994 Feb 15 ;150(4):462 39 AU - Wilson LM TI - Abstinence or controlled drinking? UR - PM:8155154 SO - CMAJ 1994 Feb 15 ;150(4):461 40 AU - Zaadstra BM AU - Looman CW AU - te Velde ER AU - Habbema JD AU - Karbaat J AD - Toegepast Natuurwetenschappelijk Onderzoek Prevention and Public Health, Leiden, The Netherlands TI - Moderate drinking: no impact on female fecundity AB - OBJECTIVE: To determine the effect of moderate alcohol intake on probability of conception. DESIGN: Prospective cohort study. SETTING: Normal healthy women enrolled in an artificial donor insemination program. PATIENTS: Women starting artificial donor insemination for the very first time were selected. INTERVENTIONS: Alcohol exposure was measured through a self-administered questionnaire at intake of study. MAIN OUTCOME MEASURE: A first positive pregnancy test as indicative for conception. RESULTS: Women with moderate alcohol intake had a slightly higher, though not significant, probability of conception compared with nondrinkers (Hazard Ratio 1.20; 95% confidence interval 0.90 to 1.60). CONCLUSION: Moderate alcohol intake has no negative impact on female fecundity UR - PM:7926140 SO - Fertil Steril 1994 Nov ;62(5):948-954 41 AU - Coate D AD - Department of Economics, Rutgers University, Newark, NJ 07102 TI - Moderate drinking and coronary heart disease mortality: evidence from NHANES I and the NHANES I Follow-up AB - Data from the National Health and Nutrition Examination Survey, conducted from 1971 through 1974, and the National Health and Nutrition Examination Survey Follow-up, conducted from 1982 through 1984, were used to test for a beneficial effect of moderate alcohol consumption on coronary heart disease mortality among White men and women. Evidence of such an effect was found for White men; accelerated time-to-failure models showed 3% to 4% longer life spans for moderate drinkers than for nondrinkers or light drinkers UR - PM:8498629 SO - Am J Public Health 1993 Jun ;83(6):888-890 42 AU - Drake RE AU - Wallach MA AD - Dartmouth Medical School, Concord, New Hampshire TI - Moderate drinking among people with severe mental illness UR - PM:8375841 SO - Hosp Community Psychiatry 1993 Aug ;44(8):780-782 43 AU - Heather N AU - Tebbutt J AU - Greeley J AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia TI - Alcohol cue exposure directed at a goal of moderate drinking AB - A novel form of moderation-oriented cue exposure treatment for alcohol dependence is illustrated in a single case study. Formal clinic-based cue exposure following a priming dose of the client's preferred beverage is succeeded by supervised and then unsupervised in vivo practice at resisting continued drinking in tempting situations. Improvements on a range of outcome measures seen up to 12-month follow-up were supported by the results of an analogue measure of desire to drink. The potential place of this form of treatment in the range of services offered to problem drinkers is discussed UR - PM:7903320 SO - J Behav Ther Exp Psychiatry 1993 Jun ;24(2):187-195 44 AU - Morgan P AU - Cohen L TI - Controlled-drinking advocates challenge use of abstinence model in treatment of addiction UR - PM:8364826 SO - CMAJ 1993 Sep 1 ;149(5):706-3 45 AU - Rosenberg H AD - Bradley University TI - Prediction of controlled drinking by alcoholics and problem drinkers AB - Recent research was reviewed on the following factors as predictors of controlled drinking (CD) by alcoholics and problem drinkers: severity of dependence, client attitudes and beliefs about controlled drinking and abstinence, previous treatment, pretreatment drinking style, psychological and social stability, demographic characteristics, family history of drinking, referral source, and posttreatment adjustment and drinking. No single personal characteristic has been consistently predictive, but there is convincing evidence that a lower severity of dependence and a persuasion that CD is possible are associated with CD after treatment. Prediction of CD might be improved by an approach that assesses the influence of three types of variables: enduring personal characteristics, changeable social and psychological characteristics, and transient precipitating events UR - PM:8426872 SO - Psychol Bull 1993 Jan ;113(1):129-139 46 AU - Makanjuola JD AD - WHO Collaborating Centre for Research and Training in Mental Health, Neuro-Psychiatric Hospital, Ogun State, Nigeria TI - Controlled drinking by chronic drunkeness offenders--a British experience AB - Twenty-seven of the 235 drunkenness offenders treated at the Manchester Detoxification Centre and followed-up for 2 years attempted controlled drinking for varying lengths of time and for different stated reasons, even though the treatment goal at the Centre was total abstinence. Only nine of the twenty-seven were able to sustain controlled drinking for periods of up to twelve weeks. The overall sub-group controlled drinking performance was 10.2% which compared favourably with the 10% overall abstinence performance of all patients followed-up. It was observed that there was little argument in favour of offering the option of controlled drinking as an alternative to the traditional treatment goal of total abstinence. It was advocated however that while total abstinence must remain the treatment goal of therapist, controlled drinking as an alternative goal may be suitable for carefully selected individual alcohol dependent persons and an important future research area should be the criteria for selecting such individuals UR - PM:1322164 SO - West Afr J Med 1992 Jan ;11(1):39-47 47 AU - Peele S TI - Alcoholism, politics, and bureaucracy: the consensus against controlled-drinking therapy in America AB - Controlled drinking has long been rejected as a therapeutic goal in traditional American alcoholism treatment. More striking has been the adoption of this position by behaviorists who once fostered controlled-drinking (CD) therapy, such as Peter Nathan, former director of the Rutgers Center of Alcohol Studies. This shift has occurred even while the evidence for rejecting the value of moderation training is unclear. Rather than being justified empirically, this rejection must instead be understood as a strategy behaviorists have used to jettison a politically explosive element in the behavioral package in order to gain overall acceptance for the behavioral approach to treating alcoholism. However, this strategy entails significant scientific, clinical, social, and ethical costs UR - PM:1595425 SO - Addict Behav 1992 ;17(1):49-62 48 AU - Rosenberg H AU - Melville J AU - Levell D AU - Hodge JE AD - Psychology Department, Bowling Green State University, Ohio 43403 TI - A 10-year follow-up survey of acceptability of controlled drinking in Britain AB - This study was designed to reassess the acceptability of controlled drinking (CD) approximately 10 years after Robertson and Heather's (1982) survey of British treatment providers. Sixty percent of a wide range of almost 300 targeted alcohol service agencies in Scotland, England and Wales responded to a mailed questionnaire. Three-quarters of these respondents reported that nonabstinence was an acceptable outcome goal. About half of the respondents who accept CD reported it as acceptable for only 1-25% of their clientele. Within the subgroup of outpatient agencies, almost one-third reported CD as appropriate for at least 50% of their clientele. Respondents endorsing CD rated severity of dependence, client attitudes and beliefs about controlled drinking and abstinence, drinking history, liver function test results and social stability/social relationships as the most important factors of those listed in selecting outcome goals. Respondents reportedly based acceptance or rejection of CD most frequently on their own professional experience and, to a lesser extent, on research evidence for or against CD and on agency policy UR - PM:1405636 SO - J Stud Alcohol 1992 Sep ;53(5):441-446 49 AU - Hall W AU - Heather N AD - National Drug and Alcohol Research Centre, University of New South Wales, Kensington, Australia TI - Issue of statistical power in comparative evaluations of minimal and intensive controlled drinking interventions AB - An analysis of recent studies of minimal and intensive cognitive-behavioural treatments for problem drinking was undertaken to decide to whether a lack of statistical power explains the failure of the majority of studies to find a difference in outcome between these two types of treatment. Although the sample sizes have typically been small (n = 12-21), the analysis suggests that low statistical power is unlikely to be the explanation for the majority of null findings. It seems more likely that the difference in outcome between one positive study and the majority of null results reflects some combination of differences in the type of clients who were treated, the therapists' experience, and the type of intensive therapy that was provided. The low power of these studies demonstrates the desirability of researchers calculating the sample size required to an effect before commencing an outcome study. If they continue to undertake studies with small sample sizes, then they should refrain from inferring that the failure to reject a null hypothesis means that there is no difference between treatments UR - PM:2048462 SO - Addict Behav 1991 ;16(1-2):83-87 50 AU - Maltzman I TI - Controlled drinking, treatment effectiveness, and the disease model of addiction: a commentary on the idealogical wishes of Stanton Peele UR - PM:1941370 SO - J Psychoactive Drugs 1991 Jan ;23(1):95 51 AU - Sitharthan T AU - Kavanagh DJ AD - Drug and Alcohol Department, Royal Prince Alfred Hospital, Camperdown, Australia TI - Role of self-efficacy in predicting outcomes from a programme for controlled drinking AB - This study predicts the outcomes of 40 men and 20 women who attended a controlled drinking programme within a general hospital. Drinking levels over a 6-month follow-up were significantly predicted by consumption during the programme, by the severity of alcohol problems in the past and by a new measure of self-efficacy level that was administered at post-treatment. The self-efficacy prediction was still significant even after all of the other variables were forced to enter a prediction equation. Results are discussed in terms of a social-cognitive theory of sustained response to treatment UR - PM:2029863 SO - Drug Alcohol Depend 1991 Jan ;27(1):87-94 52 AU - Urban R AU - Wolf M AU - Eidam J AU - Kleemann WJ AU - Schroeder G AU - Troger HD AD - Institut fur Rechtsmedizin, Medizinischen Hochschule Hannover TI - [The "Alcomat" breath alcohol analyzer in a controlled drinking trial] AB - In controlled drinking tests according to a concrete forensic problem the residual-alcohol detector of the breath alcohol analyzer "ALCOMAT" was checked in relation to the actual blood alcohol concentration. The tests with non-alcoholic persons, rinsing the mouth with US-whiskey (40 ml, 30 seconds), showed first residual-alcohol indication and later blood alcohol levels up to 0.26%. The test groups with beforehand blood alcohol concentration showed either with mouth rinsing, or with real whiskey ingestion indicated devitations up to 2.07% according to 130% of the actual BAC. A correlation with the level of BAC was not found. The electronic precautionary fittings of the "ALCOMAT" are even under best possible controlled test conditions not sufficient reliable for forensic purpose UR - PM:1953995 SO - Blutalkohol 1991 Sep ;28(5):304-311 53 AU - Booth PG AD - Windsor Clinic, Rainhill Hospital, Prescot, Merseyside, UK TI - Maintained controlled drinking following severe alcohol dependence--a case study AB - A case study is presented of a 10-year follow-up of a 46-year-old alcohol dependent client who chose a goal of controlled drinking on discharge from an ATU. Despite the severity of his problem, the data collected throughout the 10 year period from a variety of sources indicate that he has been successful in maintaining his goal. Variables are suggested which might have been influential in this particular individual's outcome UR - PM:2334819 SO - Br J Addict 1990 Mar ;85(3):315-322 54 AU - Karkkainen P AU - Jokelainen K AU - Roine R AU - Suokas A AU - Salaspuro M AD - Research Unit of Alcohol Diseases, University Central Hospital of Helsinki, Finland TI - The effects of moderate drinking and abstinence on serum and urinary beta-hexosaminidase levels AB - The effects of moderate alcohol intake on serum (SHEX)- and urinary beta-hexosaminidase (UHEX) were studied in ten healthy volunteers, who ingested 60 g of 100% ethanol daily for 10 days. The drinking period was preceded and followed by an abstinence period. Moderate drinking and abstinence were rapidly and significantly reflected on SHEX, while UHEX levels did not change significantly during the study. Gramma-glutamyl transpeptidase (GGT), aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) decreased during the first abstinence period (P less than 0.05), but stayed thereafter at a constant level. It is concluded that SHEX may better reflect recent alcohol consumption than UHEX, GGT, ASAT or ALAT UR - PM:1969791 SO - Drug Alcohol Depend 1990 Feb ;25(1):35-38 55 AU - Wallace J TI - Controlled drinking, treatment effectiveness, and the disease model of addiction: a commentary on the ideological wishes of Stanton Peele AB - Despite a long history of extravagant claims followed by sobering discomfirmations, advocates of controlled drinking continue to promote nonabstinent treatment goals and procedures for alcoholics. Recent claims by Stanton Peele in favor of controlled drinking are examined critically in the context of a continuing debate concerning empirical studies of nonabstinent treatment goals, treatment effectiveness, and inpatient versus out-patient treatment of alcoholism. Peele's views concerning "conventional disease-based alcoholism treatment," controlled drinking, and "the disease model" are shown to be based largely on inadequate scholarship, misrepresentations of the literature, inappropriate comparisons, unwarranted generalizations, and straw-man arguments UR - PM:2286860 SO - J Psychoactive Drugs 1990 Jul ;22(3):261-284 56 AU - Maltzman I AD - Department of Psychology, University of California, Los Angeles 90024 TI - A reply to Cook, "Craftsman versus Professional: Analysis of the Controlled Drinking Controversy" AB - I agree with Cook that ideology may influence the selection and presentation of facts in behavioral science. But this is not a primary issue involved in the so-called controlled drinking controversy. A primary issue is my allegation that the Sobells did not do what they said they did and they did not find what they said they found. I believe that the Sobells did not conduct their IBTA study in the manner in which they claimed. On the contrary, they have made mutually contradictory claims concerning the procedures employed. Evidence is also presented suggesting the nonrandom assignment of patients to experimental and control groups UR - PM:2779250 SO - J Stud Alcohol 1989 Sep ;50(5):466-472 57 TI - [Controlled drinking vs abstinence in the treatment of alcoholism] UR - PM:3420716 SO - Ugeskr Laeger 1988 Aug 15 ;150(33):1990-1991 58 AU - Alden LE TI - Behavioral self-management controlled-drinking strategies in a context of secondary prevention UR - PM:3372836 SO - J Consult Clin Psychol 1988 Apr ;56(2):280-286 59 AU - Hore BD TI - Controlled drinking in the severely dependent patient: a reply UR - PM:3395731 SO - Br J Addict 1988 Apr ;83(4):449 60 AU - Roine RP AD - Research Unit of Alcohol Diseases, Helsinki University Central Hospital, Finland TI - Effects of moderate drinking and alcohol abstinence on urinary dolichol levels AB - Urinary dolichols were studied during a period of 10 days of moderate drinking (60 g of alcohol daily), preceded and followed by a period of abstinence, in 10 healthy volunteers. No significant changes were observed in dolichol levels during this time. Thus, moderate alcohol consumption does not affect urinary dolichols. Furthermore, to establish the time of abstinence needed for elevated urinary dolichol levels to return to normal, 17 alcoholic patients entering a detoxification unit and with initially increased urinary dolichols, were followed for seven days. Mean urinary dolichol level, which was clearly elevated in the beginning of detoxification, returned to normal by the 5th day of the treatment. Half-life decay for increased urinary dolichols was found to be about 3 days UR - PM:2901264 SO - Alcohol 1988 May ;5(3):229-231 61 AU - Stockwell T TI - Can severely dependent drinkers learn controlled drinking? Summing up the debate UR - PM:3345391 SO - Br J Addict 1988 Feb ;83(2):149-152 62 TI - Controlled drinking or abstinence? UR - PM:3594042 SO - Br J Hosp Med 1987 Jun ;37(6):555-556 63 TI - Is controlled drinking possible for the person who has been severely alcohol dependent? UR - PM:3471255 SO - Br J Addict 1987 Mar ;82(3):237-255 64 AU - Heather N AU - Robertson I AU - MacPherson B AU - Allsop S AU - Fulton A AD - Department of Psychiatry, University of Dundee, Ninewells Medical School, UK TI - Effectiveness of a controlled drinking self-help manual: one-year follow-up results AB - Following the description of six-month follow-up results by Heather et al. (1986), this article reports one-year follow-up for a cohort of media-recruited problem drinkers sent either a controlled drinking self-help manual or a general advice and information booklet. Among those remaining in the sample, mean reduction in drinking at six months had been retained at the one-year point. This stability of reduced consumption included respondents showing evidence of late dependence or high consumption at initial assessment. When respondents who had received other forms of treatment had been excluded, the results confirmed the superior effectiveness of the self-help manual in enabling problem drinkers to reduce consumption. Evidence for a superior outcome among respondents interviewed by telephone, rather than contacted solely by post, was again observed. Some limited evidence is presented as to the reliability and validity of self-reports of consumption in the main sample UR - PM:3427250 SO - Br J Clin Psychol 1987 Nov ;26 ( Pt 4)():279-287 65 AU - Heather N AU - Campion PD AU - Neville RG AU - Maccabe D TI - Evaluation of a controlled drinking minimal intervention for problem drinkers in general practice (the DRAMS scheme) UR - PM:3448228 SO - J R Coll Gen Pract 1987 Aug ;37(301):358-363 66 AU - Hore B TI - Controlled drinking in the severely dependent patient UR - PM:3470040 SO - Br J Addict 1987 Jan ;82(1):102 67 AU - Maltzman I TI - Controlled drinking and the treatment of alcoholism UR - PM:3806871 SO - JAMA 1987 Feb 20 ;257(7):927 68 AU - Miller WR AU - Leckman AL AU - Tinkcom M TI - Controlled drinking and the treatment of alcoholism UR - PM:3586242 SO - JAMA 1987 Jun 19 ;257(23):3228-3229 69 AU - Mills JL AU - Graubard BI TI - Is moderate drinking during pregnancy associated with an increased risk for malformations? AB - The relationship between heavy drinking during pregnancy and congenital malformations is well known; however, whether moderate or light drinking is teratogenic is controversial. This prospective birth defects study collected information from 32,870 women about alcohol consumption during the first trimester of pregnancy. Total malformation rates were not significantly higher among offspring of women who had an average of less than one drink per day (77.3/1,000) or one to two drinks per day (83.2/1,000) than among nondrinkers (78.1/1,000). An increased risk as small as 12% in the group averaging less than one drink per day and 45% in those averaging one to two drinks per day would most likely have been detected if it were present. Likewise, major malformations were not increased in these drinking groups. Examining malformations by organ system and individual defect revealed that sex organ malformations and all genitourinary malformations increased significantly (P less than .05) with increasing alcohol consumption. These findings suggest that alcohol, at the levels usually consumed during pregnancy, is not a significant cause of malformations. Nonetheless, the possibility that there are some malformations for which no safe drinking level exists requires additional investigation UR - PM:3627880 SO - Pediatrics 1987 Sep ;80(3):309-314 70 AU - Ogborne AC TI - A note on the characteristics of alcohol abusers with controlled drinking aspirations AB - In an outpatient treatment sample, alcohol abusers who chose controlled drinking as a goal had characteristics in common with those who succeed in controlled drinking programs. There was no evidence that denial or other aspects of psychopathology were associated with the selection of controlled drinking as a goal UR - PM:3582166 SO - Drug Alcohol Depend 1987 Mar ;19(2):159-164 71 AU - Peele S AD - Organization Health Systems, Morristown, NJ 07960 TI - Why do controlled-drinking outcomes vary by investigator, by country and by era? Cultural conceptions of release and remission in alcoholism AB - Variations in the reported rates of controlled drinking by former alcoholics are notable, at times startling. Reports of such outcomes (which in some cases involved a large percentage of subjects) were common for a brief period ending in the mid- to late 1970s. By the early 1980s, a consensus had emerged in the United States that severely alcoholic subjects and patients could not resume moderate drinking. Yet--at a point in the mid-1980s when the rejection of the possibility of a return to controlled drinking appeared to be unanimous--a new burst of studies reported resumption of controlled drinking was quite plausible and did not depend on the initial severity of alcoholics' drinking problems. Variations in controlled-drinking outcomes--and in views about the possibility of such outcomes--involve changes in the scientific climate and differences in individual and cultural outlooks. These cultural factors have clinical implications as well as contributing to the power of scientific models of recovery from alcoholism UR - PM:3325253 SO - Drug Alcohol Depend 1987 Nov 30 ;20(3):173-201 72 AU - Roizen R TI - The great controlled-drinking controversy AB - This chapter reviews the controlled-drinking controversy. It presents cameo descriptions of the controversy's three major episodes--those occasioned by D. L. Davies' 1962 report, the 1976 publication of the first Rand Report, and the 1982 publication in Science of a paper by Pendery, Maltzman, and West--as well as a cameo for the long "interepisode" period between Davies' paper and the Rand Report. I argue that the controversy has emerged out of the failure of the "new scientific approach" to alcoholism, initiated a half century ago, to advance alcoholism treatment significantly beyond the point from which it began. Lack of progress, in turn, has generated tensions and reverberations along many of the normative dimensions that define scientific/treatment activity, both internally and in relation to the broader society. Some of the changing social and valuative forces at work in the controversy's history are examined UR - PM:3550913 SO - Recent Dev Alcohol 1987 ;5():245-279 73 AU - Rychtarik RG AU - Foy DW AU - Scott T AU - Lokey L AU - Prue DM TI - Five-six-year follow-up of broad-spectrum behavioral treatment for alcoholism: effects of training controlled drinking skills UR - PM:3571647 SO - J Consult Clin Psychol 1987 Feb ;55(1):106-108 74 AU - Skutle A AU - Berg G TI - Training in controlled drinking for early-stage problem drinkers UR - PM:3474006 SO - Br J Addict 1987 May ;82(5):493-501 75 AU - Blume S AU - Levy RI AU - Kannel WB AU - Takamine J TI - The risks of moderate drinking UR - PM:3783857 SO - JAMA 1986 Dec 19 ;256(23):3213-3214 76 AU - Chick J TI - Treatment of alcohol dependence: abstinence or controlled drinking? UR - PM:3768615 SO - Br J Hosp Med 1986 Oct ;36(4):241 77 AU - Little RE AU - Asker RL AU - Sampson PD AU - Renwick JH TI - Fetal growth and moderate drinking in early pregnancy AB - Heavy maternal drinking during pregnancy has consistently been linked to decreased intrauterine growth, but the effect of smaller amounts of alcohol is less clear. In this study, the relationship between fetal growth and "moderate" drinking by low-risk, nonsmoking prenatal patients is explored. The sample consists of 144 women seen for the first time at the prenatal clinic of University College Obstetrics Hospital, London, England, between July 1979 and May 1980 and meeting the following criteria: white, aged 19-35 years, 8-16 weeks gestation at first prenatal visit, nonsmoker, nonalcoholic, lower middle class or higher, and in general good health. Average daily consumption of 10 g of ethanol (about one drink) in the week prior to recognition of pregnancy is related to a decrease in infant birth weight of 225 g, after adjustment for gestational age, sex of child, and maternal age, weight, height, pregnancy weight gain, social class, gravidity, and parity. In addition, consumption of this amount in the week before first prenatal visit is related to a comparable decrease in birth weight for male but not for female infants. These findings suggest that risk of decreased intrauterine growth begins very early in pregnancy, and that fetal response to later alcohol use may vary with sex of the child UR - PM:3946376 SO - Am J Epidemiol 1986 Feb ;123(2):270-278 78 AU - Miller WR TI - Moderate drinking: safety and morality UR - PM:3942920 SO - CMAJ 1986 Feb 1 ;134(3):212-213 79 AU - Orford J AU - Keddie A TI - Abstinence or controlled drinking in clinical practice: indications at initial assessment AB - Previous research has suggested two leading hypotheses concerning which excessive drinkers can re-establish control: one based upon level of dependence, the other upon the client's personal persuasion. Using initial assessment data from 46 clients of a clinical psychology alcohol problems service (30 men, 16 women), an attempt was made to operationalize the concepts of dependence and personal persuasion using a variety of indicators of each. Although SADQ scores and Rand definite alcoholism were in general agreement, there were a number of borderline instances and cases of disagreement, and neither was in good agreement with estimates of problem duration, nor with reports of recent or earlier attainment of abstinence or control. Indicators of personal persuasion were more consistent. Those with dependence indicators for abstinence tended to prefer abstinence as a goal, but there were many departures from this pattern particularly for women. It is concluded that in clinical practice it will be very difficult to make a clear cut recommendation about treatment goal at initial assessment except in a few cases UR - PM:3739807 SO - Addict Behav 1986 ;11(2):71-86 80 AU - Orford J AU - Keddie A TI - Abstinence or controlled drinking in clinical practice: a test of the dependence and persuasion hypotheses UR - PM:3463349 SO - Br J Addict 1986 Aug ;81(4):495-504 81 AU - Robertson I AU - Heather N AU - Dzialdowski A AU - Crawford J AU - Winton M TI - A comparison of minimal versus intensive controlled drinking treatment interventions for problem drinkers AB - Thirty-seven problem drinkers with problems of low to moderate severity were randomly allocated to two groups, one receiving 'minimal' treatment of three or four sessions' assessment and advice, and the other 'intensive' treatment of one or more of a selection of individually tailored, cognitive-behavioural therapies lasting an average of 9.1 sessions. The two groups were followed up an average of 15.5 months after termination of treatment. Analysis of covariance revealed that the intensive group reduced consumption significantly more than the minimal group. Also, the intensive group showed a significantly greater increase in the number of days abstinent in the month prior to follow-up. Analysis of covariance also showed that, in spite of their small numbers (n = 7), women increased their days abstinent by a significantly greater amount and reported a significantly greater reduction in number of days drinking between 10 and 20 units. Overall, successful outcome was associated with higher pre-treatment employment and higher alcohol consumption although, given the large numbers of measures, these findings could have occurred by chance UR - PM:3768576 SO - Br J Clin Psychol 1986 Sep ;25 ( Pt 3)():185-194 82 AU - Stockwell T TI - Cracking an old chestnut: is controlled drinking possible for the person who has been severely alcohol dependent? UR - PM:3463346 SO - Br J Addict 1986 Aug ;81(4):455-456 83 AU - Taylor JR AU - Helzer JE AU - Robins LN TI - Moderate drinking in ex-alcoholics: recent studies AB - The literature on the occurrence of moderate drinking in ex-alcoholics that has been published since the Rand report in 1976 is reviewed. Although differences in diagnosis, definitions of moderate drinking and length of follow-up make strict comparisons of the studies difficult, the majority of studies seem to indicate that the earlier reports of the frequency of such moderate drinking may be overly optimistic. Depending on the definition of moderate drinking that is used, the longer the interval required for alcoholics to sustain moderate, problem-free drinking, the less likely is such an outcome. Among treated alcoholics, the percentage probably ranges from about 2 to 12%; the percentage may be higher among alcoholics identified in community population samples. Thus far, the only factor common to alcoholics who are able to achieve moderate drinking is their being mild cases (i.e., having fewer lifetime alcohol-related problems than other alcoholics). Factors pertinent in assessing discrepancies between the various studies are discussed UR - PM:3713173 SO - J Stud Alcohol 1986 Mar ;47(2):115-121 84 TI - Long-term moderate drinking among alcoholics discharged from the hospital UR - PM:4069183 SO - N Engl J Med 1985 Dec 26 ;313(26):1661-1662 85 AU - Campbell WG TI - Moderate drinking: an alternative treatment goal UR - PM:3971261 SO - Can Med Assoc J 1985 Mar 1 ;132(5):509 86 AU - Cook DR TI - Craftsman versus professional: analysis of the controlled drinking controversy AB - With the publication of the Pendery et al. follow-up of the Sobells' experimental studies of controlled drinking, serious questions about the relationship of paraprofessionals (i.e., craftsmen) and professionals in the improvement of alcoholism treatment have been raised. The present analysis reexamines the original published data of the controlled drinking studies in light of the Pendery et al. follow-up and draws the conclusion that readers can find support for both the success and failure of the controlled drinking by examining only the Sobells' data. On this basis, a more phenomenological view of alcoholism and alcoholism treatment is suggested as a way out of the schism between the craftsman and the professional, both of whom operate from within a linear, cause-effect mode of thinking UR - PM:4068722 SO - J Stud Alcohol 1985 Sep ;46(5):433-442 87 AU - Draper RJ TI - Moderate drinking: alternative treatment goal UR - PM:4005764 SO - Can Med Assoc J 1985 Jul 15 ;133(2):90 88 AU - Helzer JE AU - Robins LN AU - Taylor JR AU - Carey K AU - Miller RH AU - Combs-Orme T AU - Farmer A TI - The extent of long-term moderate drinking among alcoholics discharged from medical and psychiatric treatment facilities AB - To assess the frequency of an evolution to stable moderate drinking among alcoholics coming to medical or psychiatric treatment facilities, we examined the five- to seven-year outcome for 1289 diagnosed alcoholics treated in our facilities during a two-year period (between 1973 and 1975). We obtained data from personal interviews, records, or both for 83 per cent of the sample. Only 1.6 per cent of the subjects met our definition of stable moderate drinking at follow-up, 15 per cent had become totally abstinent, and 4.6 per cent were mostly abstinent with occasional drinking. The only predictors of moderate drinking that we found were female sex and less severe alcoholism. The evolution to stable moderate drinking appears to be a rare outcome among alcoholics treated at medical or psychiatric facilities UR - PM:4000215 SO - N Engl J Med 1985 Jun 27 ;312(26):1678-1682 89 AU - Matsubara K AU - Akane A AU - Maseda C AU - Takahashi S AU - Fukui Y TI - Salsolinol in the urine of nonalcoholic individuals after long-term moderate drinking AB - Urine samples were collected before breakfast from 94 normal volunteers (41 males and 53 females) aged 25-70 years. Salsolinol (SA) was analyzed by gas chromatography-mass spectrometry (GC/MS), and dopamine, norepinephrine and epinephrine were determined using high performance liquid chromatography (HPLC). SA levels were significantly higher in the urine of male moderate drinkers (MDs) than in male seldom or non drinkers (SNDs). In females, however, a significant difference of urinary SA levels was not observed between MDs and SNDs. There was a sex difference of urinary SA levels among SND subjects, i.e., females showed a higher SA than males. Urinary catecholamines were not significantly altered by long-term moderate alcohol drinking in either sex. There was no correlation between urinary levels of dopamine and SA. These results indicate that urinary SA can be increased by long-term drinking even in normal, not alcoholic subjects UR - PM:4091894 SO - Alcohol Drug Res 1985 ;6(4):281-288 90 AU - Werch CE AU - Damron CF TI - An evaluation of a controlled drinking program for drinking drivers UR - PM:4078653 SO - J Drug Educ 1985 ;15(3):205-215 91 AU - Barrison IG AU - Wright JT TI - Moderate drinking during pregnancy and foetal outcome AB - Although there are many reports of the adverse effects of alcohol on the infant in ancient literature the first modern report was by Sullivan, Physician to Liverpool gaol. He showed an increased incidence of growth retardation and stillbirth in children of alcoholic mothers using their non-drinking relatives as a control. The literature on moderate drinking is contradictory and suffers from poor control of factors known to confound pregnancy outcome such as social class, parity and smoking habit. The other major problem in assessing the effect of moderate drinking is the difficulty in obtaining accurate drinking histories and the many and varied ways in which these are taken. All histories however, should be regarded as an underestimate. Moderate drinking (less than 40 g alcohol/day before and during pregnancy) has been related to growth retardation, a higher incidence of congenital abnormality, poorer behavioural and neurological scores in the newborn. Recent American surveys have shown an increased relative risk of mid-trimester abortion in women who drink more than three times a week in early pregnancy. Recent work in this country has demonstrated a trend toward smaller head circumference and reduced weight in the babies born to mothers consuming more than 100 g alcohol a week in very early pregnancy. The interaction between smoking and drinking is particularly important for this effect. Using logistic regression analysis the effect of drinking and smoking on birth weight can be clearly seen together with the effect of social class. For any impact to be made on this problem educational intervention is necessary before pregnancy is planned, and thus should be directed at pre-conception clinics, family planning clinics and the general practitioner's surgery UR - PM:6497962 SO - Alcohol Alcohol 1984 ;19(2):167-172 92 AU - Chase JL AU - Salzberg HC AU - Palotai AM TI - Controlled drinking revisited: a review UR - PM:6440129 SO - Prog Behav Modif 1984 ;18():43-84 93 AU - Foy DW AU - Nunn LB AU - Rychtarik RG TI - Broad-spectrum behavioral treatment for chronic alcoholics: effects of training controlled drinking skills UR - PM:6715648 SO - J Consult Clin Psychol 1984 Apr ;52(2):218-230 94 AU - McIntosh MC AU - Sanchez-Craig M TI - Moderate drinking: an alternative treatment goal for early-stage problem drinking AB - Family physicians are in a particularly good position to identify problem drinking in its early stages through the recognition of various psychosocial and medical indicators. Thorough history-taking or the use of a specific questionnaire should provide confirmation. Patients so identified can then be offered treatment designed to help them moderate their drinking, if not to achieve abstinence. The treatment strategy described in this paper involves specifying a safe drinking pattern, instructing the patient in the use of aids to appropriate drinking and seeing the patient at 1- to 2-month intervals for follow-up assessment. In a pilot study of this strategy 16 of 17 patients reduced their drinking substantially, and 8 were abstinent at the last follow-up visit. Only 1 of the 17 dropped out of treatment; the high rate of compliance may have been primarily due to the patient's need to see the family physician for other problems. Visits to the family physician for other medical problems provide an opportunity to motivate patients to continue monitoring their drinking UR - PM:6488117 SO - Can Med Assoc J 1984 Oct 15 ;131(8):873-876 95 AU - Robertson I TI - Does moderate drinking cause mental impairment? UR - PM:6434049 SO - Br Med J (Clin Res Ed) 1984 Sep 22 ;289(6447):711-712 96 AU - Sanchez-Craig M AU - Annis HM AU - Bornet AR AU - MacDonald KR TI - Random assignment to abstinence and controlled drinking: evaluation of a cognitive-behavioral program for problem drinkers UR - PM:6747058 SO - J Consult Clin Psychol 1984 Jun ;52(3):390-403 97 AU - Walker KD AU - Roach CA TI - A critique of the report of the Dickens' enquiry into the controlled drinking research of the Sobells UR - PM:6589000 SO - Br J Addict 1984 Jun ;79(2):147-174 98 AU - Watson CG AU - Jacobs L AU - Pucel J AU - Tilleskjor C AU - Hoodecheck E TI - The relationship of beliefs about controlled drinking to recidivism in alcoholic men AB - A total of 100 men were studied to determine the relationship between belief in the abstinence theory and outcome after treatment of alcoholism. Twenty-seven subjects reported believing that at least some alcoholics can tolerate a single drink without losing control or can learn to drink in moderation and the remaining 73 rejected both contentions. The mean alcohol-consumption ratings of the two groups over 10 evaluations covering the first 18 months after treatment did not differ. The Groups X Time interaction effect, which would have indicated a difference in the rates at which recidivism developed in the two groups, was also nonsignificant. Finally, the percentages of the two groups who were rated as abstinent, in complete control of their drinking or in control most of the time were compared at each of 10 follow-up points. Only a chance number of these differences were significant. The results suggest that there is little relationship between belief in or rejection of the abstinence theory and recidivism UR - PM:6727379 SO - J Stud Alcohol 1984 Mar ;45(2):172-175 99 AU - Einstein S TI - Some dilemmas associated with the concept of controlled drinking UR - PM:6874151 SO - Int J Addict 1983 Apr ;18(3):iii-ivi 100 AU - Erickson RC TI - Controlled drinking UR - PM:6629355 SO - Hosp Community Psychiatry 1983 Oct ;34(10):968-969 101 AU - Gilligan T AU - Norris H AU - Yates FE TI - Management problems in a small hostel with a controlled drinking programme UR - PM:6578830 SO - Br J Addict 1983 Sep ;78(3):277-290 102 AU - Marlatt GA TI - The controlled-drinking controversy. A commentary UR - PM:6357011 SO - Am Psychol 1983 Oct ;38(10):1097-1110 103 AU - Miller WR TI - Controlled drinking. A history and a critical review UR - PM:6865431 SO - J Stud Alcohol 1983 Jan ;44(1):68-83 104 TI - Moderate drinking versus abstinence UR - PM:7149072 SO - Am J Psychiatry 1982 Dec ;139(12):1644-1645 105 TI - Controlled drinking data challenged in new study UR - PM:6809584 SO - Hosp Pract (Off Ed) 1982 Sep ;17(9):44-46 106 AU - Brown RA TI - Perceived benefits from controlled drinking for convicted problem drinkers and social drinkers AB - Convicted problem drinkers taking park in an educational course on responsible drinking and social drinkers listed perceived benefits accruing from controlled as opposed to uncontrolled drinking. Both groups saw improved financial and health status as major benefits of controlled drinking. For social drinkers others perceived benefits were positive in nature and generally related to the facilitative effect of alcohol in that they tended to be confined to the drinking situation and period. Problem drinkers appeared to expect more general and widespread benefits, either through the avoidance of aversive consequences associated with excessive drinking or by effecting some improvement in their social adjustment UR - PM:7076370 SO - Int J Addict 1982 Feb ;17(2):365-369 107 AU - Ogborne AC AU - Annis HM AU - Miller WR TI - Discriminant analysis and the selection of patients for controlled drinking programs: a methodological note AB - The criterion group classification scheme commonly used in conjunction with discriminant function analysis places individuals in the group for which their membership probability is the highest. This optimizes the proportion of correctly classified cases. The clinical utility of a discriminant based scheme may, however, be underestimated if the proportion of correctly classified cases is the only concern. For clinical purposes, attention must also be paid to minimizing serious diagnostic errors and to improving predictions for individuals. Clinicians can address these concerns by considering membership probabilities for each criterion group of interest. The utility of this approach is illustrated using data from a study in which discriminant analysis was used to identify the characteristics of problem drinkers who abstained, controlled their drinking, or continued to drink heavily after treatment UR - PM:7056869 SO - J Clin Psychol 1982 Jan ;38(1):213-216 108 AU - Pendery ML AU - Maltzman IM AU - West LJ TI - Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study AB - Controlled drinking has recently become a controversial alternative to abstinence as an appropriate treatment goal for alcoholics. In this study we reexamine the evidence underlying a widely cited report by Sobell and Sobell of successful controlled drinking by a substantial proportion of gamma (physically dependent) alcoholic subjects in a behavior therapy experiment. A review of the evidence, including official records and new interviews, reveals that most subjects trained to do controlled drinking failed from the outset to drink safely. The majority were rehospitalized for alcoholism treatment within a year after their discharge from the research project. A 10-year follow-up (extended through 1981) of the original 20 experimental subjects shows that only one, who apparently had not experienced physical withdrawal symptoms, maintained a pattern of controlled drinking; eight continued to drink excessively--regularly or intermittently--despite repeated damaging consequences; six abandoned their efforts to engage in controlled drinking and became abstinent; four died from alcohol-related causes; and one, certified about a year after discharge from the research project as gravely disabled because of drinking, was missing UR - PM:7089552 SO - Science 1982 Jul 9 ;217(4555):169-175 109 AU - Perkins DV AU - Cox WM AU - Levy LH TI - Therapists' recommendations of abstinence or controlled drinking as treatment goals. Significance of alcoholics' sex, social class and pretreatment drinking behavior UR - PM:7278274 SO - J Stud Alcohol 1981 Mar ;42(3):304-311 110 AU - Rohner SW TI - Fetal alcohol effects linked to moderate drinking levels UR - PM:7464253 SO - Md State Med J 1980 Nov ;29(11):26-27 111 AU - Sanchez-Craig M TI - Random assignment to abstinence or controlled drinking in a cognitive-behavioral program: short-term effects on drinking behavior UR - PM:7395582 SO - Addict Behav 1980 ;5(1):35-39 112 AU - Arroyave F AU - McKeown S TI - Controlled drinking--a perspective UR - PM:526696 SO - Br J Hosp Med 1979 Dec ;22(6):604-607 113 AU - Ewing JA TI - Goals: abstinence or controlled drinking? UR - PM:371443 SO - Alcohol Clin Exp Res 1979 Jan ;3(1):1-2 114 AU - Larkin EJ TI - Controlled drinking--disease concept controversy: suggestions for synthesis UR - PM:461643 SO - Psychol Rep 1979 Apr ;44(2):511-516 115 AU - Miller WR AU - Joyce MA TI - Prediction of abstinence, controlled drinking, and heavy drinking outcomes following behavioral self-control training UR - PM:500916 SO - J Consult Clin Psychol 1979 Aug ;47(4):773-775 116 AU - Neumann J AU - Kluge H AU - Muller R TI - [Controlled drinking as therapy target in the treatment of alcoholics] AB - The question of re-acquired controlled drinking as a therapy target in the treatment of alcoholics should be studied under the concrete social conditions of the GDR by specialists in treatment and prevention together with the practitioners, on the basis of an exact programme. Some proposals for the practical proceedings are submitted UR - PM:549049 SO - Psychiatr Neurol Med Psychol (Leipz ) 1979 Dec ;31(12):738-745 117 AU - Ogborne A AU - Collier D TI - A rehabilitation programme with a controlled drinking option UR - PM:89104 SO - Int J Soc Psychiatry 1979 ;25(1):47-55 118 AU - Brown RA TI - Controlled drinking training with a female alcoholic AB - Controlled drinking training based upon an avoidance conditioning paradigm (Mills, Sobell & Schaefer, 1971) has previously been demonstrated to offer an alternative to abstinence for some alcoholics. This paper describes the treatment and outcome of controlled drinking training as applied to a 33 year old female who had previously attempted abstinence and who could engage in sexual intercourse only after drinking UR - PM:647171 SO - Br J Soc Clin Psychol 1978 Jun ;17(2):153-157 119 AU - Miller WR TI - Behavioral treatment of problem drinkers: a comparative outcome study of three controlled drinking therapies UR - PM:415075 SO - J Consult Clin Psychol 1978 Feb ;46(1):74-86 120 AU - Pachman JS AU - Foy DW AU - Van Erd M TI - Goal choice of alcoholics: a comparison of those who choose total abstinence vs. those who choose responsible, controlled drinking AB - Examined possible pre-treatment differences between alcoholic veterans who choose total abstinence and those who choose responsible drinking as their drinking goal. The two groups were compared on a variety of behavioral, cognitive, affective, and demographic characteristics. It was found that those who choose responsible drinking had a significantly shorter history of abusive drinking (6.5 years vs. 11.5 years) and more education (12.5 years vs. 10.8 years). In addition, the responsible drinking group showed a stronger belief that their chance for success was 100% UR - PM:690228 SO - J Clin Psychol 1978 Jul ;34(3):781-783 121 AU - Richard GP AU - Burley PM TI - Alcoholics' beliefs about and attitudes to controlled drinking and total abstinence UR - PM:647172 SO - Br J Soc Clin Psychol 1978 Jun ;17(2):159-163 122 AU - Brown RA TI - Controlled drinking: a new concept in alcoholism UR - PM:583975 SO - Nurs Forum (Auckl ) 1977 Jan ;4(3):7-9 123 AU - Cannon DS AU - Baker TB AU - Ward NO TI - Characteristics of volunteers for a controlled drinking training program AB - Patients who volunteered for a controlled drinking training program had more severe alcohol problems and less social and family stability than those who opted for abstinence-oriented programs UR - PM:916698 SO - J Stud Alcohol 1977 Sep ;38(9):1799-1803 124 AU - Miller WR AU - Caddy GR TI - Abstinence and controlled drinking in the treatment of problem drinkers AB - Issues regarding abstinence and restricted drinking as treatment goals are discussed. It is argued that therapies oriented to both controlled drinking and abstinence are needed. Problems with differential assignment of patients to treatment modalities are considered, and tentative guidelines for the selection of treatment goals are proposed UR - PM:329004 SO - J Stud Alcohol 1977 May ;38(5):986-1003 125 AU - Ewing JA AU - Rouse BA TI - Failure of an experimental treatment program to inculcate controlled drinking in alcoholics UR - PM:1066139 SO - Br J Addict Alcohol Other Drugs 1976 Jun ;71(2):123-134 126 AU - Fox V TI - Editorial: The controlled drinking controversy UR - PM:947270 SO - JAMA 1976 Aug 16 ;236(7):863 127 AU - Ogborne A AU - Collier D TI - The drinking habits of residents of a rehabilitation program with a controlled drinking option: a preliminary report AB - Residents of an alcoholism rehabilitation program with a controlled drinking option were asked to give daily reports on their drinking. Program staff were also asked to report evide-ce of resident drinking. A comparison of information from these two sources showed, among other things, that residents were generally reluctant to report drinking which was proscribed the the program. Such drinking as was reported varied from isolated, non-problematic, small quantity drinking, to heavy, regular and problem-producing drinking. In general, residents' drinking did not prevent them from work while in residence. The men's reluctance to report proscribed drinking is seen as largely accounted for by the system of fines for intoxication and drinking without rights. It is concluded that it would be premature to recommend the program's drinking policies to other residential programs, but future experimentation is indicated.t is concluded that it would be premature to recommend the program's drinking policies to other residential programs, but future experimentation is indicated UR - PM:1017381 SO - Drug Alcohol Depend 1976 Jun ;1(5):367-372 128 AU - Popham RE AU - Schmidt W TI - Some factors affecting the likelihood of moderate drinking by treated alcoholics AB - The 1-year outcome in alcoholics who participated in an outpatient alcoholism treatment program which stressed moderate drinking as the ultimate treatment goal was investigated. The results suggest that such an approach, in an otherwise conventional treatment program, is likely to result in a higher rate of moderate drinking and a lower rate of abstinence but not in a higher over-all recovery rate than a total-abstinence orientation UR - PM:972537 SO - J Stud Alcohol 1976 Jul ;37(7):868-882 129 AU - Strickler D AU - Bigelow G AU - Lawrence C AU - Liebson I TI - Moderate drinking as an alternative to alcohol abuse: a non-aversive procedure UR - PM:962781 SO - Behav Res Ther 1976 ;14(4):279-283 130 AU - Watzl H AU - Olbrich R TI - [Controlled drinking in alcoholism therapy (author's transl)] UR - PM:1028084 SO - Psychiatr Prax 1976 Nov ;3(4):204-213 131 AU - Ewing JA TI - Some recent attempts to inculcate controlled drinking in patients resistant to Alcoholics Anonymous UR - PM:4523797 SO - Ann N Y Acad Sci 1974 Apr 15 ;233():147-154 132 AU - Cohen M AU - Liebson I AU - Faillace L TI - Controlled drinking by chronic alcoholics over extended periods of free access UR - PM:4709802 SO - Psychol Rep 1973 Jun ;32(3):1107-1110 133 AU - Gottheil E AU - Alterman AI AU - Skoloda TE AU - Murphy BF TI - Alcoholics' patterns of controlled drinking UR - PM:4691293 SO - Am J Psychiatry 1973 Apr ;130(4):418-422 134 AU - Cohen M AU - Liebson IA AU - Faillace LA TI - A technique for establishing controlled drinking in chronic alcoholics UR - PM:5059689 SO - Dis Nerv Syst 1972 Jan ;33(1):46-49 135 AU - Merry J TI - Controlled drinking for alcoholism UR - PM:5039577 SO - Br Med J 1972 Jul 1 ;3(817):51 136 AU - Rachman S TI - Controlled drinking for alcoholism UR - PM:5032793 SO - Br Med J 1972 Jun 3 ;2(813):591 137 AU - Cohen M AU - Liebson IA AU - Faillace LA AU - Allen RP TI - Moderate drinking by chronic alcoholics. A schedule-dependent phenomenon UR - PM:5123713 SO - J Nerv Ment Dis 1971 Dec ;153(6):434-444 138 AU - Cohen M AU - Liebson IA AU - Faillace LA AU - Speers W TI - Alcoholism: controlled drinking and incentives for abstinence UR - PM:5581891 SO - Psychol Rep 1971 Apr ;28(2):575-580 139 AU - Rakkolainen V AU - Turunen S TI - From unrestrained to moderate drinking UR - PM:5345565 SO - Acta Psychiatr Scand 1969 ;45(1):47-52
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