Utility of different dimensional properties of drinking practices to predict stable low-risk drinking outcomes of natural recovery attempts

Background: Functional measures indicating lower drinking problem severity predict stable low-risk drinking outcomes of recovery attempts, but findings for drinking practices are mixed. Because low-risk drinking outcomes are more common in natural than treatment-assisted recovery attempts, five studies of natural recovery attempts were integrated. Multiple dimensions of drinking practices during the year before recovery initiation were evaluated as predictors of post-recovery drinking (continuous abstinence, stable low-risk drinking, or unstable recovery involving relapse).

Methods: Community-dwelling problem drinkers (N = 616, 68% male, mean age = 46.5 years) were enrolled soon after stopping alcohol misuse and followed prospectively for one year. A Timeline Followback interview assessed daily drinking during the year before recovery initiation and yielded four dimensions for analysis: frequency of heavy drinking days (4+/5+ drinks for females/males), mean ethanol consumption per drinking day, variability in days between heavy drinking days, and variability in ethanol consumed per drinking day.

Results: Multinomial logistic regression models showed that variability in ethanol consumed per drinking day was the sole significant predictor of 1-year outcomes when all dimensions were evaluated together. The low-risk drinker group showed less fluctuation in quantities consumed on pre-recovery drinking days compared to the groups that abstained or relapsed (ps < 0.05).

Conclusions: Even when drinking heavily, problem drinkers who maintained low-risk drinking recoveries limited their quantities consumed within a relatively narrow range, a pattern they maintained post-recovery at much lower consumption levels. Assessing variability in quantities consumed may aid drinking goal selection.