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Reductions in WHO risk drinking levels correlate with alcohol craving among individuals with alcohol use disorder
Tuchman, F. R., Hallgren, K. A., Richards, D. K., Aldridge, A., Anton, R. K., Aubin, H.-J., Kranzler, H. R., Mann, K., O'Malley, S. S., & Witkiewitz, K. (2024). Reductions in WHO risk drinking levels correlate with alcohol craving among individuals with alcohol use disorder. Alcohol Clinical & Experimental Research, 48(2), 420-429. https://doi.org/10.1111/acer.15257
BACKGROUND: Abstinence has historically been considered the preferred goal of alcohol use disorder (AUD) treatment. However, most individuals with AUD do not want to abstain and many are able to reduce their drinking successfully. Craving is often a target of pharmacological and behavioral interventions for AUD, and reductions in craving may signal recovery. Whether reductions in drinking during AUD treatment are associated with reductions in craving has not been well examined.
METHODS: We conducted secondary analyses of data from three AUD clinical trial s (N's=1327, 346, and 200). Drinking reductions from baseline to end of treatment were measured via changes in World Health Organization (WHO) risk drinking levels; alcohol craving was measured using validated self-report measures. Regression analyses tested whether drinking reductions were associated with end-of-treatment craving reductions; moderation analyses tested whether associations between drinking reduction and end-of-treatment craving differed across AUD severity.
RESULTS: Reductions of at least 1 or at least 2 WHO risk drinking levels were associated with lower craving (all p's<0.05). Results were substantively similar after removing abstainers at end-of-treatment. Associations between drinking reductions and craving were generally not moderated by AUD severity.
CONCLUSIONS: WHO risk drinking level reductions are associated with significantly lower craving, as compared to those who did not achieve meaningful reductions in drinking. Results demonstrate the utility of WHO risk drinking levels as AUD clinical trial endpoints and provide evidence that drinking reductions mitigate craving.
