Showing papers in "Journal of Studies on Alcohol and Drugs in 1992"

Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory.

Abstract: Sequential stages of involvement in alcohol and/or cigarettes, marijuana, other illicit drugs and medically prescribed psychoactive drugs from adolescence to adulthood are investigated in a longitudinal cohort that has been followed from ages 15 to 35. Alternative models of progression are tested for their goodness of fit. Four stages are identified: that of legal drugs, alcohol or cigarettes; marijuana; illicit drugs other than marijuana; and medically prescribed drugs. Whereas progression to illicit drugs among men is dependent upon prior use of alcohol, among women either cigarettes or alcohol is a sufficient condition for progression to marijuana. Age of onset and frequency of use at a lower stage of drug use are strong predictors of further progression.

Measuring quantity and frequency of drinking in a general population survey: a comparison of five indices.

Abstract: This article compares five indices of alcohol consumption in a general population survey conducted in 1985 in the Netherlands. Self-reports of consumption were obtained with a prospective diary, a retrospective 7-day recall method, and three summary measures, such as a quantity-frequency index. The coverage of sales data appeared highest for the diary (67%), which suggests a higher validity. Special attention was given to comparisons of quantity and frequency of drinking between the diary, on the one hand, and the weekly recall and summary measures, on the other. It was found that underreporting, relative to the diary reports, was generally higher in the frequency than in the quantity domain. This result, together with the finding from longitudinal studies that intraindividual variation is also higher for drinking frequency, leads to the conclusion that forgetting is a potent source of undercoverage in surveys and to the hypothesis that large differences in overall drinking pattern between populations (e.g., in regularity of drinking) may account for the large differences in coverage rates of sales data. Furthermore, the subjectively assessed probability of drinking by means of a "usual" frequency question appeared a poor predictor of (diary) drinking frequency for respondents reporting a low or moderate frequency. For subjects claiming a high "usual" drinking frequency, a reasonable correspondence between diary and summary measures was found. This mitigates the fear often expressed that heavy drinkers particularly underreport their consumption.

The reduction of health care costs associated with alcoholism treatment: a 14-year longitudinal study.

Abstract: This study utilized two separate research designs to examine whether the initiation of alcoholism treatment is associated with a change in overall medical care cost in a population of alcoholics enrolled under a health plan sponsored by a large midwestern manufacturing corporation. In the longest longitudinal study of alcoholism treatment costs to date, a review of claims filed from 1974 to 1987 identified 3,729 alcoholics (3,068 of whom received treatment and 661 of whom did not). In one design, a time-series analysis found that following treatment initiation the total health care costs of treated alcoholics--including the cost of alcoholism treatment--declined by 23% to 55% from their highest pretreatment levels. Costs for identified but untreated alcoholics rose following identification. In a second design, analysis of variance was used to control for group differences including pretreatment health status and age. This analysis indicated that the posttreatment costs of treated alcoholics were 24% lower...

Combat-related posttraumatic stress disorder and severity of substance abuse in Vietnam veterans.

Abstract: This study examined the effects of Vietnam war-zone duty and combat-related posttraumatic stress disorder (PTSD) on severity of drug- and alcohol-abuse disorders among veterans seeking treatment for substance dependence. Combat-exposed Vietnam-theater veterans (N = 108) were compared with Vietnam-era veterans without war-zone duty (N = 151) on psychometric measures of drug and alcohol abuse. There were no differences between theater and era veterans on these measures. However, Vietnam-theater veterans with PTSD experienced more severe drug- and alcohol-abuse problems than did theater veterans without PTSD and were at greater risk for having both forms of substance abuse. Further analyses showed that PTSD was significantly related to some dimensions of drug- and alcohol-abuse problems but not to other dimensions. These findings indicate that PTSD, rather than combat stress per se, is linked to severity of substance abuse. Finally, reexperiencing and avoidance/numbing components of PTSD were more strongly associated with drug abuse than alcohol abuse, but physiological arousal symptoms of PTSD were more highly correlated with alcohol abuse.

Long-term follow-up of behavioral self-control training

Abstract: Four samples of problem drinkers treated by behavioral self-control training were evaluated at 3.5, 5, 7 and 8 years following treatment, respectively. Of 140 cases, 99 (71%) were accounted for: 23 abstinent, 14 with controlled and asymptomatic drinking, 22 improved but still impaired, 35 unremitted and 5 deceased. Abstinent versus controlled-drinking outcomes were most strongly differentiated by pretreatment severity of alcohol problems and dependence and by the patients' pretreatment self-assessment and goals. Percentages of abstainers and of relapsed cases increased at long-term follow-ups. A reasonably constant percentage of known outcomes (14%) were clearly controlled and asymptomatic drinkers in each of the follow-up samples. Most of the long-term controlled drinkers had established this pattern within the first year following treatment. However, periods of controlled drinking during the first year did not reliably predict maintenance of this pattern. Successful asymptomatic drinkers were discriminable from other outcomes based on pretreatment characteristics.

Ethnic differences in family factors related to early drug initiation.

Abstract: The literature on family predictors of substance use for the general population is reviewed and compared to findings for three specific ethnic groups: black, white and Asian Americans. Rates of substance use initiation are examined in a sample of 919 urban 5th-grade students. Ethnic differences on measures of family predictors are examined and significant ethnic differences are found on several of these factors. Finally, separate regressions for black, white and Asian American youths of family factors on the variety of substances initiated examine ethnic similarities and differences in predictors. The results demonstrate significant differences by ethnicity in family management practices, involvement in family activity, sibling deviance, parental disapproval of children's drinking and family structure. The regression equations identified unique as well as common predictors of the variety of substances initiated by the end of 5th grade. Implications of the results are discussed.

Recruiting a community sample of adolescent children of alcoholics: a comparison of three subject sources.

Abstract: Although there has been substantial research interest in adolescent children of alcoholics, the generalizability and consistency of previous findings have been limited by the specialized nature of the research samples (e.g., treatment samples, school-based samples). However, attempting to address this problem by recruiting subjects from community sources raises a variety of sampling issues, including the comparability and accessibility of subjects from different sources. This article compares the recruitment rates and characteristics of families enrolled from three sources--DUI records, HMO records and telephone surveys. Implications for research on children of alcoholics are discussed.

Gender patterns in consequences of collegiate alcohol abuse: a 10-year study of trends in an undergraduate population.

Abstract: Although college men have typically reported significantly more alcohol problems than women, debate about a possible convergence of gender differences has emerged in recent years. Time trend data on gender differences based on consistent measures of alcohol-related problems are scant, however. Another limitation of previous research has been the predominant focus on alcohol problems most common among men. This article provides data on gender differences and trends in several types of negative consequences of student drinking in a collegiate population from four surveys conducted between 1979 and 1989. The data do not support an overall "convergence hypothesis" as men remained much more problematic in several types of consequences-specifically abuse problems that are public, involve legal repercussions, or that endanger others. Consequences that are more personal or less prone to provoke public response reveal little or no gender differences, however, in the most recent collegiate cohorts. Thus, more gende...

Alcohol consumption and mortality in an American male population: recovering the U-shaped curve--findings from the normative Aging Study.

Abstract: Several prospective studies have suggested that moderate alcohol consumption may offer protection against total and coronary heart disease (CHD) mortality. These studies have been criticized for failing to control for changes in drinking and the influence of comorbidity on consumption decisions. In the present study, we examined whether rates of death from all causes and from CHD were related to overall consumption as well as variability in or problems with drinking. In 1973, a drinking questionnaire was completed by 1,823 male subjects participating in a longitudinal study who were prescreened for absence of serious or chronic disease. After 12 years of follow-up per subject (21,716 man years of follow-up in all), 159 men have died, 74 from CHD. Incidence rates of overall mortality were lowest for moderate drinkers in each of three age groups. CHD death rates for moderate drinkers were similar to those of non-drinkers except in the oldest men where rates were lower for moderate drinkers. Proportional haz...

Self-efficacy, aftercare and relapse in a treatment program for alcoholics.

Abstract: The role of self-efficacy in the prediction of relapse following alcoholism treatment was examined in a 12-month follow-up evaluation. Self-efficacy was assessed at intake to inpatient treatment and again at discharge. The drinking status of male alcoholics completing treatment then was assessed during six intervals over the course of the posttreatment year. Results indicated a significant increase in self-efficacy from intake to discharge. Additional analyses showed that lower intake self-efficacy ratings were associated with relapse by either 6- or 12-months posttreatment. Discharge self-efficacy, on the other hand, was not related to relapse status at either posttreatment point. A subsequent analysis of the pattern of relapses across the six follow-up intervals was conducted using survival analysis. Results revealed that only intake self-efficacy was predictive of the follow-up interval during which a relapse occurred. Individuals high in self-efficacy at intake showed the greatest resistance to relapse across time. The maintenance of aftercare further reduced the risk of relapse. The results are discussed with respect to self-efficacy theory and the problem of ceiling effects in posttreatment self-efficacy assessments.

The long-term course of treated alcoholism: II. Predictors and correlates of 10-year functioning and mortality.

Abstract: This study examines factors related to mortality and 10-year posttreatment functioning for a sample of alcoholic patients who return to their families after an index residential treatment episode. Of the 113 patients followed 2 years after treatment, 20 had died by the time of the 10-year follow-up. Mortality risk was greater among patients who, prior to treatment, consumed more alcohol and were unemployed. Mortality was more strongly associated with medical conditions, liver problems, medication use and lack of confidants assessed 2 years posttreatment. The course for the surviving patients between the 2-year and 10-year follow-ups was one of improvement in terms of alcohol consumption, relative stability in terms of physical symptoms and depression, and an aging-related decline in social activities and employment. Life context and coping factors assessed 2 years after treatment were predictive of long-term outcome. Persons in less stressful life situations, in more cohesive and organized families, and who more frequently used active cognitive coping responses at the 2-year follow-up tended to function better at the 10-year follow-up. Overall, the findings support the value of embedding long-term follow-up studies in a theory of the disorder that is the target of the intervention.

Factors associated with alcohol use in university students.

Abstract: A survey was conducted of drinking, drug use attitudes, beliefs, personality and demographic characteristics of students on a university campus. Gender, ethnic and social group differences were also examined. It was concluded that a biopsychosocial matrix of determinants influenced alcohol consumption and its excessive consumption. Two general factors emerged from analyses of the results. They may be interpreted as entering into a complex approach-avoidance conflict where the net approach tendency determines overall alcohol consumption. Personality characteristics and presumably their biological correlates, as well as set and setting, or attitudes, beliefs and environmental influences contribute to the approach-avoidance conflict that determines abstinence or varying amounts of alcohol consumption.

Detection of alcohol-related problems in general practice.

Abstract: While primary care has considerable potential as a site for detecting and intervening for alcohol-related problems, few doctors currently identify these problems. The judgments of eight primary care physicians about alcohol-related problems in 371 of their patients were compared with the patients' responses to the Short Michigan Alcoholism Screening Test (SMAST) and the CAGE. The CAGE classified 11.4% of the patients as alcoholics and the SMAST identified 23.9% as probable alcoholics. However, the doctors identified only a small proportion (7.0%) of their patients as having any level of alcohol-related problem. The doctors did not identify 65.0% of CAGE-defined alcoholics and 82.3% of those patients classified by the SMAST as probable alcoholics. The discrepancy between primary care physician's judgments and the SMAST and CAGE may be attributable to the doctor's failure to identify patients with alcohol-related problems. An alternative explanation is that the SMAST and CAGE are inappropriate screening too...

Cognitive dysfunction and the inherited predisposition to alcoholism.

Abstract: A battery of neuropsychological tests was administered to 22 nonalcoholic sons of male alcoholics (SOMAs) from families with extensive histories of male alcoholism and to 22 nonalcoholic controls with no history of familial alcoholism. In each group 11 subjects were tested while sober and 11 were tested while alcohol-intoxicated. Analyses of the results of this battery suggested (1) that SOMAs may be characterized by comparative decrements in those cognitive functions associated with the organization of novel information, dependent in theory upon the prefrontal cortex; and (2) that alcohol detrimentally affects delayed memory, associated with the temporal cortex, equally across groups. Of these SOMAs 20 had previously participated in one of two studies that demonstrated their cardiovascular hyper-reactivity to threat/stress and their increased sensitivity to the reactivity-dampening effects of alcohol intoxication. Correlational analyses of the results of the present and previous studies demonstrated the existence of a highly significant relationship between cognitive impairment, cardiovascular hyper-reactivity and susceptibility to the reactivity-dampening effects of alcohol.

The relationship between low Km aldehyde dehydrogenase phenotype and drinking behavior in Japanese

Abstract: The relationship between the low Km aldehyde dehydrogenase (ALDH2) phenotype determined by the isoelectric focusing of hair root lysates, facial flushing and alcohol drinking patterns in Japanese (N = 282) was examined. Men who had inactive ALDH2 drank significantly less alcohol than those with active ALDH2. Although the effect was less noticeable, a similar relationship was detected in women. Two types of flushing responses were determined: one due to the inactive ALDH2, the other unrelated to this variant form of the isozyme. A striking difference between these flushing types, in terms of the inhibitory influence over drinking patterns, was noted. Nearly 86% of the subjects who reported always flushing in the face were shown to have inactive ALDH2, whereas infrequent flushing and absence of flushing were associated with active ALDH2. Thus, facial flushing may be used as an indicator of ALDH2 phenotype.

An elementary school-based alcohol misuse prevention program: a follow-up evaluation.

Abstract: An alcohol misuse prevention study (AMPS) curriculum for fifth- and sixth-grade students was developed, implemented and evaluated with over 5,000 students. The AMPS program emphasized social pressures resistance training, focusing on the immediate effects of alcohol, risks of alcohol misuse and social pressures to misuse alcohol. Schools were randomly assigned to curriculum, curriculum plus booster or control groups with half of each group pretested and all posttested. Measures focused on susceptibility to peer pressure, internal health locus of control, understanding of the curriculum material, alcohol use and alcohol misuse. After 26 months, there was a significant treatment by occasion interaction on internal health locus of control (sixth grade). A significant treatment by occasion interaction effect was also found with respect to curriculum measures in both grades. There was no significant treatment by occasion interactions with respect to alcohol use or misuse when the groups as a whole were considered. When subgroup analyses based on type of prior drinking experience were conducted, however, significant program effects on alcohol misuse were found among sixth-grade students who had experienced unsupervised as well as supervised drinking prior to the prevention program.

Cognitive and attitudinal factors in the analysis of alternatives to drunk driving.

Abstract: The present study examined cognitive and attitudinal factors relevant to drunk-driving tendencies in individuals having zero, one and multiple drunk-driving convictions. Results indicate that the awareness of consequences of being in an accident was related to driving record but not to drunk-driving tendencies. In contrast, the awareness of consequences of being arrested for drunk driving (e.g., receiving fines, having one's name appear in the news and having a criminal record) was negatively related to drunk-driving tendencies. Attitudes toward alternatives to drunk driving (e.g., take a taxi, call a friend) were also negatively related to drunk-driving tendencies. The findings are discussed with respect to developing prevention programs.

Relationship of family history, antisocial personality disorder and personality traits in young men at risk for alcoholism

Abstract: Studies examining possible risk factors for the development of alcoholism have focused recently on a variety of personality factors, including those associated with risk-taking behaviors. Alcohol-seeking behavior leading to the abuse of alcohol may be associated with a variety of risk-taking behaviors that derive from certain personality traits. Further, there is evidence that personality traits are transmitted across generations. This study examined the relationship of a family history of alcoholism, antisocial personality disorder (ASP) and alcohol use to several personality traits including the Tri-dimensional Personality Questionnaire (TPQ) in a sample (N = 91) of nonalcoholic, young male volunteers. The men with ASP scored higher than the non-ASP men on the Novelty Seeking Scale of the TPQ, but not on the Harm Avoidance or Reward Dependence subscales. In addition, ASP men scored higher than non-ASP men on a measure of impulsivity and tended to score higher on measures of sensation seeking, psychopathy and monotony avoidance. A family history of alcoholism did not differentiate the young men on any of the childhood behavior problems, personality measures or alcohol-related variables.

The characterization of inconsistencies in self-reports of alcohol and marijuana use in a longitudinal study of adolescents.

Abstract: The reliability of self-reported measures remains an important issue for research on adolescent alcohol and drug use. Many studies have concluded that adolescents' self-reports are valid and reliable, but few studies have excluded consistent nonusers from their reliability estimates, and no study has examined in detail the reliability of reported age at first use of substances. This study explores the consistency of self-reports of frequency of use and age of first use of alcohol and marijuana in a sample of 5,770 secondary school students in a southeastern U.S. county. Two waves of data were collected between 1985 and 1988 using state-of-the-art data collection procedures and self-administered instruments. Consistency of reports was examined by comparing reports at T1 and T2, approximately 1 year apart. Results showed that when consistent nonusers were dropped from the analysis, consistency rates of lifetime frequency of use dropped from 82.7% to 74.7% for alcohol and from 95.6% to 83.2% for marijuana. Reports were more consistent for lifetime marijuana use than for alcohol use, but these results must be interpreted with caution given differences in the measures for the two substances. Reliability of reported age of first use was very low for both substances. When consistent nonusers were dropped from the analysis, only 27.8% of respondents made consistent estimates of their age at first alcohol use and 34.4% for their age at first marijuana use. Implications and recommendations for this area of research are discussed. Language: en

The effect of alcohol on emotional response to a social stressor.

Abstract: Social drinkers were administered either an alcoholic, placebo or no-alcohol control beverage. Subjects were next informed that they were to give a self-disclosing speech about their body and physical appearance. Subjects' heart rate and videotapes of their facial expression were recorded during this instruction. Facial reactions to the stressor were analyzed using a system based on the Maximally Discriminative Facial Coding System (Izard, 1979). Subjects who were intoxicated showed significantly less negative emotion, as measured by the facial expression analysis, than those subjects consuming either the control or placebo beverage. We attribute this effect of alcohol to its actions on subjects' appraisal of anxiety-inducing information.

Neuropsychological efficiency measures in male and female alcoholics.

Abstract: The role of time in performance on many neuropsychological tests has been relatively neglected in the literature to date. Neuropsychological functioning in 90 male and female alcoholics and 65 peer controls was examined using both accuracy and time measures for four basic types of neuropsychological functioning: verbal skills, learning and memory, problem-solving and abstracting, and perceptual-motor skills. Alcoholics had significantly lower efficiency ratios (accuracy/time) than controls in each of the four areas, and had significantly lower overall accuracy and time scores. There were no significant Group x Gender interactions for efficiency, speed or accuracy scores, indicating that male and female alcoholics have similar deficits as a result of chronic alcoholism. The study is the first to apply systematically an empirical measure of neuropsychological efficiency to different areas of cognitive function; the results have implications for neuropsychological testing procedures.

The effects of alcohol on the cardiovascular stress response in men at high risk for alcoholism: a dose response study.

Abstract: Men at risk for alcoholism appear to be cardiovascularly hyperreactive to stressors; high doses of alcohol have been found to significantly dampen this hyperreactivity. The present study examined the effects of various doses of alcohol on cardiovascular reactivity in high- versus low-risk men. Cardiovascular reactivity to a stressor (unavoidable shock) was examined in men with multigenerational family histories of alcoholism and in family history negative men while they were sober and after they had consumed one of five alcohol doses (active placebo, 0.50, 0.75, 1.00 or 1.32 ml 95% USP alcohol/kg body weight). No significant placebo effects were observed in the active placebo condition. Furthermore, the cardiovascular reactivity dampening effect in high-risk men was evident only at moderate to high doses of alcohol, suggesting that men at high risk for the development of alcoholism must consume moderately high doses of alcohol in order to obtain this potentially reinforcing consequence.

Parental drinking, parent-child communication, and social skills in young adults.

Abstract: The goals of this study are to determine (1) if parent-child communication is associated with the level of alcoholic problems within the family and (2) if there is a relationship between problem drinking, family communication and the self-reported social skills of the young adult child. The self-reports of 338 students indicate that young adults who have memories of regular problem drinking within the family perceive less positive regard and a greater denial of or inattention to their feelings by the parents. Problem-drinking level interacted with either criticism or denial of feelings or emotional support to parents to predict primarily nonverbal social skills such as decreased emotional expressivity and increased sensitivity to the emotional cues of others. The results indicate that the effect of parental alcoholism on social skills of the young adult child must be considered in conjunction with specific types of family communication.

Length of stay, patient severity and treatment outcome: sample data from the field of alcoholism.

Abstract: Lengths of stay (LOS) have been markedly reduced since the institution of diagnosis-related groups (DRGs). To determine whether such reductions represent increased efficiency or undertreatment, however, requires that LOS be examined in relation to (1) severity of patient's impairment and (2) treatment outcome. Accordingly, a retrospective analysis was conducted using a data set in which initial severity assessments and 6-month outcome results were available for 126 male veterans treated for alcohol dependence. Greater improvement was found in patients with less severe impairment, and in such patients longer periods of treatment resulted in better outcomes than shorter periods of the same treatment.

The relationship between license type and alcohol-related problems attributed to licensed premises in Perth, Western Australia.

Abstract: Drink-driving offenses, alcohol-related traffic accidents and number of assault charges were used as indicators of the degree of alcohol-related problems associated with individual licensed premises in the Perth Traffic Police region of Western Australia. These indicators were used to rank five main categories of licensed premises according to the levels of harm experienced by their customers while controlling for the amounts of alcohol sold in each category. Nightclubs, taverns and hotels emerged as "high-risk" in comparison with clubs and restaurants. The role of such factors as different customer characteristics, opening hours, types of entertainment, restrictions on clientele and provision of meals are discussed as possible explanations underlying this finding.

Validity of self-reported alcohol consumption in the emergency room: data from the United States, Mexico and Spain.

Abstract: The validity of self-reported alcohol consumption within 6 hours prior to injury based on breath-analyzer readings obtained at the time of emergency room (ER) admission is compared among probability samples of ER patients in Contra Costa County, California (n = 450), Mexico City (n = 500) and Barcelona, Spain (n = 864). The same questionnaire, study design and methods were used in all three countries to maintain comparability for comparative analyses. The analysis was restricted to those breath analyzed within 6 hours of injury occurrence who reported no drinking following the event. Validity of self-reports was high in all three samples. The proportion of those reporting not drinking prior to injury who had positive breath-analyzer readings was .5% in the U.S., 1.5% in Spain and 3.3% in Mexico. Validity of self-reports was not associated with cause of injury in the United States. In Mexico those injured in motor vehicle accidents or by violence were most likely to deny drinking, while in Spain those injured in violent situations were most likely to report not drinking. Validity of self-reports in these studies is much higher than that found in other U.S. studies, but this may be partly due to the fact that self-reports were obtained after the patient had been breath analyzed.

Factor structure and correlates of the Tridimensional Personality Questionnaire.

Abstract: Cloninger has proposed a model linking personality characteristics to patterns of responses to various stimuli, including alcohol. The model also uses personality characteristics to divide alcoholics into two types. In order to assess the relevant aspects of personality, the Tridimensional Personality Questionnaire (TPQ) was developed. This study examined the factor structure and correlates of the questionnaire to shed light on its validity. A confirmatory factor analysis of the TPQ failed to replicate the three proposed factors of novelty seeking, harm avoidance and reward dependence. Alternative models also failed to fit the data. The three factors were correlated with other personality measures theoretically linked to drinking (MacAndrew, Socialization and Sensation-Seeking scales), quantity and frequency measures of alcohol use and a measure of alcohol abuse (the Michigan Alcoholism Screening Test). The pattern of correlations provides evidence for the convergent validity of the TPQ. Nevertheless, the failure to replicate the factor structure suggests that the scale requires further revision before the model can be adequately tested.

Genetic differences in psychomotor performance decrement after alcohol: a multivariate analysis.

Abstract: We reanalyzed data on the decline in performance on a battery of psychomotor tests, after a standard dose of ethanol (0.75 g/kg body weight), of 206 same-sex twin pairs. Principal components analysis identified two orthogonal factors. The first factor was strongly associated with increased body sway, self-rated intoxication and unwillingness to drive, and reported low average weekly alcohol consumption, but showed a very weak association with blood alcohol concentration. The second factor had high loadings on tests assessing psychomotor coordination, was strongly associated with blood alcohol concentration, but was unrelated to willingness to drive or self-rated intoxication. Multivariate genetic analysis indicated independent genetic and environmental determination of differences in sensitivity to the effects of alcohol on these two factors.

A follow-up study of problem drinkers offered a goal choice option.

Abstract: Patients (N = 100) who had been admitted to behaviorally oriented residential treatment for their drinking problems were followed up for 1 year. A treatment goal option of controlled drinking was explicitly catered for. Overall outcome, in which 27% of those available for follow-up were categorized as "successful," 35% as "equivocal" and 38% as "failure," does not appear to be markedly dissimilar to that reported from other agencies. The distribution of approximately equal abstinent and nonabstinent successful outcomes is similar to that found following treatment programs that promote a single goal. Sociodemographic variables were less influential in predicting outcome than were treatment variables--with frequency of aftercare attendance being particularly significant. Those who had received previous hospital treatment for their problem, those who habitually drank in company and those who had abnormal blood test results prior to entering treatment had poorer outcome.