ABSTRACT
Background: Controlled drinking is an attractive treatment goal among a large proportion of individuals with alcohol use disorder (AUD), with Behavioral Self-control Training (BSCT) as the most established treatment intervention, for this purpose. Yet, few controlled trials have aimed at investigating the efficacy of interventions with controlled drinking as treatment goal, and the implementation of these treatments in addiction care is scarce. Methods: A multi-site randomized controlled parallel superiority trial compared the efficacy of BSCT (5 sessions) to the active comparator Motivational Enhancement Therapy (MET) (4 sessions). A sample of 250 patients fulfilling criteria for AUD (DSM 5) with a goal of controlled drinking were included. As a result of the covid pandemic, a total of 76 participants received treatment via video meeting instead of face-to-face. Follow-ups were conducted at 12- and 26 weeks after inclusion. Primary outcome measure was mean weekly alcohol consumption. Treatment effects were analyzed by linear mixed-models. Results: Both treatment arms showed significant treatment effects for the primary outcome as well as binge drinking days (BDD) and measures of alcohol-related harm at 26 weeks after inclusion. There were no significant differences between treatment groups for the primary outcome. A total of 41,6 % of the patients obtained a level of low-risk drinking at the 26-week follow-up (9/14 standard drinks of 12 g of alcohol for women/men). No significant differences based on how the treatment was delivered i.e., between the face-to-face or video based intervention were detected. A subgroup of individuals (n = 25) with 75% or more of BDD before inclusion, reduced their drinking to 29% BDD at the 26-week follow-up. Conclusions: These results suggest that BSCT and MET designed as short-term treatments, are efficacious for a wide range of patients with AUD. This is evident in that a substantial proportion of patients obtained low-risk drinking levels, and individuals with more heavy consumption patterns, also significantly reduced their consumption. These results highlight a need for a more diverse approach within health care services to recovery from AUD with possibility of offering psychological treatments with controlled drinking as a treatment goal.