ArticleThe lancet. Psychiatry2017
Change in non-abstinent WHO drinking risk levels and alcohol dependence: a 3 year follow-up study in the US general population.
Article in The lancet. Psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06620276 (Acceptance and Commitment Therapy in Patients With Alcohol Use Disorder and Comorbid Treatment-Resistant Depression Who Are Undergoing Ketamine Intervention), which is not on this map. Cited by 82 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acceptance and Commitment Therapy in Patients With Alcohol Use Disorder and Comorbid Treatment-Resistant Depression Who Are Undergoing Ketamine Intervention: A Feasibility Study
Who cites it
82 citing papers in PubMed, 5 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Guideline
- Screening for high-risk drinking and alcohol use disorder: update of the 2023 national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- Baseline severity and the prediction of placebo response in clinical trials for alcohol dependence: A meta-regression analysis to develop an enrichment strategy.Alcoholism, clinical and experimental research · 2021Pooled it
- Evidence based models of care for the treatment of alcohol use disorder in primary health care settings: a systematic review.BMC family practice · 2020Pooled it
- Using social network analysis to examine alcohol use among adults: A systematic review.PloS one · 2019Pooled it
- Wearable Intervention for Alcohol Use Risk and Sleep in Young Adults: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Preliminary effects of oral ANS-6637, an ALDH2 inhibitor, on cue-induced craving, safety and alcohol consumption among adults with alcohol use disorder: a proof-of-concept, randomized, human laboratory trial.Alcohol and alcoholism (Oxford, Oxfordshire) · 2025Trial
- World Health Organization (WHO) risk level reductions in inpatients with alcohol use disorder and comorbid anxiety disorders.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2023Trial
- Characterizing cannabis use reduction and change in functioning during treatment: Initial steps on the path to new clinical endpoints.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2022Trial
- Predictors of abstinence, no heavy drinking days, and a 2-level reduction in World Health Organization drinking levels during treatment for alcohol use disorder in the COMBINE study.Alcoholism, clinical and experimental research · 2022Trial
- HealthCall: A randomized trial assessing a smartphone enhancement of brief interventions to reduce heavy drinking in HIV care.Journal of substance abuse treatment · 2022Trial
- Three-year trajectories of alcohol use among at-risk and among low-risk drinkers in a general population sample of adults: A latent class growth analysis of a brief intervention trial.Frontiers in public health · 2022Trial
- Ibudilast, a neuroimmune modulator, reduces heavy drinking and alcohol cue-elicited neural activation: a randomized trial.Translational psychiatry · 2021Trial
- Treating alcohol use disorders in primary care - a qualitative evaluation of a new innovation: the 15-method.Scandinavian journal of primary health care · 2021Trial
- Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder.Journal of general internal medicine · 2021Trial
- World Health Organization risk drinking level reductions are associated with improved functioning and are sustained among patients with mild, moderate and severe alcohol dependence in clinical trials in the United States and United Kingdom.Addiction (Abingdon, England) · 2020Trial
- Effects of Alcohol Cue Reactivity on Subsequent Treatment Outcomes Among Treatment-Seeking Individuals with Alcohol Use Disorder: A Multisite Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Varenicline.Alcoholism, clinical and experimental research · 2020Trial
- Changes in DSM criteria following a culturally-adapted computerized CBT for Spanish-speaking individuals with substance use disorders.Journal of substance abuse treatment · 2020Trial
- Maintenance of World Health Organization Risk Drinking Level Reductions and Posttreatment Functioning Following a Large Alcohol Use Disorder Clinical Trial.Alcoholism, clinical and experimental research · 2019Trial
- Evaluation of Drinking Risk Levels as Outcomes in Alcohol Pharmacotherapy Trials: A Secondary Analysis of 3 Randomized Clinical Trials.JAMA psychiatry · 2019Trial
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 9 institutions in 2 countries.
Funding
Abstract
backgroundAlcohol dependence is often untreated. Although abstinence is often the aim of treatment, many drinkers prefer drinking reduction goals. Therefore, if supported by evidence of benefit, drinking reduction goals could broaden the appeal of treatment. Regulatory agencies are considering non-abstinent outcomes as efficacy indicators in clinical trials, including reduction in WHO drinking risk levels-very high, high, moderate, and low-defined in terms of mean ethanol consumption (in grams) per day. We aimed to study the relationship between reductions in WHO drinking risk levels and subsequent reduction in the risk of alcohol dependence.
methodsIn this population-based cohort study, we included data from 22 005 drinkers who were interviewed in 2001-02 (Wave 1) and re-interviewed 3 years later (2004-05; Wave 2) in the US National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol consumption (WHO drinking risk levels) and alcohol dependence (at least three of seven DSM-IV criteria in the previous 12 months) were assessed at both waves. We used logistic regression to test the relationship between change in WHO drinking risk levels between Waves 1 and 2, and alcohol dependence at Wave 2.
findingsAt Wave 1, 2·5% (weighted proportion) of the respondents were very-high-risk drinkers, 2·5% were high-risk drinkers, 4·8% were moderate-risk drinkers, and most (90·2%) were low-risk drinkers. Reduction in WHO drinking risk level predicted significantly lower odds of alcohol dependence at Wave 2, particularly among very-high-risk drinkers (adjusted odds ratios 0·27 [95% CI 0·18-0·41] for reduction by one level, 0·17 [0·10-0·27] for two levels, and 0·07 [0·05-0·10] for three levels) and high-risk drinkers (0·64 [0·54-0·75] for one level and 0·12 [0·09-0·15] for two levels), and among those with alcohol dependence at Wave 1 (0·29 [0·15-0·57] for one level, 0·06 [0·04-0·10] for two levels, and 0·04 [0·03-0·06] for three levels in very-high-risk drinkers).
interpretationOur results support the use of reductions in WHO drinking risk levels as an efficacy outcome in clinical trials. Because these risk levels can be readily translated into standard drink equivalents per day of different countries, the WHO risk levels could also be used internationally to guide treatment goals and clinical recommendations on drinking reduction.
fundingUS National Institute on Alcohol Abuse and Alcoholism, New York State Psychiatric Institute, the Alcohol Clinical Trials Initiative.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.