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Am J Addict. 2017 Oct;26(7):673-675. doi: 10.1111/ajad.12558. Epub 2017 Aug 18.

Pretreatment ethyl glucuronide levels predict response to a contingency management intervention for alcohol use disorders among adults with serious mental illness.

Author information

1
Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington.
2
Department of Clinical Sciences, Washington State University Elson S. Floyd College of Medicine, Spokane, Washington.
3
Program of Excellence in Addictions Research, Washington State University, Spokane, Washington.
4
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington.
5
Providence Medical Research Center, Providence Health Care, Spokane, Washington.

Abstract

BACKGROUND AND OBJECTIVES:

This study investigated if pretreatment ethyl glucuronide (EtG) levels corresponding to light (100 ng/mL), heavy (500 ng/mL), and very heavy (1,000 ng/mL) drinking predicted longest duration of alcohol abstinence (LDA) and proportion of EtG-negative urine tests in outpatients receiving a 12-week EtG-based contingency management (CM) intervention for alcohol dependence.

METHODS:

Participants were 40 adults diagnosed with alcohol use disorders and serious mental illness who submitted up to 12 urine samples for EtG analysis during a 4-week observation period and were then randomized to 12-weeks of CM for alcohol abstinence and addiction treatment attendance. Alcohol use outcomes during CM as assessed by EtG and self-report were compared across those who did and did not attain a pre-treatment average EtG level of 500 ng/mL-a level that equates to frequent heavy drinking.

RESULTS:

Only the 500 ng/mL cutoff was associated with significant differences in LDA and proportion of EtG-negative samples during CM. Those with a pre-treatment EtG < 500 ng/mL attained a LDA 2.3 (alcohol) to 2.9 (drugs) weeks longer than pre-treatment heavy drinkers.

DISCUSSION AND CONCLUSIONS:

The EtG biomarker can be used to determine who will respond to a CM intervention for alcohol use disorders and could inform future trials that are designed to be tailored to individual patients.

SCIENTIFIC SIGNIFICANCE:

Results suggest pre-treatment EtG cutoffs equivalent to heavy and very heavy drinking predict outcomes in CM. (Am J Addict 2017;26:673-675).

KEYWORDS:

alcohol treatment; contingency management; ethyl glucuronide; predicting treatment outcomes; serious mental illness

PMID:
28833832
PMCID:
PMC5610611
DOI:
10.1111/ajad.12558
[Indexed for MEDLINE]
Free PMC Article

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