For Problem Drinkers The Check-Up Is In the Mail

For problem drinkers, the check-up is in the mail.

A new study indicates that problem drinkers can get help without having to visit a counselor, but by taking part in a "mail intervention."

Problem drinkers reported a significant decrease in high-risk drinking and related consequences by filling in a questionnaire, mailing it, and following the instructions in the materials they received in return, says lead author Linda Carter Sobell, a professor of psychology at Nova Southeastern University in Fort Lauderdale, Fla.

"The majority of people with alcohol problems resist the term 'alcoholic' and will not seek treatment," says Sobell. "So, what can we do? We can take the treatment to them."

Prior research has proven that more than three-quarters of adults who recover from an alcohol problem do so by "natural recovery", without the aid of any formal treatment. The study, which appeared in the June 2002 issue of "Alcoholism: Clinical and Experimental Research," found a "mail intervention" can reach large numbers of individuals who are unwilling, not ready, or not motivated to seek treatment.

Researchers created an advertisement to appeal to problem drinkers who wanted to address their drinking problems on their own, privately. The respondents received questionnaires about their drinking habits during the past year, how problematic their drinking was and how much they wanted to change.

Based on this, Sobell and her colleagues from the University of Toronto, The Center for Addition and Mental Health Services in Toronto, The College of Nursing at the University of Nebraska Medical Center in Omaha, and St. Joseph's Health-Care Hospital in Hamilton, Ontario, sent printed guidance on alcohol consumption to the 825 respondents who reported consuming an average of 12 or more drinks per week and who reported binge drinking (five or more drinks per single occasion) at least five times in the past year.

Approximately half the subjects were randomly selected to receive materials personalized to their reported drinking habits and level of motivation; the other half received generic pamplets with no individualized contact.

Surprisingly, both groups were equally successful. "We thought the personalized feedback would have more impact than the general pamphlet, but found it didn't matter," says Sobell. "That's not a bad surprise, when you consider the cost of alcohol problems on society. We got a big bang for our buck."

After following-up with respondents a year later, researchers discovered that both groups showed strong improvements in drinking patterns. On average, participants reported drinking 15 percent fewer days per week and consuming 20 percent fewer drinks per day when they did drink. They reported reducing their intake of drinks per week by 28 percent and binged 33 percent less often than before taking part in the study. Their new drinking habits resulted in 58 percent fewer negative consequences, according to the study.

The study, supported in part by a grant from the U.S. National Institute on Alcohol Abuse and Alcoholism, also found that individuals who previously reported a stronger desire and intent to change and had a greater confidence in their ability to do so, showed larger changes in drinking than other participants.

"There's a neglected majority of problem drinkers out there that will not cross the clinical threshold," says Sobell. "Most of them will never come in for treatment. But if the majority of individuals can change on their own, we can foster that."

Feel free to contact Dr. Sobell directly at (954) 262-5811 (office), (954) 346-6974 (home), or sobelll@cps.nova.edu.