Evaluating multiple outcomes and gender differences in alcoholism treatment (original) (raw)

1995, Addictive Behaviors

This study followed 592 alcoholics (180 women and 412 men) after discharge from inpatient treatment. Multiple measures of treatment outcome were used to broaden our understanding of the process of recovery from alcohol abuse, and how that process differs for men and women. Patients were interviewed by telephone between 3 and 15 months after discharge to gather information about post-treatment experiences including: relationship with family, role performance, psychological impairment, and effort toward recovery. Additionally, if any alcohol use took place after treatment, information was collected about the pattern of alcohol consumption. Results indicated being married is consistently related to less drinking for men, while for women, being married contributes to relapse in the short term. The determinants of each measure of outcome were different for women and men, indicating that the process of recovery is not the same for both genders. The study confirms that drinking is related to other adverse outcomes for men, but not necessarily for women. It is evidence that women and men have different post-treatment functioning, and that different characteristics are predictive of these outcomes. Since the 194Os, when Jellinek's definition of alcoholism as a disease became accepted in the medical community, alcoholism largely has been regarded as a disease that the individual cannot control (Wilson, 1988). According to this "loss of control" theory, or disease model of alcoholism (Jellinek, 1960), once exposed to alcohol, the alcoholic has an insatiable desire for alcohol and drinks to intoxication. Therefore, the goal for alcoholism treatment traditionally has been complete abstinence (Ornstein & Cherepon, 1985; Vannicelli, 1984). Although the loss of control theory of alcoholism has been widely challenged (Polich, Armor, & Braiker, 1981; Wilson, 1988), total abstinence from alcohol remains the goal for most treatment centers. This is true despite studies showing that abstinence is an unlikely outcome of treatment, even in the short term (