Treatment of problem alcohol use in women of childbearing age: Results of a brief intervention trial

Background: Studies suggest that 14% of women age 18 to 40 drink alcohol ab ove recommended limits. Of special concern is the increasing use of alcohol by women during pregnancy. This article reports 48 month follow-up data fr om a subanalysis of a trial for early alcohol treatment (Project TrEAT) foc used on women of childbearing age. Methods: Project TrEAT was conducted in the offices of 64 primary care, com munity-based physicians from 10 Wisconsin counties. Of 5979 female patients ages 18 to 40 who were screened for problem drinking, 205 were randomized into an experimental group (n = 103) or control group (n = 102). The interv ention consisted of two 15 min, physician-delivered counseling visits that included advice, education, and contracting by using a scripted workbook. A total of 174 subjects (85%) completed the 48 month follow-up procedures. Results: No significant differences were found between the experimental and control groups at baseline for alcohol use, age, socioeconomic status, smo king, depression or anxiety, conduct disorder, lifetime drug use, or health care utilization. The trial found a significant treatment effect in reduci ng both 7 day alcohol use (p = 0.0039) and binge drinking episodes (p = 0.0 021) over the 48 month follow-up period. Women in the experimental group wh o became pregnant during the follow-up period had the most dramatic decreas es in alcohol use. A logistic regression model based on a 20% or greater re duction in drinking found an odds ratio of 1.93 (confidence interval 1.07-3 .46) in the sample exposed to physician intervention. Age, smoking, depress ion, conduct disorder, antisocial personality disorder, and illicit drug us e did not reduce drinking significantly. No significant differences were fo und in health care utilization and health status between groups. Conclusions: This trial provides the first direct evidence that brief inter vention is associated with sustained reductions in alcohol consumption by w omen of childbearing age. The results have enormous implications for the U. S. health care system.