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Evidence from regression-discontinuity analyses for beneficial effects of a criterion-based increase in alcohol treatment

Authors

  • Rosely Flam-Zalcman,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Robert E. Mann,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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  • Gina Stoduto,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Thomas H. Nochajski,

    1. Faculty of Social Work, SUNY Buffalo, Buffalo, NY, USA
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  • Brian R. Rush,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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  • Anja Koski-Jännes,

    1. School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
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  • Christine M. Wickens,

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Rita K. Thomas,

    1. Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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  • Jürgen Rehm

    1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
    3. Epidemiological Research Unit, Klinische Psychologie and Psychotherapie, Technische Universität Dresden, Dresden, Germany
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Correspondence: Robert Mann, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.

Telephone (+1) 416-535-8501 ext. 4496

Email: robert_mann@camh.net

Abstract

Brief interventions effectively reduce alcohol problems; however, it is controversial whether longer interventions result in greater improvement. This study aims to determine whether an increase in treatment for people with more severe problems resulted in better outcome. We employed regression-discontinuity analyses to determine if drinking driver clients (n = 22,277) in Ontario benefited when they were assigned to a longer treatment program (8-hour versus 16-hour) based on assessed addiction severity criteria. Assignment to the longer16-hour program was based on two addiction severity measures derived from the Research Institute on Addictions Self-inventory (RIASI) (meeting criteria for assignment based on either the total RIASI score or the score on the recidivism subscale). The main outcome measure was self-reported number of days of alcohol use during the 90 days preceding the six month follow-up interview. We found significant reductions of one or two self-reported drinking days at the point of assignment, depending on the severity criterion used. These data suggest that more intensive treatment for alcohol problems may improve results for individuals with more severe problems. Copyright © 2012 John Wiley & Sons, Ltd.

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