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Predictors of 16-Year Mortality Among Individuals Initiating Help-Seeking for an Alcoholic Use Disorder

Authors

  • Christine Timko,

    1. Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, Palo Alto, California.
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  • Anna DeBenedetti,

    1. Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, Palo Alto, California.
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  • Bernice S. Moos,

    1. Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, Palo Alto, California.
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  • Rudolf H. Moos

    1. Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, Palo Alto, California.
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  • This project was supported by National Institute on Alcohol Abuse and Alcoholism Grants AA12718 and AA15685 and by the Department of Veterans Affairs Office of Research and Development (Health Services Research and Development Service).

Reprint requests: Christine Timko, Veterans Affairs Health Care System (152-MPD), 795 Willow Road, Menlo Park, CA 94025; Fax: 650-617-2736; E-mail: ctimko@stanford.edu

Abstract

Background and Methods: We examined rates and predictors of mortality in individuals (47% women) who had just initiated help-seeking for their alcohol use disorders (AUDs) at the start of the study (n=628) and were followed for 16 years.

Results: For both women and men, the observed-to-expected mortality ratio (1.4) was lower than rates found in samples of treated individuals with AUDs, suggesting that those initiating help-seeking careers have better chances of long-term survival. Of the individuals for whom cause of death was known, 68% died of alcohol-related causes. Men were more likely to die than were women. When gender was controlled, individuals who were older and unmarried and had more alcohol dependence symptoms at baseline were more likely to die over the 16-year period. When these baseline characteristics were controlled, better drinking outcomes at 1 year were associated with a lower likelihood of subsequent death. The combination of a shorter duration of inpatient/residential care and better drinking outcomes at 1 year was related to a lower probability of death, as was the combination of a longer duration of outpatient care or Alcoholics Anonymous attendance and better drinking outcomes at 1 year.

Conclusions: Efforts should be made to help providers identify individuals who are not responding positively to inpatient or residential treatment and intervene to motivate participation in continuing outpatient care and community 12-step self-help groups to reduce the likelihood of a chronic and fatal AUD course.

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