Randomised Controlled Trial of a New Intervention for Alcohol Craving (2007)

Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.