The Relationship of World Health Organization Drinking Risk Categories to Alcohol Consequences and Mental Health in Alcohol Clinical Trials

Sandra Helinski

Katie Witkiewitz, Center on Alcoholism, Substance Abuse, and Addictions (CASAA), University of New Mexico, Albuquerque, NM 87131, United States

The goal of the current study was to examine the correspondence between levels of alcohol consumption and experiences of drinking-related consequences and mental health during and following treatment among individuals receiving treatment for alcohol dependence. Data from the COMBINE study (n=1383) was used. We examined the correspondence between drinking levels (defined as the World Health Organization (WHO) alcohol consumption risk levels) and risk of drinking consequences and mental health symptoms. After controlling for numerous demographic variables and clinical characteristics assessed as baseline, results indicated reductions in WHO risk levels were associated with significantly fewer alcohol related consequences and improved mental health among patients in COMBINE. Importantly, even a one level decrease in WHO risk drinking levels predicted statistically and clinically significant decreases in the risk of experiencing a variety of alcohol related consequences. The reduction in risk of experiencing alcohol related consequences and improvements in mental health were greater for each additional decrease in WHO risk drinking level. The results from the current study provide evidence of reductions in WHO risk levels as a viable alternative to abstinence as an endpoint for alcohol clinical trials. The paper will also discuss the application of WHO risk levels in clinical practice and provide clear guidance for clinicians on the targets for alcohol risk reduction that are most likely to be associated with meaningful reductions in alcohol related consequences.