STEPS outpatient program improves alcohol treatment outcomes in Ukrainian regional narcologic dispensary

摘要

Alcohol abuse is of epidemic proportions in Ukraine, including the Vinnitsya Oblast (county), a midsized urban area in central Ukraine. Care for persons with alcohol disorders, provided in regional narcologic dispensaries, consists primarily of inpatient medical detoxification and short-term psychologic care. Structured outpatient and aftercare programs have not been investigated systematically for potential widespread dissemination. Materials and Methods: This study investigated the feasibility and efficacy of adding a 12 step-based outpatient and aftercare program (STEPS) to inpatient Regional Narcological Dispensary (RND) treatment using a randomized controlled design. Persons with alcohol disorders (N=68) were recruited from the Vinnitsya RND. After approximately 30 days of inpatient RND treatment, controls were discharged whereas experimental participants voluntarily entered 2 months of STEPS outpatient day treatment, plus 1 month of aftercare and 1 month of sponsors' group. Results: Both RND and STEPS produced positive alcohol-related outcomes at 2 months that were sustained at 4 months. However, adding STEPS resulted in outcomes superior to RND alone. At 4-month follow-up, STEPS reduced average total drinking days in the last 30 days from 18.2 to 2.5 days; average number of drinks per drinking day from 13.6 to 2.9 drinks; and heavy drinking days from 7.7 to 0.4 days. Participation in STEPS also was associated with fewer negative alcohol-related consequences, less depression, and better signs of mental health as compared with RND treatment alone. Conclusions: Adding a 12 step-based outpatient and aftercare intervention to standard inpatient alcohol detoxification was feasible and efficacious for alcohol-dependent patients in a midsized Ukrainian city.