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Original article

Vol. 149 No. 3940 (2019)

“Alcochoix+”: controlled drinking within a structured programme – a cohort study in Switzerland

  • Thierry Favrod-Coune
  • Gaspard Aebischer
  • Fabienne Grondin-Giletti
  • Isabelle Girod
  • Hélène Simoneau
  • Barbara Broers
Cite this as:
Swiss Med Wkly. 2019;149:w20120



Controlled drinking as a therapy goal for problematic alcohol use is still a matter for debate, especially with regard to dependent drinkers. Furthermore, few structured controlled drinking programmes have been evaluated. The aim of this study was to observe the evolution of excessive and dependent drinkers in a French-language six-step controlled drinking programme called “Alcochoix+”.


This was a cohort study of patients in four centres in the French-speaking part of Switzerland who were enrolled between May 2010 and September 2011, and evaluated before and up to 1 year after completion of the programme, according to criteria such as drinking habits, evolution of the Alcohol Use Disorder Identification Test (AUDIT) score and quality of life indicators. We considered the patients who chose not to be followed up to have unchanged alcohol consumption.


Recruitment was slow: 60 persons were enrolled, mostly middle-aged men, with excessive alcohol use / moderate alcohol dependence (median AUDIT score 20.5, median weekly alcohol consumption 350 g). Thirty-four participants (56.7%) completed the programme and their median weekly alcohol reduction was 160 g. The mean AUDIT score decreased to 14.1 points. Several aspects of quality of life improved. Changes were stable 1 year after the programme. Expressed satisfaction with the programme was high.


This six-step structured controlled drinking programme designed for excessive drinkers also attracted moderately dependent drinkers. Those who had participated fully in the study significantly reduced their alcohol consumption, with a slight improvement in their quality of life. Future studies should identify the barriers to problem drinkers integrating controlled drinking programmes, and to underline the role of these programmes for moderately dependent drinkers.


  1. World Health Organization. Global status report on alcohol and health 2014. Geneva: World Health Organization; 2014. ISBN 978 92 4 069276 3 (PDF).
  2. World Health Organization. Public health successes and missed opportunities. Trends in alcohol consumption and attributable mortality in the WHO European Region, 1990-2014. Geneva: World Health Organization; 2016. ISBN 978 92 890 5167 5 (PDF).
  3. Anderson P, Møller L, Galea G, eds. Alcohol in the European Union Consumption, harm and policy approaches. Geneva: World Health Organization; 2012. ISBN 978 92 890 0264 6.
  4. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009;373(9682):2223–33. doi:.
  5. Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, et al.; CDBE2010Study Group. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(10):718–79. doi:.
  6. Marmet S, Rehm J, Gmel G, Frick H, Gmel G. Alcohol-attributable mortality in Switzerland in 2011--age-specific causes of death and impact of heavy versus non-heavy drinking. Swiss Med Wkly. 2014;144:w13947. doi:.
  7. Wood AM, Kaptoge S, Butterworth AS, Willeit P, Warnakula S, Bolton T, et al.; Emerging Risk Factors Collaboration/EPIC-CVD/UK Biobank Alcohol Study Group. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. 2018;391(10129):1513–23. doi:.
  8. Kaner E. NICE work if you can get it: Development of national guidance incorporating screening and brief intervention to prevent hazardous and harmful drinking in England. Drug Alcohol Rev. 2010;29(6):589–95. doi:.
  9. Sobell MB, Sobell LC. Alcoholics treated by individualized behavior therapy: one year treatment outcome. Behav Res Ther. 1973;11(4):599–618. doi:.
  10. Walters GD. Behavioral self-control training for problem drinkers: A meta-analysis of randomized control studies. Behav Ther. 2000;31(1):135–49. doi:.
  11. van Amsterdam J, van den Brink W. Reduced-risk drinking as a viable treatment goal in problematic alcohol use and alcohol dependence. J Psychopharmacol. 2013;27(11):987–97. doi:.
  12. Simoneau H, Landry M, Tremblay J. Alcochoix+: un guide pour atteindre vos objectifs. Quebec: Ministère de la Santé et des Services Sociaux du Québec ; 2004.
  13. Cournoyer LG, Simoneau H, Landry M, Tremblay J, Patenaude C. Évaluation d’implantation du programme Alcochoix+. Rapport final d’une recherche subventionnée par le Fonds québécois de la recherche sur la société et la culture (FQRSC #2008‐TO‐120890). Québec: Fond de recherche societé et culture; 2009.
  14. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993;88(6):791–804. doi:.
  15. Gache P, Michaud P, Landry U, Accietto C, Arfaoui S, Wenger O, et al. The Alcohol Use Disorders Identification Test (AUDIT) as a screening tool for excessive drinking in primary care: reliability and validity of a French version. Alcohol Clin Exp Res. 2005;29(11):2001–7. doi:.
  16. Raistrick D, Dunbar G, Davidson R. Development of a questionnaire to measure alcohol dependence. Br J Addict. 1983;78(1):89–95. doi:.
  17. Foster JH, Powell JE, Marshall EJ, Peters TJ. Quality of life in alcohol-dependent subjects--a review. Qual Life Res. 1999;8(3):255–61. doi:.
  18. Gmel G, Kuendig H, Notari L, Gmel C. Monitorage suisse des addictions - Consommation d'alcool, de tabac et de drogues illégales en Suisse en 2016. Lausanne: Addiction Suisse; 2017.
  19. Bertholet N, Daeppen JB, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005;165(9):986–95. doi:.
  20. Robson E, Edwards J, Gerry P, Mills K. Drinking decisions, final evaluation report. Capital Health Authority, Public Health Services; 1995.
  21. Dawson DA, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ. Recovery from DSM-IV alcohol dependence: United States, 2001-2002. Addiction. 2005;100(3):281–92. doi:.
  22. Rosenberg H. Prediction of controlled drinking by alcoholics and problem drinkers. Psychol Bull. 1993;113(1):129–39. doi:.
  23. Sanchez-Craig M, Annis HM, Bronet AR, MacDonald KR. Random assignment to abstinence and controlled drinking: evaluation of a cognitive-behavioral program for problem drinkers. J Consult Clin Psychol. 1984;52(3):390–403. doi:.
  24. Favrod-Coune T, Aebischer G, Grondin-Giletti F, Girod I, Simoneau H, Broers B. Evaluation descriptive du programme «Alcochoix+» en Suisse romande. Available at:

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