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Although the patient in the vignette is considered to be in “full, sustained remission” (i.e., he has had no adverse consequences for >12 months) and should be lauded for cutting down on his use of alcohol, he should understand that he continues to be at risk for relapse. He should be counseled that abstinence remains his safest option, because only about 1 in 10 men with alcohol dependence can maintain controlled drinking over the long term. The clinician should inquire at regular follow-up visits about his alcohol consumption; its consequences and related health problems; attendance at specialty aftercare and mutual support groups; progress toward functional goals; craving, triggers, and coping strategies; and readiness to consider further reductions in drinking.
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