ABSTRACT
Alcohol use disorder (AUD) causes immense global burden and has a significant impact on economic
and societal functioning,1 as it affects 15.1 million adults.2 Efficacious treatments for AUDs have been well-
established and researched within the literature, and there are numerous options for evidence-based
therapies.3,4 The most commonly accessed treatments for AUD are alcohol-related services, such as self-help
groups, outpatient clinics, and detoxification centers.4,5 Effectiveness studies assessing these alcohol-related
services have found that though these services are effective at treating AUDs, there are numerous differences
between individuals who receive alcohol-related services and individuals who do not.5,6 These differences
cause inherent selection bias in studies of effectiveness, confounding findings regarding outcomes.
Furthermore, current studies of alcohol-related services frequently define recovery outcomes as abstinence
from drinking.7 However, this approach reduces variability in viable recovery outcomes, such as reduction of
drinking behaviors to moderate levels, effectively reducing alcohol-related problems.8 In addition, reduction in
drinking behaviors and alcohol-related problems should theoretically have an impact on broader aspects of
functioning, particularly psychological and psychosocial functioning. Familial functioning in particular is an
important aspect of daily life that is impacted by AUDs.9 Improved familial context has the capacity to reduce
risk to family members, who are otherwise at heightened risk for emotional and behavioral problems when
living with a family member with AUD.10 Yet these indices of functioning are rarely evaluated in alcohol-related
services research.11 The current proposal seeks to investigate the effect of alcohol-related services after
eliminating selection bias by using a propensity score matching approach to create a comparison group that is
matched to the alcohol-related services group on all measured variables. Moreover, the current proposal will
further add to the literature by broadening the assessment of outcomes to include variability in drinking
behaviors, as well as familial functioning.
