Frontier: Depression complicates alcoholism recovery

by Elizabeth Norton Lasley

February, 2008

A new study examines the role of depression among patients in treatment for alcoholism who also were trying to quit smoking. The findings indicate that depression makes it more difficult to stay off alcohol but does not have a clear-cut effect on smoking.

In one of only a few studies that have looked for an interrelationship among these conditions, Molly Kodl and colleagues at the  Minneapolis VA Medical Center analyzed 462 patients from the Timing of Alcohol and Smoking Cessation Study. This 2004 clinical trial found that people trying to quit smoking while under intensive treatment for alcoholism had a harder time staying sober. In a study published in the January issue of Alcoholism: Clinical and Experimental Research, Kodl’s team re-examined the original results, this time focusing on a possible role for depression.

At follow-up assessments 6, 12 and 18 months after the study began, people who scored highly on measures of depression were more than 1.5 times more likely to backslide with drinking. They had more drinks per month, drank on more days per month, and consumed
more drinks per day than those without depressive symptoms.

Among participants who had a harder time quitting smoking, depression was not a factor; instead, the analysis turned up a link with unemployment and education levels (college graduates were more likely to quit smoking successfully). The authors say it is possible that
no relationship exists.

“Alternatively, there may be links between depression and smoking cessation that are masked by the presence of other, more significant disorders, such as alcohol dependence,” they wrote.

One recent study found that successful treatment with antidepressants helped alcoholics with depression cut back significantly on their drinking. Future research should focus on aggressively treating for depression at the same time as alcoholism, and being vigilant for signs of depression when working with patients addicted to alcohol and nicotine, the authors conclude.

“News” was written by Elizabeth Norton Lasley, a science writer in Woodbury, Conn.