“Killing Two Birds with One Stone”: Alcohol Use Reduction Interventions with Potential Efficacy at Enhancing Self-control

Abstract

We review interventions with empirical support for reducing alcohol use and enhancing self-control. Although any intervention that reduces drinking could improve self-control, we focus here on interventions with evidence of direct benefit for both indications. Although no intervention yet has strong evidence for dual efficacy, multiple interventions have strong evidence for one indication and solid or suggestive evidence for the other. Among pharmacotherapy, opioid antagonists currently have the best evidence of efficacy at reducing alcohol use and enhancing self-control. Nicotinic partial agonist varenicline also seems to be efficacious for alcohol use and self-control. Many psychosocial and behavioral interventions (e.g. cognitive behavioral therapy, contingency management, mindfulness training) may have efficacy for both indications, on the basis of purported mechanisms of action and empirical evidence. Cognitive bias modification and neurophysiological interventions have promise for alcohol use and self-control, and warrant further research. We offer several other suggestions for future research.