Academic journal article Alcohol Research

Research Refines Alcoholism Treatment Options

Academic journal article Alcohol Research

Research Refines Alcoholism Treatment Options

Article excerpt

Every day, more than 700,000 people in the United States receive treatment for alcoholism. In recent years, much progress has been made in understanding how both psychological approaches and medications can help these patients achieve sobriety, including evaluation of existing treatment approaches and development of new ones. Continued research to refine therapies for alcoholism will have widespread benefits for alcohol-dependent people, for their families, and for society as a whole, which bears the weight of the enormous economic and social costs of problem drinking. This article reviews the current state of alcoholism treatment research. KEY WORDS: treatment research; screening and diagnostic method for AOD (alcohol or other drug) use; brief intervention; patient-treatment matching; twelve-step model; treatment outcome in Health Services Research (HSR); drug therapy; psychotherapy; interview; questionnaire

For patients who are at-risk or problem drinkers but not alcohol dependent, health care providers can significantly reduce alcohol use and related problems by providing brief interventions, which consist of feedback and advice from the health care provider and agreement by the patient on a course of action. For patients who are alcohol dependent, numerous inpatient and outpatient treatment options are available. In recent years, escalating health care costs have propelled a shift from inpatient to outpatient treatment at all stages of recovery; although inpatient care remains more appropriate for patients with serious concurring medical or psychiatric conditions or in social environments that are not supportive of recovery. Whether inpatient or outpatient, the treatment can involve psychological approaches, medications, or a combination of the two.

Continued research to refine therapies for alcoholism will have widespread benefits for alcohol-dependent people, for their families, and for society as a whole, which bears the weight of the enormous economic and social costs of problem drinking. This article reviews the current state of alcoholism treatment research. It first discusses screening approaches and brief interventions that have been tested and validated in clinical settings. The article then summarizes research evaluating the effectiveness of the many psychological therapies currently used to treat alcoholism. Finally, the article describes recent advances in the development of medications both to treat alcohol dependence and to treat patients who suffer not only from alcohol dependence but also from psychiatric disorders, primarily depression.

SCREENING AND BRIEF INTERVENTION FOR ALCOHOL PROBLEMS

One in 5 men and 1 in 10 women who visit their primary care providers meet the criteria for at-risk drinking, problem drinking, or alcohol dependence (Manwell et al. 1998). Furthermore, estimates suggest that alcohol dependence is found in 25 percent of persons seen in primary care settings who drink above recommended limits of alcohol use. [1] Many of these patients do not consult alcohol treatment specialists; consequently, their primary health care providers have an important opportunity to identify and treat both potential and existing drinking problems.

Screening for alcohol-related problems usually involves asking the patient questions about drinking through structured interviews or self-report questionnaires; it may also involve laboratory tests to detect abnormalities associated with excessive alcohol consumption. Once a drinking problem--or a level of increased risk--has been identified, health care providers can take steps to help the patient minimize or prevent future problems. Often this intervention rakes the form of advice or counseling to encourage the patient to alter behaviors that are contributing to the problem. In some cases, more detailed assessments are needed to specify the nature and extent of the problems so that appropriate treatment can be initiated. …

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