Summary - It is well known that alcoholism and the abuse of alcohol cause serious medical, psychiatric, social, economic and legal problems. Alcohol abuse-related problems appear as early as in primary school, together with smoking, while the drug problem appears a little later. Alcoholism is especially dangerous in traffic. It strikes women ever more frequently, lonely elderly people and especially the people in the undeveloped, transitional and wartorn countries. Alcoholism is becoming a major social and medical problem, so over a million of Croats (including the families of alcoholics) suffer from alcoholism-related problems.
Solutions to these problems are hard to find due to the serious economic and historical connotations of the consumption of alcohol, as well as those that have to do with cultural heritage of every country. The development of public health policy towards alcoholism includes the need for national planning and coordination regarding prevention and rehabilitation, and must be understood as closely connected, complementary and sometimes joined activities of the public health system services, with the goal of solving the problems connected with the excessive consumption and addiction to alcohol. This paper deals with the treatment of alcoholism as a public health problem.
(Alcoholism 2005; 41:73-85)
Key words: Alcohol dependence; Public health, Croatia; Treatment programs
The organization of treatment and methods used vary in different countries and partly depend on country's resources and its social philosophy and tradition.1 Since alcohol and the problems related to its excessive consumption take up an important place in social context, a policy of treatment (or prevention) that presumes that the alcohol-related problems are not connected with the wider social and economic consequences is doomed to fail.2
The family procedures in hospital and out-patient treatment are generally recognized in the world and had proved successful in our practice, particularly at the Department of Psychiatry, Sestre milosrdnice University Hospital with the Referral Center of Ministry oh Health of the Republic of Croatia for Alcoholism, Vinogradska c.29, Zagreb, Croatia. We also attempt to, besides various other positive effects achieved in the clubs of treated alcoholics, include the kids in the treatment procedure and succeed in breaking the family chain of alcoholism, i.e. return the sober happiness to the entire family.3-7
The range of factors and measures dealing with counseling and treatment of alcoholics, and persons with problems related to alcohol is wide. That range encircles activities and employees from primary health care, general hospitals, psychiatric services and specialized services, designed to treat both hospitalized patients and out-patients. There is also a contribution of laymen's organizations and self-health groups. In our social surroundings, such are the clubs of treated alcoholics (CTA).8-9
The requirements that need to be fulfilled for the treatment of alcoholics vary considerably. The public policy should strive to provide different modes of intervention, to suit the needs of different individuals, depending on the level of addiction, level of problems related to alcohol, weaknesses, personalities, psychopathologies and somatic and social status.
In many countries, the modes of treatment are not enough specialized to suit the individual needs of different patients. The various, but indispensable types of services are not always provided, and some services, particularly those dealing with out-patients, are frequently concentrated just in towns. In some countries, we have noticed the uniformity of the models of treatment.10
Leading the program of treatment according to some rule-book can not be the right way, although even such strict approach to the treatment can have its advantages. Different patients with different problems related to alcohol require the different models of aid. …