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Journal of Marital and Family Therapy Jan 2012This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We... (Review)
Review
This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.
Topics: Adaptation, Psychological; Alcoholism; Attitude to Health; Behavior Control; Counseling; Evidence-Based Practice; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Marital Therapy; Outcome Assessment, Health Care; Patient Compliance; Research Design; Self Efficacy; Sex Factors
PubMed: 22283384
DOI: 10.1111/j.1752-0606.2011.00242.x -
Alcohol Research & Health : the Journal... 2000Every 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... (Review)
Review
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.
Topics: Alcohol Deterrents; Alcoholics Anonymous; Alcoholism; Evidence-Based Medicine; Humans; Mass Screening; Psychotherapy, Group; Research; Treatment Outcome; United States
PubMed: 11199275
DOI: No ID Found -
Alcohol Research & Health : the Journal... 2010Research on the treatment of alcoholism has gained significant ground over the past 40 years. Studies such as the National Institute on Alcohol Abuse and Alcoholism's... (Review)
Review
Research on the treatment of alcoholism has gained significant ground over the past 40 years. Studies such as the National Institute on Alcohol Abuse and Alcoholism's Project MATCH, which examined the prospect of tailoring treatments for particular people to better suit their needs, and Project COMBINE, which examined in-depth, cognitive-behavioral therapy and medical management, helped pave the way for a new way of approaching alcoholism treatment. New findings garnered through the National Epidemiologic Survey on Alcohol and Related Conditions further defined the problem. At the heart of this research has been the development of procedures to characterize, measure, and monitor the fidelity to a particular conceptual psychotherapeutic approach so that clear comparisons can be made between conceptually and technically distinct approaches. Advances in scientific methodology and statistics have provided tools to analyze complex datasets. The resulting findings mark an improvement over the first models of treatment developed decades ago, which tended to focus on anecdotal findings and assumptions. This hard-earned progress has enabled scientists today to move ahead and address the next set of challenges. Future research, coupled with a restructured treatment system capable of making new scientific findings rapidly available to the community, hold the key to significantly improving treatment outcomes and reducing suffering from alcohol-related disorders.
Topics: Alcoholism; Animals; Biomedical Research; Forecasting; Humans; National Institute on Alcohol Abuse and Alcoholism (U.S.); Treatment Outcome; United States
PubMed: 23579936
DOI: No ID Found -
British Medical Journal (Clinical... Jul 1982
Topics: Adult; Alcoholism; Follow-Up Studies; Humans; Male; Middle Aged
PubMed: 6805803
DOI: 10.1136/bmj.285.6334.3 -
CNS Drugs Apr 2013Alcohol dependence represents a chronic and relapsing disease affecting nearly 10 % of the general population both in the USA and in Europe, with a widespread burden of... (Review)
Review
Alcohol dependence represents a chronic and relapsing disease affecting nearly 10 % of the general population both in the USA and in Europe, with a widespread burden of morbidity and mortality. Alcohol dependence represents the most common cause of liver damage in the Western world. Although alcoholic liver disease is associated primarily with heavy drinking, continued alcohol consumption, even in low doses after the onset of liver disease, increases the risk of severe consequences, including mortality. Consequently, the ideal treatment of patients affected by alcohol dependence and alcoholic liver disease should aim at achieving long-term total alcohol abstinence and preventing relapse. The aim of the present review is to provide an update on the management of alcohol dependence in patients with alcoholic liver disease. Increasing evidence suggests the usefulness of psychosocial interventions and medications combined in order to reduce alcohol intake, promote abstinence and prevent relapse in alcohol-dependent patients. Disulfiram, naltrexone and acamprosate have been approved for this indication; gamma-hydroxybutyric acid (GHB) is approved in Italy and Austria. However, these drugs have not been tested in patients with advanced liver disease. Amongst other emerging pharmacotherapies for alcoholism, topiramate, ondansetron, and baclofen seem the most promising ones. Both topiramate and ondansetron have a safe profile in alcoholic patients; however, none of them has been tested in alcoholic patients with advanced liver disease. To date, baclofen represents the only anti-craving medication formally tested in a randomized clinical trial in alcoholic patients affected by liver cirrhosis, although additional confirmatory studies are warranted.
Topics: Alcohol Abstinence; Alcohol Deterrents; Alcohol Drinking; Alcoholism; Drug Approval; Humans; Liver Diseases, Alcoholic; Secondary Prevention
PubMed: 23456576
DOI: 10.1007/s40263-013-0043-4 -
Alcohol Research & Health : the Journal... 2000Animal models on alcohol preference have a long-standing tradition in biomedical research on alcoholism. However, these models allow only limited conclusions regarding... (Review)
Review
Animal models on alcohol preference have a long-standing tradition in biomedical research on alcoholism. However, these models allow only limited conclusions regarding alcohol addiction. Therefore, during the past 15 years, researchers have developed new animal models that mimic different aspects of human alcohol addiction, such as craving, relapse, and loss of control over drinking. These models include the reinstatement model, the alcohol deprivation model, and the point-of-no-return model. Some of these models have been pharmacologically validated with anti-craving compounds that are used clinically for treating alcoholics. The detailed behavioral characterization of these new models and their pharmacological validation also allow researchers to study the neurochemical and molecular bases of addictive behavior.
Topics: Alcoholism; Animals; Brain Chemistry; Disease Models, Animal; Drug Evaluation, Preclinical; Humans; Mice; Rats; Recurrence; Reproducibility of Results
PubMed: 11199279
DOI: No ID Found -
Clinical Medicine (London, England) Apr 2015It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This... (Review)
Review
It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis. At this late stage, management consists of expert supportive care, with prompt identification and treatment of bleeding, sepsis and renal problems, as well as support to change behaviour and stop harmful alcohol consumption. There are opportunities to improve care by bringing liver care everywhere up to the standards of the best liver units, as detailed in the Lancet Commission report. We also need a fundamental rethink of the technologies and approaches used in primary care to detect and intervene in liver disease at a much earlier stage. However, the most effective and cost-effective measure would be a proper evidence-based alcohol strategy.
Topics: Alcoholism; Humans; Liver Diseases, Alcoholic; United Kingdom
PubMed: 25824072
DOI: 10.7861/clinmedicine.15-2-179 -
Alcohol Research & Health : the Journal... 1999Recent data suggest that most people experiencing alcohol problems have problems of mild to moderate severity. Relative to alcoholics, these drinkers have a shorter... (Review)
Review
Recent data suggest that most people experiencing alcohol problems have problems of mild to moderate severity. Relative to alcoholics, these drinkers have a shorter problem-drinking history, greater social and economic stability, and greater personal resources. This article describes a cognitive-behavioral treatment approach designed specifically for problem drinkers with low levels of physical dependence on alcohol who choose to reduce their drinking. After describing various drinking-reduction techniques, the article reviews empirical evidence for drinking-reduction training. The increasing availability of drinking-reduction interventions holds considerable promise for reducing alcohol-related dysfunction among problem drinkers.
Topics: Alcohol Drinking; Alcoholism; Behavior Therapy; Humans; Motivation
PubMed: 10890808
DOI: No ID Found -
The Western Journal of Medicine Mar 1992Primary care physicians can play an important role in managing alcoholic patients. Identifying and treating alcoholism early, before it has interfered with patients'... (Comparative Study)
Comparative Study Review
Primary care physicians can play an important role in managing alcoholic patients. Identifying and treating alcoholism early, before it has interfered with patients' relationships and work, may increase the likelihood of prolonged recovery. Simple office interventions can help motivate patients to abstain and seek treatment. People who abuse alcohol and are unwilling to abstain can benefit from a recommendation to reduce their intake of alcohol. For alcohol-dependent patients who decide to stop drinking, primary care physicians often can manage withdrawal on an outpatient basis. Selecting an appropriate treatment program for each alcoholic patient is important, and referral to a specialist to assist in matching patients to treatments is often necessary. Primary care physicians also can help prevent relapse. Although disulfiram is of limited value, primary care physicians can support recovery by identifying coexistent psychosocial problems, helping patients to restructure their lives, and ensuring continuity of care.
Topics: Alcohol Drinking; Alcoholics Anonymous; Alcoholism; Ambulatory Care; Hospitalization; Humans; Mental Disorders; Primary Health Care; Temperance
PubMed: 1595243
DOI: No ID Found -
Alcohol Health and Research World 1997Alcohol has numerous adverse effects on the various types of blood cells and their functions. For example, heavy alcohol consumption can cause generalized suppression of... (Review)
Review
Alcohol has numerous adverse effects on the various types of blood cells and their functions. For example, heavy alcohol consumption can cause generalized suppression of blood cell production and the production of structurally abnormal blood cell precursors that cannot mature into functional cells. Alcoholics frequently have defective red blood cells that are destroyed prematurely, possibly resulting in anemia. Alcohol also interferes with the production and function of white blood cells, especially those that defend the body against invading bacteria. Consequently, alcoholics frequently suffer from bacterial infections. Finally, alcohol adversely affects the platelets and other components of the blood-clotting system. Heavy alcohol consumption thus may increase the drinker's risk of suffering a stroke.
Topics: Alcoholism; Animals; Ethanol; Hematologic Diseases; Humans
PubMed: 15706762
DOI: No ID Found