Abstract
Recent epidemiologic and clinical studies have shown that alcohol abuse and dependence are highly prevalent. Careful assessment of drinking habits and related problems is warranted in all patients presenting with either medical or psychiatric complaints. Once a diagnosis of abuse or dependence is made, treatment can be individualized to address the specific needs of the patient, including the potential for alcohol withdrawal and factors relevant to ongoing rehabilitation. The treatment of alcohol withdrawal requires attention to concomitant medical disorders, that if neglected can exacerbate the withdrawal reaction. Good supportive care is generally adequate for the treatment of mild-to-moderate withdrawal reactions. Medications that are cross-tolerant with alcohol (e.g. benzodiazepines) are indicated for moderate-to-severe withdrawal. Alcoholism rehabilitation, while in general shown to be beneficial, consists of a wide variety of treatment settings and therapeutic approaches. There is little evidence, however, that any one treatment setting or approach is better than any other. Similarly, the intensity and duration of treatment have not been shown, in controlled studies, to produce pronounced differences in outcome. Advances in the clinical management of alcoholism will depend on better translation of research findings to everyday practice, as well as continued investigation. Efforts to match treatment elements to specific patient characteristics are likely to result in significant advances in the treatment of alcohol abuse and dependence.