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Treating alcohol dependence: Medication plus therapy leads to longer abstinence
Date:11/19/2013

Alcohol treatment that incorporates a stepped-care rationale, in which services are escalated, appears to increase the overall efficacy of the treatment regimen. However, in countries such as Germany and the U.S., medication and individual psychotherapy either separately or in combination are rarely used to treat alcohol dependence (AD). A recent study of AD patients who were given a stepped-care approach first medication, then additional psychotherapy found that patients who are willing to attend psychotherapy in addition to pharmacotherapy benefit from a reduced or delayed relapse to heavy drinking.

Results will be published in the April 2014 online-only issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"In Germany, usually care is delivered by addiction counselors," said Michael Berner, a professor of psychiatry at the Freiburg University Medical Center as well as chief physician at the Rhine-Jura Hospital for Psychiatry, Psychosomatics and Psychotherapy in Bad Sckingen, Germany. "But this is usually not disorder-specific, evidence-based psychotherapy. It is has only been a few years that formal psychotherapy delivered by physicians or clinical psychologists will be reimbursed. But even now many of the psychotherapists decline therapy for patients with AD because of an assumed poor prognosis. Therefore, this population is generally not offered psychotherapeutic services by regular psychotherapists."

Berner, who is also the corresponding author for the study, added that the situation for AD medication is not much better. "Anti-craving medications, though effective, are rarely used," he said. "Thus, people neither receive one nor the other. And an additional and possibly the biggest problem is public opinion, which does not consider AD a kind of disorder. So if the public is asked where to cut costs, they always choose alcohol-related disorders."

Berner and
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Contact: Michael Berner, M.D.
dr.m.berner@rhein-jura-klinik.de
49-7761-5600-172
Freiburg University Medical Center

Alcoholism: Clinical & Experimental Research
Source:Eurekalert


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