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  1. Alcoholism treatment service systems: a health services research perspective.

    PubMed Central

    Wallen, J

    1988-01-01

    This article examines the role of health services research in alcoholism treatment. Alcoholism services research has only recently emerged as a self-defined discipline. Alcoholism services research can be grouped into five classifications: a) descriptive studies of resources for alcoholism treatment and of the use or cost of these services, b) estimates of the need or demand for alcohol services in the population or in particular subpopulations, c) studies of the costs or cost-effectiveness of alcoholism treatment or of alternative treatments, d) studies of the possible "cost-offsets" of treating alcoholism, and e) studies that examine strategies for financing and reimbursement for alcoholism treatment. Research is needed to determine how alcoholism treatment services are now delivered, who uses these services, how treatment setting and organization affect service delivery, who pays for alcoholism treatment, and how reimbursement policies affect the delivery of alcoholism services. Research on large-scale social issues is also needed, such as the effects of warning labels appearing on alcoholic beverage containers or estimates of the overall cost to society of alcohol abuse. PMID:3141954

  2. Service Quality in Alcohol Treatment: A Qualitative Study

    ERIC Educational Resources Information Center

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2010-01-01

    The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…

  3. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    ERIC Educational Resources Information Center

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  4. The practical business of treatment--15. The alcoholism treatment service at the Maudsley Hospital, London.

    PubMed

    Edwards, G

    1991-02-01

    This article describes the linked clinical, research and teaching functions of the Maudsley's Alcoholism Treatment service. Emphasis is placed on the heterogeneity of the patients who are seen. Therapy must therefore always be patient-specific and the Procrustean insistence that patients should fit the programme rather than the programme fit the patients should be resisted. Within the diversity of approaches which are employed some important common elements can though be identified: detailed case assessment as the necessary basis for everything else, goal setting, a flexible intensity of response, networking with other treatment resources, and attention to methods of patient recruitment. The relationship between outpatient and inpatient services is discussed: about 80% of all new referrals are treated entirely on an outpatient basis. The clinical setting provides a teaching base for the Diploma in Addiction Behaviour. There is a close link between this clinical service and the Addiction Research Unit; issues of clinical and research collaboration and the interpretation and clinical application of research findings are considered. Whatever the theories in which a team believes or the techniques which it practices, the nurturing of hope is the vital essence of the practical business of treatment. PMID:2021697

  5. Navigating the Alcohol Treatment Pathway: A Qualitative Study from the Service Users' Perspective

    PubMed Central

    Gilburt, Helen; Drummond, Colin; Sinclair, Julia

    2015-01-01

    Aims Provision of effective treatment for dependent drinkers has been identified as a priority in England yet evidence suggests that access is problematic and there are low levels of retention. This qualitative study explores how the alcohol treatment system is experienced by service users, identifying barriers and facilitators that influence treatment outcomes. Methods A total of 20 semi-structured face-to-face interviews were conducted with patients from community alcohol treatment services in three London boroughs in 2012. Interviews were undertaken one year after initially entering treatment. A thematic analysis was conducted, with the results further abstracted to relate them to specific aspects of the treatment journey. Results Patients journeys were characterized by a perceived lack of control leading to help-seeking, with treatment outcomes influenced by an individuals' self-efficacy and the capabilities and skills of staff in actively engaging and supporting patients on the journey. A focus of services on the detoxification process and fragmented care pathways impacted negatively on engagement. Conclusions Current alcohol care pathways require significant levels of motivation and self-efficacy to navigate that few patients possess. Pathways need to better reflect the capacity and capabilities of patients to be successful in supporting recovery. PMID:25825267

  6. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section...

  7. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section...

  8. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section...

  9. A Key Informant Survey To Assess Service Adequacy in California's Publicly Funded Alcohol and Other Drug Treatment System.

    ERIC Educational Resources Information Center

    Clapp, John D.; Hohman, Melinda M.

    2002-01-01

    Study examined administrators' perceptions of service adequacy, provision of services, and evaluation of services of publicly funded alcohol and other drug treatment systems in California. Administrators reported that systems adequately serve most populations; however some suggested that adolescents, elderly, and homeless were not as adequately…

  10. Similarity of Outcome Predictors across Opiate, Cocaine, and Alcohol Treatments: Role of Treatment Services.

    ERIC Educational Resources Information Center

    McLellan, A. Thomas; And Others

    1994-01-01

    Outcomes were predicted by similar factors, regardless of drug problem or type of treatment. Greater substance use at follow-up was predicted by greater severity of use at admission, not number of services during treatment. Social adjustment was negatively predicted by more severe psychiatric problems at admission and positively predicted by more…

  11. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Contracts for residential treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section 17.81 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Services of Other Federal Agencies § 17.81 Contracts...

  12. Alcoholic liver disease: Treatment

    PubMed Central

    Suk, Ki Tae; Kim, Moon Young; Baik, Soon Koo

    2014-01-01

    The excess consumption of alcohol is associated with alcoholic liver diseases (ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation. PMID:25278689

  13. ALCOHOL AND DRUG SERVICE STUDY (ADSS)

    EPA Science Inventory

    The Alcohol and Drug Services Study (ADSS) is a nationally representative survey of substance abuse treatment facilities and clients. The data were collected to estimate the client length of stay and the costs of treatment as well as to describe the post-treatment status of clien...

  14. Perceived Unmet Need for Alcohol and Drug Use Treatments and Future Use of Services: Results from a Longitudinal Study*

    PubMed Central

    Mojtabai, Ramin; Crum, Rosa M.

    2012-01-01

    BACKGROUND This study assessed the association of perceived need for treatment of and perceived barriers to treatments for substance use disorder (SUD) with subsequent use of these treatments in community settings. METHODS Drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined the association of perceived need and barriers to SUD treatments in waves 1 of NESARC (2001-2002; n=43,093) with the subsequent use of these treatments in the follow-up wave 2 (2004-2005; n=34,625). RESULTS Only 8.5% (n=195) of the 2,333 NESARC participants with an untreated 12-month SUD in wave 1 perceived a need for SUD treatment. Participants who reported a perceived need were more likely to use these services in follow-up than those who did not report such a need (14.8% vs. 4.9%, adjusted odds ratio [aOR]=3.16, 95% confidence intervals [CI]=1.70-5.90, P<0.001). Among participants who perceived a need, those who reported pessimistic attitudes towards treatments as a barrier were less likely than others to use services in follow-up (aOR=0.08, 95% CI=0.01-0.73, P=0.027). Other barriers, including financial barriers and stigma were not significantly associated with treatment seeking. CONCLUSIONS The findings suggest the need for a two-pronged approach to improving treatment seeking for SUD in community settings: one focusing on enhancing recognition of these disorders, the other focusing on educating potential consumers regarding the benefits of SUD treatments. PMID:22770461

  15. Alcohol, Drug, and Mental Health Specialty Treatment Services and Race/ Ethnicity: A National Study of Children and Families Involved With Child Welfare

    PubMed Central

    Libby, Anne M.; Orton, Heather D.; Barth, Richard P.; Webb, Mary Bruce; Burns, Barbara J.; Wood, Patricia; Spicer, Paul

    2006-01-01

    We used data on a national sample of children involved with child welfare systems to compare American Indian caregivers with White, Black, and Hispanic caregivers in their need for, and receipt of, specialty alcohol, drug, and mental health treatment. American Indian caregivers were significantly less likely to receive services than were Hispanic caregivers (P<.05) but not significantly less likely than were White or Black caregivers. Child placement, child age, and caregiver psychiatric comorbidity were significantly associated with service receipt. PMID:16507729

  16. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 552(a) and 1 CFR part 51. These materials incorporated by reference are available for inspection at... must be approved by the appropriate Veterans Health Administration Veterans Integrated Service Networks... “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II) and the “Confidentiality of...

  17. Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

    ERIC Educational Resources Information Center

    Zakletskaia, Larissa; Wilson, Ellen; Fleming, Michael Francis

    2010-01-01

    Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students…

  18. Attendance at Alcohol-Free and Alcohol-Service Parties and Alcohol Consumption among College Students

    PubMed Central

    Wei, Jill; Barnett, Nancy P.; Clark, Melissa

    2010-01-01

    Objective To examine attendance at alcohol-service and alcohol-free parties among college students, and to compare alcohol consumption on nights of these parties. Method A random sample of 556 students (38.6% male) completed a web survey that measured past-semester alcohol use, alcohol-service party attendance, alcohol-free party attendance, and alcohol consumed on the nights of recent parties. Results Participants were twice as likely to attend alcohol-service parties as they were to attend alcohol-free parties (90% vs. 44%). First-year students and Black students were more likely than other students to attend alcohol-free parties. Alcohol use was higher in students who attended alcohol-service parties but there were no differences in levels of alcohol use between students who attended alcohol-free parties and those who did not. Pre-gaming was more prevalent, but number of drinks and intoxication were lower on nights of alcohol-free parties than on nights of alcohol-service parties. Conclusions The lack of association between attendance at alcohol-free parties and alcohol use indicates both heavy and light drinkers attend these parties. The lower drinking and intoxication on alcohol-free party nights suggests alcohol-free programming should be investigated to determine if it may reduce alcohol use on college campuses. PMID:20188482

  19. Alcohol dependence in the Naval Service.

    PubMed

    Dickie, A K; Coetzee, R H

    2014-01-01

    Alcohol misuse is a significant occupational health issue in the United Kingdom Armed Forces. Dependence associated with alcohol misuse represents the severe end of the clinical and occupational consequences of sustained alcohol misuse. This article aims to explore the diagnosis, management and occupational considerations of alcohol dependence in the Naval Service environment. PMID:25335312

  20. Utilizing Alcohol Expectancies in the Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    Brown, Sandra A.

    The heterogeneity of alcoholic populations may be one reason that few specific therapeutic approaches to the treatment of alcoholism have been consistently demonstrated to improve treatment outome across studies. To individualize alcoholism treatment, dimensions which are linked to drinking or relapse and along which alcoholics display significant…

  1. Recent Developments in Alcohol Services Research on Access to Care

    PubMed Central

    Schmidt, Laura A.

    2016-01-01

    In the United States, only about 10 percent of people with an alcohol or drug use disorder receive care for the condition, pointing to a large treatment gap. Several personal characteristics influence whether a person will receive treatment; additionally, many people with an alcohol use disorder do not perceive the need for treatment. The extent of the treatment gap differs somewhat across different population subgroups, such as those based on gender, age, or race and ethnicity. Recent health care reforms, such as implementation of the Patient Protection and Affordable Care Act of 2010, likely will improve access to substance abuse treatment. In addition, new treatment approaches, service delivery systems, and payment innovations may facilitate access to substance abuse services. Nevertheless, efforts to bridge the treatment gap will continue to be needed to ensure that all people who need alcohol and drug abuse treatment can actually receive it. PMID:27159809

  2. Recent Developments in Alcohol Services Research on Access to Care.

    PubMed

    Schmidt, Laura A

    2016-01-01

    In the United States, only about 10 percent of people with an alcohol or drug use disorder receive care for the condition, pointing to a large treatment gap. Several personal characteristics influence whether a person will receive treatment; additionally, many people with an alcohol use disorder do not perceive the need for treatment. The extent of the treatment gap differs somewhat across different population subgroups, such as those based on gender, age, or race and ethnicity. Recent health care reforms, such as implementation of the Patient Protection and Affordable Care Act of 2010, likely will improve access to substance abuse treatment. In addition, new treatment approaches, service delivery systems, and payment innovations may facilitate access to substance abuse services. Nevertheless, efforts to bridge the treatment gap will continue to be needed to ensure that all people who need alcohol and drug abuse treatment can actually receive it. PMID:27159809

  3. Treatment of Severe Alcoholic Hepatitis.

    PubMed

    Thursz, Mark; Morgan, Timothy R

    2016-06-01

    Alcoholic hepatitis (AH) is a syndrome of jaundice and liver failure that occurs in a minority of heavy consumers of alcohol. The diagnosis usually is based on a history of heavy alcohol use, findings from blood tests, and exclusion of other liver diseases by blood and imaging analyses. Liver biopsy specimens, usually collected via the transjugular route, should be analyzed to confirm a diagnosis of AH in patients with an atypical history or presentation. The optimal treatment for patients with severe AH is prednisolone, possibly in combination with N-acetyl cysteine. At present, only short-term increases in survival can be expected-no treatment has been found to increase patient survival beyond 3 months. Abstinence is essential for long-term survival. New treatment options, including liver transplantation, are being tested in trials and results eagerly are awaited. PMID:26948886

  4. Latent class analysis of alcohol treatment utilization patterns and 3-year alcohol related outcomes.

    PubMed

    Mowbray, Orion; Glass, Joseph E; Grinnell-Davis, Claudette L

    2015-07-01

    People who obtain treatment for alcohol use problems often utilize multiple sources of help. While prior studies have classified treatment use patterns for alcohol use, an empirical classification of these patterns is lacking. For the current study, we created an empirically derived classification of treatment use and described how these classifications were prospectively associated with alcohol-related outcomes. Our sample included 257 participants of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who first received alcohol treatment in the 3-year period prior to their baseline interview. We used latent class analysis to identify classes of treatment users based on their patterns of treatment use of 13 types of alcohol treatment. Regression models examined how classes of treatment use at baseline were associated with alcohol-related outcomes assessed at a 3-year follow-up interview. Outcomes included a continuous measure of the quantity and frequency of alcohol use and DSM-IV alcohol use disorder status. Four classes of treatment users were identified: (1) multiservice users (8.7%), (2) private professional service users (32.8%), (3) alcoholics anonymous (AA) paired with specialty addiction service users (22.0%), and (4) users of AA alone (36.5%). Those who utilized AA paired with specialty addiction services had better outcomes compared to those who used AA alone. In addition to elucidating the most common treatment utilization patterns executed by people seeking help for their alcohol problems, the results from this study suggest that increased efforts may be needed to refer individuals across sectors of care to improve treatment outcomes. PMID:25744651

  5. Study protocol: a dissemination trial of computerized psychological treatment for depression and alcohol/other drug use comorbidity in an Australian clinical service

    PubMed Central

    2012-01-01

    Background The rise of the internet and related technologies has significant implications for the treatment of complex health problems, including the combination of depression and alcohol/other drug (AOD) misuse. To date, no research exists to test the real world uptake of internet and computer-delivered treatment programs in clinical practice. This study is important, as it is the first to examine the adoption of the SHADE treatment program, a DVD-based psychological treatment for depression and AOD use comorbidity, by clinicians working in a publicly-funded AOD clinical service. The study protocol that follows describes the methodology of this dissemination trial. Methods/design 19 clinicians within an AOD service on the Central Coast of New South Wales, Australia, will be recruited to the trial. Consenting clinicians will participate in a baseline focus group discussion designed to explore their experiences and perceived barriers to adopting innovation in their clinical practice. Computer comfort and openness to innovation will also be assessed. Throughout the trial, current, new and wait-list clients will be referred to the research program via the clinical service, which will involve clients completing a baseline and 15-week follow-up clinical assessment with independent research assistants, comprising a range of mental health and AOD measures. Clinicians will also complete session checklists following each clinical session with a client, outlining the extent to which the SHADE computer program was used. Therapeutic alliance will be measured at intake and discharge from both the clinician and client perspectives. Discussion This study will provide comprehensive data on the factors associated with the adoption of an innovative, computer-delivered evidence-based treatment program, SHADE, by clinicians working in an AOD service. The results will contribute to the development of a model of dissemination of SHADE, which could be applied to a range of technological

  6. Telemedicine-Based Alcohol Services for Rural Offenders

    PubMed Central

    Staton-Tindall, Michele; Wahler, Elizabeth; Webster, J. Matthew; Godlaski, Theodore; Freeman, Rebecca; Leukefeld, Carl

    2016-01-01

    Research has consistently shown that alcohol use is a problem in rural communities and access to substance abuse treatment, particularly evidence-based treatment is limited. Because telemedicine has been shown to be effective in delivering services, this article presents a novel and innovative way of using telemedicine technology in the form of videoconferencing to deliver an evidence-based alcohol intervention (motivational enhancement therapy) with at-risk alcohol users in real-world settings (rural probation and parole offices). This article focuses on: (a) creating a profile of an at-risk group of rural alcohol users; (b) describing the evidence-based intervention; and (c) describing the innovative telemedicine-based service delivery approach. PMID:22867122

  7. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  8. A Guide to Planning Alcoholism Treatment Programs.

    ERIC Educational Resources Information Center

    McGough, Dixie P.; Hindman, Margaret H.

    This guide contains information from the alcoholism literature and from interviews with people in state alcoholism agencies, major professional associations, and public and private service programs. It is designed to help readers plan and develop community alcoholism programs by providing an overview of the many considerations involved in starting…

  9. The Delivery of Alcoholism Services: Meeting Whose Needs?

    ERIC Educational Resources Information Center

    Christmas, June J.

    Of grave concern to all who are involved in the delivery of health and mental health services are two recently-observed trends in the drug and alcohol abusing population: the emergence of formerly hidden individuals in need of treatment (among them women, children and the elderly), and the increasing incidence and severity of emotional problems…

  10. Selection of Treatment Type of Alcoholic Population.

    ERIC Educational Resources Information Center

    Beshai, Nabila

    1984-01-01

    Investigates the referral of subjects (N=7,335) to alcohol treatment. Variables were demographics, drinking pattern, alcohol-related behavior, and pathology. The most important factor in referring to outpatient therapy was employment. Inpatient subjects had heavier prior involvement with alcohol and more severe physical problems. (JAC)

  11. Improving Care for the Treatment of Alcohol and Drug Disorders

    PubMed Central

    McCarty, Dennis; Gustafson, David; Capoccia, Victor A.; Cotter, Frances

    2008-01-01

    The Network for the Improvement of Addiction Treatment (NIATx) teaches alcohol and drug treatment programs to apply process improvement strategies and make organizational changes that improve quality of care. Participating programs reduce days to admission, increase retention in care and spread the application of process improvement within their treatment centers. More generally, NIATx provides a framework for addressing the Institute of Medicine’s six dimensions of quality care (i.e., safe, effective, patient-centered, efficient, timely and equitable) in treatments for alcohol, drug and mental health disorders. NIATx and its extensions illustrate how the behavioral health field can respond to the demand for higher quality treatment services. PMID:18259871

  12. Alcohol use in the service industry.

    PubMed

    Larsen, S

    1994-06-01

    It is frequently alleged that hotel and restaurant personnel drink more than other groups in the service industry, although only indirect evidence has been presented to substantiate this allegation. This paper reports data from two surveys concerning alcohol use in different segments of the service industry. In the first study 84 students at three different colleges in the Stavanger region were interviewed concerning their alcohol habits using the screening instrument AUDIT (Alcohol Use Disorders Identification Test). The second survey concentrated on service employees in the Rogaland area. One hundred and five respondents answered the AUDIT questionnaire in this study. The results showed that hotel and restaurant affiliated individuals scored significantly higher on the AUDIT than the other respondents. The first survey indicated that students at the Norwegian College of Hotel Management obtained significantly higher AUDIT scores than other groups of students, whereas the second survey indicated that restaurant workers scored significantly higher than employees in other branches of the service industry. Implications of these results, as well as future research demands were indicated. PMID:8069174

  13. The Public Sector: A National Resource for Alcohol and Drug Treatment.

    ERIC Educational Resources Information Center

    de Miranda, John

    Economic analysis of alcohol and drug treatment services usually focuses on understanding the private, profit-oriented, hospital-based setting. Professional publications of the alcoholism treatment field, as well as popular press and electronic media exposure, also focus heavily on the private system. Low cost, quality treatment services, however,…

  14. Comprehensive Substance Abuse Services for Homeless Persons with Alcohol and Other Drug Problems.

    ERIC Educational Resources Information Center

    Kirby, Michael W., Jr.; Braucht, G. Nicholas

    Homeless people with alcohol and other drug problems present the traditional substance abuse services delivery provider with special challenges. This paper discusses the optimal designs of comprehensive treatment services for homeless persons with alcohol and other drug problems. Most importantly, the homeless must have immediate access to a safe…

  15. Acamprosate in the treatment of alcohol dependence.

    PubMed

    Mason, Barbara J

    2005-10-01

    Acamprosate is indicated for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation in combination with psychosocial support. Acamprosate is a synthetic taurine analogue that seems to act centrally to restore the normal activity of glutamatergic neurotransmission altered by chronic alcohol exposure. Over the past 15 years, the safety and efficacy of acamprosate for alcohol dependence have been well established in multiple double-blind, placebo-controlled trials. Overall, acamprosate has been consistently associated with greater beneficial effects on measures of alcohol abstinence compared with placebo. Specifically, patients treated with acamprosate achieve greater rates of complete abstinence, longer times to first drink and/or increased duration of cumulative abstinence when compared with placebo. Acamprosate received approval by the US FDA for the treatment of alcohol dependence in July 2004 and is currently prescribed in 28 countries. PMID:16197362

  16. ALCOHOL DEPENDENCE--NEUROBIOLOGY AND TREATMENT.

    PubMed

    Michalak, Agnieszka; Biała, Grazyna

    2016-01-01

    The consequences of alcohol dependence concern serious health care, social and economic problems. The scope of many studies is to better understand mechanisms underlying alcohol addiction in order to work out new, more effective treatment strategies. Alcohol affects many neurotransmission systems within the brain. In general, acute alcohol enhances inhibitory transmission, up-regulating the GABAergic system and impairing glutamatergic function, therefore interfering the balance between excitatory and inhibitory synaptic inputs. Chronic alcohol consumption, meanwhile, in order to restore equilibrium leads to neuroadaptive changes caus- ing both decreased GABAergic and increased glutamatergic activity. Also function of other neurotransmitters and modulators is modified by the presence of alcohol, including glycine, adenosine, serotonin and dopamine. Moreover, a significant impact of alcohol on the endogenous opioid system, nicotinic cholinergic transmission and the endocannabinoids system has been also established. At present, only four medications are approved for the treatment of alcohol dependence in Europe, that is naltrexone, acamprosate, disulfiram and the most recent nalmefene. Among other promising strategies the following drugs are mentioned: baclofen, topiramate, ondansetron, aripiprazole, rimonabant and varenicline. Additionally, the role of appetite-regulating hormones, neuroimmune modulators or the body's stress-response system modulators in reducing alcohol consumption is currently of great interest, however, further investigations are needed. PMID:27008795

  17. [Misuse of alcohol and new drug treatments].

    PubMed

    Paille, François

    2011-12-01

    Three drugs are currently marketed in France in the prevention of relapse in alcohol-dependent patients. Their efficacy though real remains limited and it is useful to develop other molecules. Some products are at present under evaluation, and are already or could be used in the near future in the treatment of alcohol dependence: baclofene, oxybate de sodium (GHB), nalmefene, topiramate, ondansetron and aripiprazole. The available studies on these molecules are still limited and the results sometimes clinically modest. Nevertheless, some of them open interesting future prospects. If there is no big revolution to wait in the short term in the treatment of alcohol dependence, we can consider some interesting orientations: better effectiveness on alcohol consumption, but also change of paradigm concerning the objectives and the methods of this treatment: reduction of consumption versus abstinence, treatment on request, choice of the molecule guided by objective criteria (psychosocial, biological, genetic...). PMID:22288352

  18. Alcohol prescription by surgeons in the prevention and treatment of delirium tremens: historic and current practice.

    PubMed

    Rosenbaum, Milton; McCarty, Teresita

    2002-01-01

    Beer, other alcohol beverages, and IV alcohol are still used to prevent or treat alcohol withdrawal delirium on surgical services. The history of the use of alcohol by surgeons may play a role in its continued use for withdrawal. In this policy survey 32 inpatient hospital pharmacies were called and asked if alcohol was available, if it was used to treat alcohol withdrawal, and the medical specialties that requested it. Recommendations about the use of alcohol were examined in recent textbooks and from those published early in the twentieth century. One half of the 32 hospitals surveyed had alcoholic beverages available for patient use and eleven hospitals used either package alcohol or IV alcohol in the treatment of alcohol withdrawal. Surgeons used alcohol before anesthesia to help patients tolerate procedures, and the use of alcohol for treatment of alcohol withdrawal still appears in the surgical literature. This preliminary survey indicates that some hospitals still provide beverage alcohol for the treatment of alcohol withdrawal and that surgeons are the specialty ordering alcohol for their patients. PMID:12100836

  19. The Alcohol Services Reporting System (ASRS) Revision Study.

    ERIC Educational Resources Information Center

    Borkman, Thomasina

    This document reports a revision study of the California Alcohol Services Reporting System (ASRS), a system which consists of a structure of definitions and categories of services, a budget form of planned alcohol services, instructions for the county plan, and the report of expenditures. The study problem is that the ASRS structure of…

  20. Psychoanalytic Treatment of Psychological Addiction to Alcohol (Alcohol Abuse)

    PubMed Central

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments. PMID:22144975

  1. Treatment of the depressed alcoholic patient.

    PubMed

    DeVido, Jeffrey J; Weiss, Roger D

    2012-12-01

    Alcohol use disorders (AUDs) and depressive illnesses are highly prevalent, frequently co-occur, and are associated with worse outcomes when paired. The assessment and treatment of patients with co-occurring alcohol use disorders and depressive illnesses is wrought with many significant challenges. When it comes to advocating treatment guidelines for this dually-diagnosed population, the data are limited, but, nonetheless, do suggest that an integrated approach to patients presenting with co-occurring AUD and depressive symptoms can be efficacious. In this approach, ongoing evaluation and treatment are provided under one roof according to the evolving needs of each patient. Utilizing antidepressant medications in conjunction with psychosocial therapies may augment overall treatment efficacy; data also suggest that combining and tailoring psychosocial therapies, such as motivational enhancement therapies, cognitive therapies, and twelve-step facilitation may further improve treatment outcomes for patients with co-occurring depressive and alcohol use disorders. PMID:22907336

  2. Senior Alcohol Services Revisited: Elderly Alcoholism--Current State of the Art.

    ERIC Educational Resources Information Center

    Dunlop, Jean D.

    This report notes the growing awareness of alcohol problems among the elderly during the past 5 to 10 years, and reviews the final conclusions of the federal demonstration project, Senior Alcohol Services. Five basic concepts are included: (1) there are a growing number of elderly persons with alcohol problems (10-15% of all persons over age 60);…

  3. A Drug and Alcohol Aftercare Service: Linking Adolescents, Families and Schools.

    ERIC Educational Resources Information Center

    Fertman, Carl I.; Toca, Olivia A.

    1988-01-01

    Describes first-year service process and implementation evaluation of aftercare service for adolescents who had completed drug and alcohol treatment programs. Results showed that aftercare service, developed cooperatively by schools and community agencies to support and link adolescents, parents, and schools during adolescents' recovery, helped…

  4. New treatment options for alcoholic hepatitis

    PubMed Central

    Shasthry, Saggere Muralikrishna; Sarin, Shiv Kumar

    2016-01-01

    The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using “Omics” platforms, newer options for patients with alcoholic hepatitis are expected soon. PMID:27099434

  5. Nature and Treatment of Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Among American Military Personnel and Veterans

    PubMed Central

    Allen, John P.; Crawford, Eric F.; Kudler, Harold

    2016-01-01

    Many service members and veterans seeking treatment for alcohol problems also have post-traumatic stress disorder (PTSD). This article considers the effectiveness of treating alcohol problems and PTSD simultaneously. The authors begin by summarizing the extent of excessive alcohol use among military service members and veterans. They then explore the relationship between combat exposure and subsequent alcohol use; identify and briefly describe evidence-based treatments for alcohol problems and PTSD, separately; and review research on the effects of single treatments for both PTSD symptoms and alcohol use. PMID:27159820

  6. Web-based treatment of alcohol problems among rural women.

    PubMed

    Finfgeld-Connett, Deborah; Madsen, Richard

    2008-09-01

    It is estimated that 6 million women in the United States misuse alcohol. Of that number, many live in rural areas and face numerous barriers to treatment. The World Wide Web has the potential to help such individuals overcome these barriers. In light of emergent findings supporting the effectiveness of online alcohol treatment services for women, a randomized pilot study was conducted to evaluate a Web-based, self-guided alcohol treatment program. Eligible women were randomized to standard care or an online treatment program. Web-based treatment components included gender-specific reference modules and decision making modules, an asynchronous bulletin board, and a synchronous chat feature. The average age of the participants (N = 44) was 50 (SD = 11 years), and their baseline Alcohol Use Disorders Identification Test score was 18 (SD = 6), with 8 being the cut-off score for problem drinking. At 3-month follow up, both treatment groups decreased their drinking; however, no significant differences were found between them. PMID:18823000

  7. Impacts of international trade, services and investment treaties on alcohol regulation.

    PubMed

    Grieshaber-Otto, J; Sinclair, S; Schacter, N

    2000-12-01

    There is an underlying incompatibility between government efforts to minimize the harm associated with alcohol, particularly by regulating its supply, and international commercial treaties that promote the freer flow of goods, services and investment. These treaties have already forced changes to many government measures affecting alcohol availability and control, primarily by constraining the activities of government alcohol monopolies and by altering taxation regimes. The North American Free Trade Agreement and the World Trade Organization agreements open new avenues for challenges against alcohol control measures. Some of these agreements extend beyond trade, border measures and differential taxation and allow challenges that intrude into areas of non-discriminatory domestic regulation affecting market access, intellectual property, investment and services. Effective protection from these agreements for vital public health measures has rarely been obtained, although it is increasingly essential. The WTO "services" agreement, basically unknown to the public, is currently being re-negotiated and poses the gravest new challenge to policies designed to influence patterns of alcohol use and minimize alcohol-related harm. In future, these international agreements will probably affect adversely those alcohol approaches considered to be the most effective or promising. These include: maintaining effective state monopolies, restricting the number and locations of retail outlets, taxing and regulating beverages according to alcohol strength, restricting commercial advertising, and maintaining and enhancing public alcohol education and treatment programs. These effects can, in turn, be expected to increase the availability and access to alcohol, to lower alcohol taxes, and to increase advertising and promotion, resulting in increased alcohol consumption and associated health problems. Until more balanced international rules are developed, the challenge facing alcohol

  8. Divalproex in the treatment of alcohol withdrawal.

    PubMed

    Myrick, H; Brady, K T; Malcolm, R

    2000-02-01

    The present study represents an open-label clinical trial comparing treatment with a benzodiazepine (lorazepam) to divalproex in 11 inpatients with uncomplicated alcohol withdrawal syndrome. The trial used the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) scale. There were no significant differences in demographics or substance use parameters between the divalproex group (n = 6) or the lorazepam group (n = 5). A significant Group x CIWA-Ar score interaction [F(8,72) = 2.57, p < or = .01] was confirmed and further substantiated by a quadratic trend component for the interaction [F(1,9) = 24.9, p < or = .001]. This preliminary study supports further investigation of divalproex in the treatment of alcohol withdrawal. PMID:10718170

  9. Predicting Alcohol Treatment Outcome: Using Expectancy to Enhance Prediction.

    ERIC Educational Resources Information Center

    Brown, Sandra A.; Berger, Barry

    Research in the field of alcohol abuse evidences a long history of attempts to predict outcome from alcohol treatment programs using situational and intrapsychic factors. To investigate whether alcohol reinforcement expectancies are related to drinking behavior, 42 male veteran graduates of an inpatient alcohol treatment program were interviewed 1…

  10. Evaluating Alcoholism Treatment Programs: An Integrated Approach.

    ERIC Educational Resources Information Center

    Cronkite, Ruth C.; Moos, Rudolf H.

    1978-01-01

    Examined variables (social background, intake symptoms, program type, treatment experiences, and perceptions of environment) related to posttreatment functioning of alcoholic patients. Results showed the combined explanatory power of program-related variables was more than expected. Explained variance was shared between patient-related and…

  11. Early alcoholism treatment: the Emmanuel Movement and Richard Peabody.

    PubMed

    McCarthy, K

    1984-01-01

    The history of alcoholism treatment in the early twentieth century is outlined. The methods of the Emmanuel Movement and of Richard Peabody are described, biographical details of their main practitioners are given, the populations treated are described, and the predecessors and successors of the two methods are discussed. In addition, the two methods are compared with each other and with the methods of Alcoholics Anonymous and Freudian psychoanalysis. The founder of the E. Movement was a clergyman, Dr. Elwood Worcester, whose method was designed to treat a variety of neurotic disorders. He felt that all diseases, including alcoholism, had physical, mental and spiritual components. His principal techniques of relaxation therapy and suggestion (including autosuggestion) were used to reach the unconscious. Worcester felt that alcoholics could be helped by redirecting their attention away from their problems to a life of service and spirituality. Prayer, group support and self-help were important. Worcester tried to reduce patients' guilt and rejected temperance preaching. He felt that recovery must come from surrender to external forces and to the healing capacities of the unconscious. One patient of his, Courtenay Baylor, began to work with him at the E. Church. Like Worcester, Baylor believed that alcohol, and not one's life history, caused alcoholism. Baylor believed that alcoholism resulted from mental and physical "tenseness" and, like Worcester, he used relaxation therapy. He believed in giving a longer period of treatment than did Worcester and in providing more treatment for the families of alcoholics. One of Baylor's most famous patients was Peabody. Peabody had no credentials but he refined and professionalized the E. treatment method. He was a strong believer in the control of one's feelings and in increased efficiency--his patients were told to follow detailed time plans. He believed that early family history caused alcoholism. Like the E. Movement, he

  12. Elderly Alcoholism: Implications for Human Service Education

    ERIC Educational Resources Information Center

    Beechem, Michael

    2004-01-01

    Incumbent upon those faculty who teach substance abuse courses is the need to integrate elderly alcoholism-related course content to encourage and adequately prepare university students to serve this "hidden" population. Course content would ideally include theories specific to loss-grief, aging, and alcoholism. In addition, field placement…

  13. Utilization of Alcohol Treatment Among HIV-Positive Women with Hazardous Drinking.

    PubMed

    Hu, Xingdi; Harman, Jeffrey; Winterstein, Almut G; Zhong, Yue; Wheeler, Amber L; Taylor, Tonya N; Plankey, Michael; Rubtsova, Anna; Cropsey, Karen; Cohen, Mardge H; Adimora, Adaora A; Milam, Joel; Adedimeji, Adebola; Cook, Robert L

    2016-05-01

    Hazardous alcohol consumption has been frequently reported among women with HIV infection and is associated with a variety of negative health consequences. Treatments to reduce alcohol use may bring in health benefits. However, little is known regarding the utilization of alcohol treatment services among HIV+ women with hazardous drinking. Using data from the Women's Interagency HIV Study (WIHS), this study assessed utilization of any alcohol treatment in the past 6months and performed multivariable logistic regression to determine correlates of receipt of any alcohol treatment. Among 474 HIV+ women reporting recent hazardous drinking, less than one in five (19%) reported recent utilization of any alcohol treatment. Alcoholics Anonymous (AA) was the most commonly reported (12.9%), followed by inpatient detoxification (9.9%) and outpatient alcohol treatment program (7.0%). Half (51%) receiving any alcohol treatment reported utilization of multiple treatments. Multivariable analyses found alcohol treatment was more often utilized by those who had social support (odds ratio [OR]=1.68, 95% confidence interval [CI]=1.00 to 2.83), fewer economic resources (income ≤$12,000 vs. >$12,000, OR=3.10, 95% CI=1.53 to 6.27), higher levels of drinking (16-35 drinks/week vs. 12-15 drinks/week, OR=3.02, 95% CI=1.47 to 6.21; 36+ drinks/week vs. 12-15 drinks/week, OR=4.41, 95% CI=2.03 to 9.59), and those who reported any illicit drug use (OR=2.77, 95% CI=1.44 to 5.34). More efforts are needed to enhance the utilization of alcohol treatment. Our findings highlight the unique profile of those who utilized alcohol treatment. Such information is vital to improve treatment delivery to address unmet need in this particular population. PMID:26961420

  14. The Indian Health Service approach to alcoholism among American Indians and Alaska Natives.

    PubMed Central

    Rhoades, E R; Mason, R D; Eddy, P; Smith, E M; Burns, T R

    1988-01-01

    The transfer to the Indian Health Service (IHS) of 158 alcohol treatment programs that had been administered by the National Institute on Alcohol Abuse and Alcoholism began in 1978. Today, approximately 300 alcohol and substance abuse treatment programs offer services to American Indians, among them primary residential treatment, halfway houses, outreach, and aftercare. This system provides a national network upon which additional activities may be established. Along with increasing its attention to health promotion and disease prevention, the IHS has moved toward the prevention of alcoholism. A variety of preventive programs are in place that emphasize improved self-image, value and attitude clarification, decision-making, and physical and emotional effects of alcohol and substance abuse. Many begin as Head Start programs and continue through adulthood. In 1986, after consulting with both academic and tribal experts, the IHS devised a strategic plan for alcoholism control that stresses comprehensive care and prevention activities; it serves as a guide for further program development. The Secretary of Health and Human Services created a Task Force on Indian Alcoholism in 1986 to serve as a coordinating body for activities carried out by the IHS and other agencies and units of the Department. Passage of the Anti-Drug Abuse Act in 1986 added resources for the development of adolescent treatment centers and, more importantly, for community-based pre- and post-residential care for youths and their families. Concomitant with these initiatives have been several instances of increased attention by various tribes to the problem of alcoholism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141956

  15. Individualised treatment in alcohol-dependent patients.

    PubMed

    Mann, Karl; Hermann, Derik

    2010-11-01

    Long-term relapse prevention is the biggest challenge in treating alcohol-dependent patients. It is equally based on psychotherapy and pharmacotherapy. Psychotherapy includes motivational interviewing, community reinforcement, cognitive behavioural therapy, motivational enhancement, twelve-step facilitation, social network behaviour therapy, cue exposure, etc. For pharmacological treatment, we dispose of disulfiram, acamprosate and naltrexone. Reviews and meta-analyses reveal only modest effect sizes of these approaches probably because they are usually tested in large and heterogeneous samples where "one size does not fit all". However, attempts to form more homogeneous subgroups for which specific psychotherapies should be more effective ("matching") also failed. We suppose that this failure may have to do with the fact that these studies used only psychopathology and behavioural analyses as a basis for subtyping. Things look more promising once biologically defined endophenotypes are used as well in order to form more homogeneous subgroups. For example, naltrexone treatment seems more effective in carriers of a specific variant of the mu-opioid receptor gene. The same could be true for acamprosate if a newly found polymorphism was used to preselect potential responders. Very recently biological differences between patient groups are also being detected using functional imaging. Naltrexone is suggested to work better in a subgroup of patients with higher cue reactivity when shown appetitive alcohol pictures. MR spectroscopy of brain glutamate levels may detect potential acamprosate responders. On such a basis, an individualised approach in the treatment of alcoholism ("personalised medicine") seems to hold promise. PMID:20953618

  16. Providing Post-Treatment Support in an Outpatient Alcohol and Other Drug Treatment Context: A Qualitative Study of Staff Opinion

    ERIC Educational Resources Information Center

    Pulford, Justin; Black, Stella; Wheeler, Amanda; Sheridan, Janie; Adams, Peter

    2010-01-01

    This paper examines the post-treatment support practices, attitudes and preferences of outpatient alcohol and other drug (AOD) treatment staff as well as perceived barriers to implementing a post-treatment support service in an outpatient AOD treatment context. Data were collected via semi-structured interview and group discussion (n = 23).…

  17. Alcohol misuse in Greece: a 15-year experience from a specialized outpatient service.

    PubMed

    Pomini, V; Mellos, L; Paparrigopoulos, T; Liappas, J

    2014-01-01

    Alcohol use in Greece is traditionally diffused among its population. According to general population surveys, three out of four Greeks aged 12-64 referred to alcohol consumption during the last year and 10% reported at least one episode of alcohol abuse during the last month. Furthermore, the large majority of young people aged 13-18 reported lifetime use of alcohol and 14.8% of them reported more than three episodes of alcohol abuse during the last month. Apparently, cultural factors have influenced the pattern of alcohol consumption and the ensuing alcohol-related problems during the last two decades. The "Athena" Service is an outpatient therapeutic unit for the management of substance misusers and their families. It is a specialized abstinence-oriented service that does not administer substance substitutes; mental health professionals of the service work as a multidisciplinary team. Motivational approaches, individual cognitive-behavioural psychotherapy and family interventions of a systemic orientation are the principal therapeutic techniques applied. Adjunctive medication is prescribed whenever mild to moderate concomitant psychopathology is detected. Support measures such as provisional use of medication, use of antagonistic agents or brief hospitalization can be provided if deemed necessary. No strict time limits are applied regarding treatment duration and discharge from the program. During the period 1998-2013, a total of 1511 individuals with alcohol-related problems addressed the service. The changing pattern of substance misuse over the last fifteen years can be summarized as follows: (a) there is a gradually increasing number of women misusing substances; (b) there is an increasing proportion of young adults reporting multi-substance use with concurrent psychiatric disorders; (c) there is an increasing proportion of young adults regularly using/misusing substances; (d) there is a decreasing proportion of middle-aged individuals presenting with

  18. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Alcohol and...

  19. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Alcohol and...

  20. Alcohols as hydrogen-donor solvents for treatment of coal

    DOEpatents

    Ross, David S.; Blessing, James E.

    1981-01-01

    A method for the hydroconversion of coal by solvent treatment at elevated temperatures and pressure wherein an alcohol having an .alpha.-hydrogen atom, particularly a secondary alcohol such as isopropanol, is utilized as a hydrogen donor solvent. In a particular embodiment, a base capable of providing a catalytically effective amount of the corresponding alcoholate anion under the solvent treatment conditions is added to catalyze the alcohol-coal reaction.

  1. The Current Situation of Treatment Systems for Alcoholism in Korea

    PubMed Central

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon

    2013-01-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care. PMID:23400047

  2. Services for Alcoholic Women: Foundations for Change. Trainer Manual [and] Session Outline Cards.

    ERIC Educational Resources Information Center

    National Center for Alcohol Education, Arlington, VA.

    This training program, designed to assist treatment programs decision-makers in planning, implementing, and monitoring practices and services for alcoholic women, provides participants the opportunity to: (1) measure the current state of their agency programs; (2) select priorities for change; and (3) develop an action plan for change. The program…

  3. Treatment Services Received in the CASAWORKS for Families Program

    ERIC Educational Resources Information Center

    Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert

    2003-01-01

    This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…

  4. Thai men’s experiences of alcohol addiction and treatment

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    Background Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand. Objective The aim of this study was to explore men’s experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results Through men’s descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking. PMID:24845212

  5. Concurrent Alcohol and Tobacco Treatment: Effect on Daily Process Measures of Alcohol Relapse Risk

    PubMed Central

    Cooney, Ned L.; Litt, Mark D.; Sevarino, Kevin A.; Levy, Lucienne; Kranitz, Linda S.; Sackler, Helen; Cooney, Judith L.

    2014-01-01

    Objective The aim of this study was to compare the effects of alcohol treatment along with concurrent smoking treatment or delayed smoking treatment on process measures related to alcohol relapse risk. Method Alcohol dependent smokers (N = 151) who were enrolled in an intensive outpatient alcohol treatment program and were interested in smoking cessation were randomized to a concurrent smoking cessation (CSC) intervention or to a waiting list for delayed smoking cessation (DSC) intervention scheduled to begin three months later. Daily assessments of relapse process measures were obtained using an Interactive Voice Response (IVR) system for 12 weeks after the onset of smoking treatment in the CSC condition, and before beginning smoking treatment in the DSC condition. Smoking outcomes were assessed at 2 and 13 weeks after starting treatment. Results Seven-day CO-verified smoking abstinence in the CSC condition was 50.5% at 2 weeks and 19.0% at 13 weeks compared to 2.2% abstinence at two weeks and 0% abstinence at 13 weeks for those in the DSC condition. Drinking outcomes were not significantly different for CSC vs. DSC treatment conditions. On daily IVR assessments, CSC participants had significantly lower positive alcohol outcome expectancies relative to DSC participants. Multilevel modeling (MLM) analyses of within-person effects across the 12 weeks of daily monitoring showed that daily smoking abstinence was significantly associated with same day reports of lower alcohol consumption, lower urge to drink, lower negative affect, lower positive alcohol outcome expectancies, greater alcohol abstinence self-efficacy, greater alcohol abstinence readiness to change, and greater perceived self-control demands. Conclusions; Analyses of process measures provide support for recommending smoking intervention concurrent with intensive outpatient alcohol treatment. Public Health Significance Statement Study results support conveying a message to alcohol dependent smokers that

  6. A Qualitative Study of Service Provision for Alcohol Related Health Issues in Mid to Later Life

    PubMed Central

    Haighton, Catherine; Wilson, Graeme; Ling, Jonathan; McCabe, Karen; Crosland, Ann; Kaner, Eileen

    2016-01-01

    Aims Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over. Methods Qualitative interviews (n = 24, 12 male/12 female, ages 51–90 years) and focus groups (n = 27, 6 male/21 female, ages 50–95 years) were carried out with a purposive sample of participants who consumed alcohol or had been dependent. Findings Participants’ alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people. Conclusion Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced

  7. The Indian Health Service approach to alcoholism among American Indians and Alaska Natives.

    PubMed

    Rhoades, E R; Mason, R D; Eddy, P; Smith, E M; Burns, T R

    1988-01-01

    The transfer to the Indian Health Service (IHS) of 158 alcohol treatment programs that had been administered by the National Institute on Alcohol Abuse and Alcoholism began in 1978. Today, approximately 300 alcohol and substance abuse treatment programs offer services to American Indians, among them primary residential treatment, halfway houses, outreach, and aftercare. This system provides a national network upon which additional activities may be established. Along with increasing its attention to health promotion and disease prevention, the IHS has moved toward the prevention of alcoholism. A variety of preventive programs are in place that emphasize improved self-image, value and attitude clarification, decision-making, and physical and emotional effects of alcohol and substance abuse. Many begin as Head Start programs and continue through adulthood. In 1986, after consulting with both academic and tribal experts, the IHS devised a strategic plan for alcoholism control that stresses comprehensive care and prevention activities; it serves as a guide for further program development. The Secretary of Health and Human Services created a Task Force on Indian Alcoholism in 1986 to serve as a coordinating body for activities carried out by the IHS and other agencies and units of the Department. Passage of the Anti-Drug Abuse Act in 1986 added resources for the development of adolescent treatment centers and, more importantly, for community-based pre- and post-residential care for youths and their families. Concomitant with these initiatives have been several instances of increased attention by various tribes to the problem of alcoholism. The IHS strategic plan, together with the Secretary's initiative, the Anti-Drug Act, and tribal actions, has added substantial momentum to efforts directed at controlling alcoholism among American Indians. Although the mortality rate from alcoholism is about four times greater for the American Indian population than for the entire U

  8. Smoking Cessation and Alcohol Consumption in Individuals in Treatment for Alcohol Use Disorders

    PubMed Central

    Friend, Karen B.; Pagano, Maria E.

    2008-01-01

    Most individuals with alcohol use disorders are dependent on both alcohol and nicotine, and combined use of both substances is more damaging to health than use of either alone. Although research indicates that alcoholics can quit smoking, discrepant results have been reported regarding whether smoking cessation is associated with increased risk of alcohol relapse. The purpose of this paper was to examine the relationship between smoking cessation and alcohol consumption using data from Project MATCH. Of the 1,307 participants who smoked at any point during the study, 160 (12%) quit. Quitters consumed less alcohol than those who continued smoking. In addition, quitters demonstrated a significant reduction in alcohol consumption at the time of smoking cessation, which was sustained for six months post-cessation. These findings suggest that individuals in treatment for alcohol use disorders who are motivated to stop smoking can safely be encouraged to do so without jeopardizing their sobriety. PMID:15784524

  9. Rural Issues in Alcohol and Other Drug Abuse Treatment: Award for Excellence Papers. Technical Assistance Publication Series No. 10.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Prevention.

    This document consists of papers that received recognition in a competition sponsored by the Center for Substance Abuse Treatment and the National Rural Institute on Alcohol and Drug Abuse. The competition sought to focus attention on problems in providing treatment and prevention services for drug and alcohol problems in rural areas. The papers…

  10. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  11. Criminal Justice and Alcohol Treatment: Results from a National Sample

    PubMed Central

    Booth, Brenda M.; Curran, Geoffrey M.; Han, Xiaotong; Edlund, Mark J.

    2012-01-01

    This study investigates the associations of recent criminal justice involvement with perceived need for alcohol treatment and alcohol treatment utilization, adjusting for demographic and clinical characteristics. We examined a national sample of adults with alcohol use disorders (AUD, N=4,390) from the 2006 National Survey on Drug Use and Health (NSDUH). Almost 15% reported criminal justice involvement in the past year. Generalized logit models regressed perceived need for alcohol or drug treatment and past year treatment utilization (versus neither) on past year legal involvement, demographic, and clinical information. In general, results found stronger associations between frequency of criminal justice involvement for treatment utilization compared to perceived need for treatment alone. Treatment utilization was also associated with being on probation, arrests for drug possession/sale and DUI but perceived need was not. Study results suggest opportunities for interventions to increase treatment rates or treatment need, a major correlate of treatment utilization. PMID:22954511

  12. [Treatment of alcohol dependence: rational and arguable approaches.

    PubMed

    Sivolap, Iu P

    2014-01-01

    Treatment of alcohol dependence consist of alcohol detoxification with withdrawal alleviation and relapse prevention or maintenance therapy. Drugs of choice for alcohol withdrawal cure are benzodiazepines and anticonvulsants are an alternative for them. Relapse prevention and alcohol abuse alleviation are carried out using disulfiram, acamprosate, naltrexone and nalmefene. Moreover, therapeutic possibilities of memantine, gabapentine, pregabalin, baclofen, modafinil, ondansetron D-cycloserine and aripiprazole are studying nowadays. Use of selective serotonin reuptake inhibitors including fluvoxamine for alcohol patients is of great importance due to frequent comorbidity of alcoholism, depression and anxiety. There are some doubtful methods of alcoholism treatment accepted in Russian addictive medicine such as clearance detoxification and use of antipsychotics for craving elimination. PMID:24988976

  13. Alcoholic liver disease. Treatment strategies for the potentially reversible stages.

    PubMed

    Hill, D B; Kugelmas, M

    1998-04-01

    Even modest alcohol ingestion can increase the risk of steatosis, and long-term, excessive consumption can lead to alcoholic hepatitis and eventually cirrhosis. Most patients with clinically significant alcoholic liver disease have histologic findings typical of all three conditions. The only clearly beneficial treatment is abstinence from alcohol. Abstinence in combination with proper nutrition and general supportive care is state of the art. Steatosis is reversible upon withdrawal of alcohol, but alcoholic hepatitis can persist even with abstinence and may progress to cirrhosis. Corticosteroid therapy may reduce short-term mortality rates in patients with moderate or severe alcoholic hepatitis who have hepatic encephalopathy but no evidence of infection or gastrointestinal bleeding. Treatment with colchicine may decrease the risk of cirrhosis; however, once cirrhosis has developed, the liver damage is irreversible. The prognosis is improved with abstinence, but complications (e.g., ascites, gastrointestinal bleeding) often occur. Liver transplantation may be considered in patients with severe complications. PMID:9553600

  14. Acamprosate: a prototypic neuromodulator in the treatment of alcohol dependence.

    PubMed

    Mason, Barbara J; Heyser, Charles J

    2010-03-01

    Alcoholism is one of the most prevalent substance dependence disorders in the world. Advances in research in the neurobiological mechanisms underlying alcohol dependence have identified specific neurotransmitter targets for the development of pharmacological treatments. Acamprosate, marketed under the brand name Campral, is an orally administered drug available by prescription in the U.S. and throughout much of the world for treating alcohol dependence. Its safety and efficacy have been demonstrated in numerous clinical trials worldwide. Here we provide an overview of acamprosate in the context of the neurobiological underpinnings of alcohol dependence. We propose that unlike previously available pharmacotherapies, acamprosate represents a prototypical neuromodulatory approach in the treatment of alcohol dependence. A neuromodulatory approach seeks to restore the disrupted changes in neurobiology resulting from chronic alcohol intake. We believe that a neuromodulatory approach will provide a heuristic framework for developing more effective pharmacotherapies for alcohol dependence. PMID:20201812

  15. Mobile Delivery of Treatment for Alcohol Use Disorders

    PubMed Central

    Quanbeck, Andrew; Chih, Ming-Yuan; Isham, Andrew; Johnson, Roberta; Gustafson, David

    2014-01-01

    Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based systems engage the user using video games. Although many commercial applications for treatment of AUDs exist, few (if any) have empirical evidence of effectiveness. The available evidence suggests that although texting-based applications may have beneficial effects, they are probably insufficient as interventions for AUDs. Comprehensive recovery management systems have the strongest theoretical base and have yielded the strongest and longest-lasting effects, but challenges remain, including cost, understanding which features account for effects, and keeping up with technological advances. PMID:26259005

  16. Treatment of alcohol use disorders in adolescents.

    PubMed

    Mack, Avram H; Frances, Richard J

    2003-05-01

    The treatment of alcohol use disorders (AUDs) in adolescents is a very important issue in the field of substance use disorders; however, it is a complex and understudied area in which there are limited data concerning evidence-based treatment. The authors first briefly review the epidemiology of AUDs in adolescents, describe existing guidelines for the treatment of such disorders in adolescent patients, and consider differences between AUDs as they present in adolescents and adults. In the next section of the paper, the authors review the assessment and diagnosis of AUDs in adolescents and consider how findings from such assessments will influence subsequent treatment planning. They also describe prognostic factors (e.g., family issues, socioeconomic factors, psychiatric comorbidity, gender, ability to form a therapeutic alliance) that may affect treatment outcome and need to be considered in treatment selection. The various settings in which adolescent AUDs may be treated and the types of patients and situations for which each is most appropriate are described. The second half of the article focuses on the treatment of adolescents with AUDs. The authors describe techniques for establishing abstinence and then preventing subsequent relapse. Although there is an interest in the use of medications (e.g., naltrexone) to treat AUDs in this population, there are unfortunately few if any data concerning the use of these agents in adolescent patients. More data are available concerning psychosocial treatments. The authors describe a variety of psychosocial modalities that have been tested in adolescents, including individual psychotherapy (e.g., interpersonal therapy, cognitive-behavioral therapy, motivational enhancement therapy), group therapies, 12 step/self-help programs, family therapy, skills training for parents, and psychoeducation. The authors then consider the importance of targeting comorbid psychiatric conditions, especially anxiety and depression, in the

  17. Treatment of alcohol use disorders in patients with alcoholic liver disease.

    PubMed

    Addolorato, Giovanni; Mirijello, Antonio; Barrio, Pablo; Gual, Antoni

    2016-09-01

    Alcohol use disorders (AUDs) is one of the leading causes of disease and disability in almost all European countries. Among the alcohol-related diseases, alcoholic liver disease (ALD) is the most common. At present, alcohol is the most frequent cause of liver cirrhosis in the Western world. The cornerstone of treatment for ALD is achieving total alcohol abstinence and preventing relapse; medical and surgical treatments for ALD are limited when drinking continues. This narrative review summarizes current treatments for AUDs with a particular emphasis to the treatment of AUDs in patients with ALD. Medical management, psychosocial and pharmacological interventions are analyzed, underlying limits and options in AUD patients. Finally, this review discusses the most appropriate setting for the management of AUD patients with advanced liver disease as well as the indications for liver transplantation in AUD patients. PMID:27155530

  18. Fetal Alcohol Syndrome: Characteristics, Prevention, Treatment and Long Term Outlook.

    ERIC Educational Resources Information Center

    Seward, Cynthia A.; Barber, William H.

    1991-01-01

    This article discusses fetal alcohol syndrome (FAS) including causes, common characteristics, secondary characteristics, prevention, and treatment. Economic implications are noted which suggest that treatment costs are 100 times the cost of prevention programs. (DB)

  19. Drug and Alcohol Abuse: Implications for Treatment. Treatment Research Monograph Series.

    ERIC Educational Resources Information Center

    Gardner, Stephen E., Ed.

    Articles in this monograph examine key issues in combined drug and alcohol use. The first chapter discusses clinical and research evidence about the physical and psychological effects of various drug and alcohol combinations. Chapter Two presents findings about usage patterns of alcohol and drugs. The impact of alcohol use in a treatment setting…

  20. [Alcoholism and aging. 1. Epidemiology, clinical aspects and treatment].

    PubMed

    Pierucci-Lagha, Amira

    2003-09-01

    Demographic trends reveal the elderly to be the fastest growing segment of the population. Physicians can therefore anticipate to be faced with a growing number of older patients with alcohol-related problems. It is now being increasingly recognized that alcoholism does not only concern the young population, but can appear for the first time late in life. One third of older alcoholic people develop a problem with alcohol in later life, while the other two thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism. In addition, as the number of the elderly increases, clinicians are more faced with patients who began drinking earlier in life and who continue to do so late on life. Furthermore, increasing age is associated with a higher prevalence of chronic disease and use of medication that may interact to amplify the effects of alcohol. Alcohol may cause or worsen chronic illnesses or symptoms such as insomnia, depression, and hypertension. On the other hand, older drinkers are therefore more likely to have adverse consequences of drinking at lower levels of alcohol consumption, and these consequences are likely to be more severe. In this paper, we review the prevalence of geriatric alcoholism, the drinking pattern seen in the elderly i.e., early vs. late onset alcoholism, and we expose the danger of alcohol problems underdiagnosis. In addition, we review the comorbidities associated with alcohol use and finally we discuss treatment options. PMID:15683955

  1. Fetal Alcohol Spectrum Disorders: Experimental Treatments and Strategies for Intervention

    PubMed Central

    Idrus, Nirelia M.; Thomas, Jennifer D.

    2011-01-01

    Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol’s teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD. PMID:23580044

  2. Evaluating the Impact of Hospital Based Drug and Alcohol Consultation Liaison Services.

    PubMed

    Reeve, Rebecca; Arora, Sheena; Butler, Kerryn; Viney, Rosalie; Burns, Lucinda; Goodall, Stephen; van Gool, Kees

    2016-09-01

    Consultation liaison (CL) services provide direct access to specialist services for support, treatment advice and assistance with the management of a given condition. Alcohol and other drugs (AOD) CL services aim to improve identification and treatment of patients with AOD morbidity. Our objective was to evaluate the costs and consequences of AOD CL services in hospitals in New South Wales, Australia. Patients were surveyed at eight hospitals and problematic AOD use was identified using the Alcohol, Smoking and Substance Involvement Screening Test (n=1615). For consenting participants, medical record data were obtained from 18 months pre- to 12 months post-survey. We used interrupted time series analyses to compare utilization and costs for patients with and without AOD problems and changes over time between those who received AOD CL and similar patients. Approximately 35% of patients surveyed had AOD problems (excluding tobacco) with 7% requiring intensive treatment. Only 24% of patients requiring intensive treatment were treated by AOD CL. Those treated had relative improvements over time in the cost of presentations to emergency departments, emergency admission performance and increased uptake of appropriate pharmaceuticals. The estimated net benefit of AOD CL services was at least AUD$100,000 savings per hospital per year. Expanding AOD CL services to address current unmet need may lead to even greater cost savings for hospitals. PMID:27431045

  3. A Case of Psychosis in Disulfiram Treatment for Alcoholism

    PubMed Central

    de Melo, Raquel Calvão; Lopes, Rui; Alves, José Carlos

    2014-01-01

    Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account. PMID:24818034

  4. Hypnosis in the Treatment of Alcoholism: A Theoretical Perspective.

    ERIC Educational Resources Information Center

    Steffenhagen, R. A.

    1983-01-01

    Reviews the history and theory of alcoholism and hypnosis and proposes a theoretical model of alcholism based on self-esteem. Suggets that hypnosis may be an effective tool in the treatment of alcoholism with cure as the goal, and calls for more consistency in theory and practice. (JAC)

  5. The Role of the Spouse in the Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    McCrady, Barbara S.; Hay, William

    The role of the spouse in both the etiology and the maintenance of alcoholism has been focussed on by theoreticians of various persuasions, including psychoanalytic, behavioral, sociological and family systems. These models, focussing on individual and interactional components of alcoholism, have generated a variety of treatment interventions…

  6. Long-term drug treatment of patients with alcohol dependence.

    PubMed

    Crowley, Philip

    2015-04-01

    Drug therapy for alcohol dependence should only be used in conjunction with a comprehensive treatment plan. Naltrexone and acamprosate have well established efficacy and are first-line treatments. Naltrexone is recommended for patients aiming to cut down their alcohol intake who do not have severe liver disease or an ongoing need for opioids. Acamprosate is recommended for those who have achieved and wish to maintain abstinence. Disulfiram is no longer considered first-line treatment due to difficulties with compliance and toxicity. Although baclofen and topiramate have evidence of benefit, they are not registered for alcohol dependence and should only be considered in specialist practice. PMID:26648614

  7. Treatment of older women with alcohol problems: meeting the challenge for a special population.

    PubMed

    Blow, F C

    2000-08-01

    As a larger proportion of the U.S. population reaches late life, there are new challenges to providing quality health care services for this group. Record numbers of adults over 60 are seeking health care for acute and chronic conditions. Older women represent the largest single group of health care users in this country. Twelve percent of older women regularly drink in excess of recommended guidelines (no more than one drink per day or seven drinks per week) and can be considered at-risk drinkers. Problems related to alcohol use and misuse can seriously affect many of the health concerns common among older women, including chronic illnesses and depression. Older women have specific risks and vulnerabilities to alcohol use, which include a swifter progression to alcohol-related illness. However, women in later life who have alcohol problems are underscreened and underdiagnosed, have significant barriers in accessing health care, and respond differentially to standard specialized treatment protocols. To date, research on these topics has been limited. Furthermore, there is a paucity of research focused on treatment outcomes for elderly adults with alcohol problems, with almost no emphasis on women. This paper presents the state of knowledge about alcohol health services for older women and provides recommendations for necessary future health services research on this vulnerable population. PMID:10968666

  8. A descriptive study of alcohol-dependent women attending Alcoholics Anonymous, a regional council on alcoholism and an alcohol treatment unit.

    PubMed

    Smith, L N

    1992-11-01

    A total of 86 women, attending three different agencies, were interviewed on their help-seeking behaviours for problem drinking. Each agency represented a different type of help available in the community. Self-help was represented by Alcoholics Anonymous; the non-statutory sector by a regional council on alcoholism's offices; and the statutory sector by an alcohol treatment unit's out-patient department. Differences between the groups in terms of demography and drinking history are explored in this paper. It was found that the regional council group resembled the female problem drinkers in other alcohol treatment agencies in terms of alcohol dependency, pattern of alcohol consumption and drinking styles, but differed in age and abstinence behaviour. PMID:1292440

  9. [Neuropsychological performance and demographic characteristics in alcoholic patients in treatment].

    PubMed

    Dos Santos Rigoni, Maisa; Quarti Irigaray, Tatiana; Feliz Duarte de Moraes, João; Ferrão, Ygor; da Silva Oliveira, Margareth

    2014-01-01

    This study compared the cognitive performance of alcoholics (AG) and participants from the general population (CG) without alcohol dependence. The sample consisted of 141 men, aged 18 and 59. Divided into two groups, 101 alcoholic patients without comorbidities, hospitalized for drug abuse treatment, and 40 healthy individuals from the general population, matched for age and socioeconomic status. The instruments assessed the sociodemographics data and economic classification, alcohol dependence, psychiatric comorbidities, cognitive performance, executive functions, memory and perception. The results showed that the AG group presented severe dependence on alcohol and 92.1% indicated having a family with problems associated with alcohol for only 41.5 % of the CG. At the moment of the evaluation, 59.4 % of the participants of the AG group were abstinent between 8 and 15 days, and the in CG, 43.9%, were more than 60 days alcohol free. The neuropsychological performance verified that there was a decline in cognitive functions in alcoholics’ participants, whereas the AG suggests psychomotor retardation. Thus, it can be inferred that alcohol greatly affects cognitive functions of people who depend on this substance. In addition, there was a greater number of family stories with prevalence of symptoms of anxiety and depression and nicotine addiction in alcoholic patients compared with the general population. PMID:25314037

  10. A Profile of Clients Entering Treatment for Alcohol Problems.

    ERIC Educational Resources Information Center

    Finkbiner, Richard

    Large numbers of clients entering publicly-funded substance abuse treatment facilities cite problems with alcohol as one reason for seeking treatment. This report presents the results of a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES) data set. It profiles the treatment experiences of three study groups that…

  11. Adolescent drug misuse treatment and use of medical care services.

    PubMed

    Freeborn, D K; Polen, M R; Mullooly, J P

    1995-05-01

    Research on adults has documented that use of medical services decreases after initiation of treatment for alcohol problems, but little is known about this relationship among adolescents. We studied utilization and costs of care following participation in the Adolescent Chemical Health Program (ACHP) of Kaiser Permanente, Northwest Region, in 1986-88. Three groups of adolescents (and their parents) were identified: adolescents who were assessed and initiated treatment in ACHP (n = 561), adolescents who were assessed and recommended for treatment but did not return for treatment (n = 278), and adolescents with no known substance use problems (n = 381). Medical records were reviewed for 1 year pre- and 1.5 years postassessment. After adjusting for preassessment medical visits, severity of alcohol and drug use, gender, and age, analyses suggested that substance user treatment was not associated with reduced use of medical services or costs by either adolescents or parents. PMID:7558471

  12. An intervention to increase alcohol treatment engagement: a pilot trial

    PubMed Central

    Stecker, Tracy; McGovern, Mark P.; Herr, Beverly

    2011-01-01

    Objectives Previous research has documented the difficulty individuals with alcohol use disorders have initiating alcohol treatment. This study assessed the feasibility of a brief, cognitive behavioral intervention designed to increase treatment initiation among individuals with alcohol use disorders. Methods This randomized controlled trial included one hundred and ninety six participants who screened positive for a possible alcohol use disorder on the AUDIT. Randomly assigned intervention participants were administered a brief cognitive-behaviorally-based intervention by phone designed to modify beliefs that may interfere with treatment-seeking behavior. Beliefs about treatment and treatment-seeking behavior were assessed post-intervention. Results Participants receiving the intervention had significantly improved their attitudes toward addiction treatment (p < 0.002) and increased their reported intention to seek treatment (p < 0.000) post-intervention. Further, intervention participants were almost three times more likely to attend treatment within a three-month period (OR = 2.60, p < 0.025) than participants in the control group. Conclusions A brief, cognitive-behavioral intervention delivered by phone and focused on modifying treatment interfering beliefs holds promise for increasing alcohol treatment-seeking among individuals in need. PMID:22138200

  13. Partner Violence Before and After Couples-Based Alcoholism Treatment for Female Alcoholic Patients

    PubMed Central

    Schumm, Jeremiah A.; O'Farrell, Timothy J.; Murphy, Christopher M.; Fals-Stewart, William

    2010-01-01

    This study examined partner violence before and in the first and second year after behavioral couples therapy (BCT) for 103 married or cohabiting women seeking alcohol dependence treatment and their male partners, and used a demographically matched non-alcoholic comparison sample. The treatment sample received M = 16.7 BCT sessions over 5-6 months. Follow-up rates for the treatment sample at years 1 and 2 were 88% and 83%, respectively. In the year before BCT, 68% of female alcoholic patients had been violent toward their male partner, nearly five times the comparison sample rate of 15%. In the year after BCT, violence prevalence decreased significantly to 31% of the treatment sample. Women were classified as remitted after treatment if they demonstrated abstinence or minimal substance use and no serious consequences related to substance use. In year 1 following BCT, 45% were classified as remitted, and 49% were classified as remitted in year 2. Among remitted patients in the year after BCT, violence prevalence of 22% did not differ from the comparison sample and was significantly lower than the rate among relapsed patients (38%). Results for male-perpetrated violence and for the second year after BCT were similar to the first year. Results supported predictions that partner violence would decrease after BCT, and that clinically significant violence reductions to the level of a non-alcoholic comparison sample would occur for patients whose alcoholism was remitted after BCT. These findings replicate previous research among men with alcoholism. PMID:19968389

  14. Inpatient treatment of the psychiatric patient with alcoholism.

    PubMed

    Bean-Bayog, M

    1987-05-01

    Patients with both alcoholism and mental illness, or the one masquerading as the other, are very common and often puzzling and discouraging to clinicians. This article reviews several aspects of these problems: epidemiologic studies show that substantial proportions of mentally ill people suffer from alcoholism, and these disorders interlock in complex ways, each exacerbating the other. Many physicians feel uncomfortable working with alcoholic people, mostly because of poor training, and this impinges on difficulties of giving excellent care to these taxing patients. Complexities and resistances to interviewing obstruct evaluation. Interviewing and history taking techniques and the reason for them are discussed. The decision whether a patient needs medical or psychiatric hospitalization, alcoholism rehabilitation, or outpatient psychiatric or alcoholism treatment is reviewed along with the management and sequencing of treatment for primary and secondary alcoholism with concomitant psychosis, mania, depression, panic disorder, and adult attention deficit disorder. Clinical intervention and referral for the patient on a medical or surgical floor who may have alcoholism is discussed. Two special clinical problems, the differential diagnosis of postdetoxification depression and the risks of using alcohol cross-tolerant drugs, are also reviewed. PMID:2884166

  15. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-01-01

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented. PMID:26054494

  16. Treatment needs and experiences of Australian women with alcohol and other drug problems.

    PubMed

    Swift, W; Copeland, J

    1996-03-01

    Two hundred and sixty-seven women were interviewed as part of a national survey examining the treatment needs and experiences of Australian women who had received assistance for their alcohol and other drug problems. The majority of women had previously received assistance for their substance use, and of these most had left alcohol and other drug treatment programs before completion. While the women cited a number of ways in which they were helped by such services, several areas were identified by the women as important and amenable to improvement. Among the service issues raised were access, models of service delivery, service structure and staffing, physical environment, physical and psychological safety and the handling of issues such as health status and sexual assault. PMID:8861399

  17. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

    PubMed Central

    Lee, Jinhee; Kresina, Thomas F.; Campopiano, Melinda; Lubran, Robert; Clark, H. Westley

    2015-01-01

    Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence. PMID:25629034

  18. Dynamic Association Between Negative Affect and Alcohol Lapses Following Alcohol Treatment

    PubMed Central

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-01-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13–0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes. PMID:19634957

  19. Dynamic association between negative affect and alcohol lapses following alcohol treatment.

    PubMed

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-08-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13-0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes. PMID:19634957

  20. Nalmefene: a new approach to the treatment of alcohol dependence

    PubMed Central

    Paille, François; Martini, Hervé

    2014-01-01

    Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient’s and the doctor’s perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient’s active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. PMID:25187751

  1. Nalmefene: a new approach to the treatment of alcohol dependence.

    PubMed

    Paille, François; Martini, Hervé

    2014-01-01

    Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient's and the doctor's perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient's active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. PMID:25187751

  2. Partner Violence before and after Couples-Based Alcoholism Treatment for Female Alcoholic Patients

    ERIC Educational Resources Information Center

    Schumm, Jeremiah A.; O'Farrell, Timothy J.; Murphy, Christopher M.; Fals-Stewart, William

    2009-01-01

    This study examined partner violence before and in the 1st and 2nd year after behavioral couples therapy (BCT) for 103 married or cohabiting women seeking alcohol dependence treatment and their male partners; it used a demographically matched nonalcoholic comparison sample. The treatment sample received M = 16.7 BCT sessions over 5-6 months.…

  3. The Alcohol Mandatory Treatment Act: evidence, ethics and the law.

    PubMed

    Lander, Fiona; Gray, Dennis; Wilkes, Edward

    2015-07-01

    The Northern Territory Alcohol Mandatory Treatment Act 2013 (AMT Act) permits mandatory residential alcohol rehabilitation for up to 3 months. International guidelines and human rights law confirm that mandatory rehabilitation should only be used for short periods. Evidence concerning the efficacy of long-term mandatory alcohol rehabilitation is lacking, and minimal data concerning the efficacy of the scheme have been released. Specific legal issues also arise concerning the AMT Act, including its potentially discriminatory application to Aboriginal and Torres Strait Islander peoples. The program only permits referral by police, despite the fact that it is ostensibly a medical intervention. Use of a treatment as a method of effectively solving a public intoxication problem is highly dubious, and should be of concern to the medical community. Given that more cost-effective and proven measures exist to combat alcohol dependence, the utility of the AMT Act is questionable. PMID:26126570

  4. [Inpatient care in the treatment of alcohol use disorders].

    PubMed

    Balester Mouret, Sylvain

    2011-12-01

    Inpatient treatment has long been considered the reference in the treatment of alcoholism. It may indeed have many conceptual advantages, but practically it is a method of treatment with high costs and long waiting period. Moreover, reviews of studies evaluating effectiveness of treatment settings for alcohol dependence suggest that no significant differences exist between inpatient and outpatient programs. Therefore, it seems useful to determine indications of inpatient detoxification programs. As we may see, the choice of inpatient detox should be primarily guided by the contra-indications of outpatient detox. However, it also depends very much on patients' preference, essential to success, since they are the lead actors. Some other situations require urgent residential care, regardless of readiness to change or type of alcohol disorder underlying. PMID:22288351

  5. Role of exercise in the treatment of alcohol use disorders

    PubMed Central

    MANTHOU, EIRINI; GEORGAKOULI, KALLIOPI; FATOUROS, IOANNIS G.; GIANOULAKIS, CHRISTINA; THEODORAKIS, YANNIS; JAMURTAS, ATHANASIOS Z.

    2016-01-01

    Excessive alcohol use can cause harmful effects on the human body, which are associated with serious health problems, and it can also lead to the development of alcohol use disorders (AUDs). There is certain evidence that physical exercise positively affects excessive alcohol use and the associated problems by leading to reduced alcohol intake. A literature search was conducted using the databases PubMed, Medline and Web of Science. The search terms used as keywords were: Addiction, abuse, alcohol use disorders, exercise training, β-endorphin, opioids, brain, ethanol and alcohol. The current study presents the studies that reported on the use of exercise in the treatment of AUDs between 1970 and 2015. The potential psychological and physiological mechanisms that contribute to the action of exercise were also reviewed, highlighting the role of β-endorphin and the hypothalamic-pituitary-adrenal axis in AUDs and the possible association among physical activity, the endogenous opioid system and the desire for alcohol. Only 11 studies were identified that refer to the effect of exercise on alcohol consumption and/or the associated outcomes. Six of those studies concluded that exercise may have a positive impact towards alcohol consumption, abstinence rates or the urge to drink. One of those studies also indicated that a bout of exercise affects the endogenous opioids, which may be associated with the urge to drink. Another 3 studies indicated that responses to acute exercise in individuals with AUDs are different compared to those in healthy ones. Generally, despite limited research data and often contradictory results, there is certain early promising evidence for the role of exercise as an adjunctive tool in the treatment of AUDs. Physiological and biochemical parameters that would confirm that exercise is safe for individuals with AUDs should be examined in future studies. PMID:27123244

  6. Probation officers' beliefs about the effectiveness of alcohol treatment.

    PubMed

    Polcin, Douglas L

    2004-06-01

    Research has shown that a large number of individuals on probation have alcohol problems but only a fraction of them receive treatment. This study surveyed 145 probation officers about their views on alcohol problems among probationers. A previous analysis of the data found that two beliefs predicted probation officers' use of coercion to mandate probationers to alcohol treatment: the belief that treatment was effective and the belief that one's peers were using coercion to mandate treatment. The analysis reported here examined factors associated with probation officers' belief that treatment works. Multiple regression found that several factors predicted the belief that treatment is effective. Officers who had a family member with a drinking problem (current or family of origin), those who had a strong belief about their self-efficacy in handling alcohol problems, and those who were more likely to make coerced referrals had stronger beliefs that treatment was effective. Strategies for facilitating accurate beliefs about the effectiveness of treatment and increasing self-efficacy among probation officers are reviewed. PMID:15369210

  7. College Student Receptiveness to Various Alcohol Treatment Options

    ERIC Educational Resources Information Center

    Epler, Amee J.; Sher, Kenneth J.; Loomis, Tiffany B.; O'Malley, Stephanie S.

    2009-01-01

    Objective: Heavy episodic drinking remains a significant problem on college campuses. Although most interventions for college students are behavioral, pharmacological treatments, such as naltrexone, could provide additional options. Participants: The authors evaluated receptivity to various alcohol treatment options in a general population of…

  8. Trends in the treatment of alcohol problems in the US general population, 1979 through 1990.

    PubMed Central

    Weisner, C; Greenfield, T; Room, R

    1995-01-01

    OBJECTIVES. The purpose of this study was to conduct a comprehensive analysis of alcohol-treatment service utilization trends in the general population during the 1980s. METHODS. Three national surveys of the US household population (1979, 1984, and 1990) were used for trend analysis of treatment utilization. Trends in demographic characteristics of persons with lifetime treatment rates and particular types of treatment were examined by means of logistic regression analysis, controlling for alcohol problem severity and other variables. RESULTS. Substantial increases in the numbers reporting treatment were found. In all surveys, Alcoholics Anonymous was the treatment used most frequently and its use increased most, especially for women. Men were more likely than women (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.20, 5.39) and unmarried persons were twice as likely as married persons to have been treated [corrected]. Social consequences carried more predictive power than dependence symptoms. CONCLUSIONS. From a general population perspective, while overall treatment capacity has increased, the structural changes in the public/private balance of services have not positively affected the representation of women or other characteristics of the treatment population. PMID:7832262

  9. Outcomes of Treatment for Alcohol Problems: Current Methods, Problems, and Results.

    ERIC Educational Resources Information Center

    Nathan, Peter E.; Skinstad, Anne-Helene

    1987-01-01

    Discusses current methods, problems, and results of psychological treatment for alcohol abuse, including alcoholism. Addresses external and internal validity problems specific to issues regarding who is treated for alcohol problems, and treatment and patient factors that predict response to alcoholism treatment. Reviews current data on…

  10. Changes in Use of Alcohol, Marijuana, and Services by Adolescents with Serious Emotional Disturbance: A Parallel-Process Growth Mixture Model

    ERIC Educational Resources Information Center

    Greenbaum, Paul E.; Dedrick, Robert F.

    2007-01-01

    For the study reported here, the authors used growth mixture modeling to analyze changes in alcohol and marijuana use and the use of drug and alcohol treatment services for a sample of 180 adolescents with serious emotional disturbance (ages 12-14 years at the beginning of the 7-year longitudinal study). Three latent classes of substance users…

  11. Alcoholic hepatitis: A comprehensive review of pathogenesis and treatment

    PubMed Central

    Chayanupatkul, Maneerat; Liangpunsakul, Suthat

    2014-01-01

    Alcoholic hepatitis (AH) is an acute hepatic inflammation associated with significant morbidity and mortality. Current evidence suggests that the pathogenesis is the end result of the complex interplay between ethanol metabolism, inflammation and innate immunity. Several clinical scoring systems have been derived to predict the clinical outcomes of patients with AH; such as Child-Turcotte-Pugh score, the Maddrey discriminant function, the Lille Model, the model for end stage liver disease scores, and the Glasgow alcoholic hepatitis score. At present, Corticosteroids or pentoxifylline are the current pharmacologic treatment options; though the outcomes from the therapies are poor. Liver transplantation as the treatment of alcoholic hepatitis remains controversial, and in an era of organ shortage current guidelines do not recommend transplantation as the treatment option. Because of the limitations in the therapeutic options, it is no doubt that there is a critical need for the newer and more effective pharmacological agents to treat AH. PMID:24876748

  12. Alcoholic hepatitis: a comprehensive review of pathogenesis and treatment.

    PubMed

    Chayanupatkul, Maneerat; Liangpunsakul, Suthat

    2014-05-28

    Alcoholic hepatitis (AH) is an acute hepatic inflammation associated with significant morbidity and mortality. Current evidence suggests that the pathogenesis is the end result of the complex interplay between ethanol metabolism, inflammation and innate immunity. Several clinical scoring systems have been derived to predict the clinical outcomes of patients with AH; such as Child-Turcotte-Pugh score, the Maddrey discriminant function, the Lille Model, the model for end stage liver disease scores, and the Glasgow alcoholic hepatitis score. At present, Corticosteroids or pentoxifylline are the current pharmacologic treatment options; though the outcomes from the therapies are poor. Liver transplantation as the treatment of alcoholic hepatitis remains controversial, and in an era of organ shortage current guidelines do not recommend transplantation as the treatment option. Because of the limitations in the therapeutic options, it is no doubt that there is a critical need for the newer and more effective pharmacological agents to treat AH. PMID:24876748

  13. [ENT emergency treatment and alcohol related head and neck injuries].

    PubMed

    Teudt, I; Grundmann, T; Pueschel, K; Hogan, B; Leventli, B

    2013-08-01

    The spectrum of ENT-diseases can differ widely among emergency departments (ED) of different geographic regions. Especially in terms of head and neck trauma a higher number of injuries can be expected in large cities due to alcohol related violence.The ED of a large hospital situated in the center of Hamburg Germany was analysed for ENT-emergency treatments in 2011 retrospectively. Beside usual patient statistics, the study focused on alcohol related injuries with an ENT-surgeon involved. All data were compared to reports by other EDs in Germany and alcohol related costs were approximated for initiation of prevention programs in the future.2 339 ENT-patients were admitted to the ED. 19% of all patients used an ambulance whereas 80% reached the ED by private transportation. The majority of patients were between 21 and 30 years of age. For 143 of all trauma cases alcohol involvement was documented. Subanalysis revealed male dominance and a high use of ambulance transportation.The high number of traumata differs considerably from other ENT studies. One reason is the hospital's close proximity to all time party districts like "Reeperbahn" and the "Port of Hamburg". In those areas high amounts of alcohol ingestion takes place leading to more injuries at the head- and neck region. Theoretically financial resources would be plenty after the initiation of those programs as the severe costs for alcohol related medical treatment would decline. PMID:23568584

  14. THE TREATMENT OF ALCOHOL AND OPIOID DEPENDENCE IN PREGNANT WOMEN

    PubMed Central

    Heberlein, Annemarie; Leggio, Lorenzo; Stichtenoth, Dirk; Thomas, Hillemacher

    2016-01-01

    Purpose of the review This article addresses the question of “best treatment options,” which clinicians face when treating pregnant women with alcohol and/or opioid dependence. Recent findings Alcohol Studies show that alcohol consumption is associated with fetal abnormalities and long-term cognitive problems depending on amount consumed, drinking pattern, and time of gestation. Screening and evaluation of specific interventions are important to reduce alcohol consumption during pregnancy and associated problems in infants. Opioids Withdrawal-induced fetal distress and the risk of relapse are the primary reasons why opioid detoxification is only recommended in the second or third trimesters and only in those pregnant women who refuse opioid maintenance therapy (OMT). Methadone is the most established treatment of pregnant opioid-dependent women, but recent investigations suggest that substitution with buprenorphine may have advantages over methadone in terms of neonatal abstinence syndrome (NAS). Promising results have been also reported for slow-release oral methadone and the heroin equivalent diamorphin. Summary Data regarding the pharmacological treatment of alcohol abuse and/or dependence is limited in pregnant women. So far, benzodiazepines seem to be the most recommendable option for managing alcohol withdrawal, and psychosocial interventions succeed in reducing alcohol consumption or in maintaining abstinence in alcohol-dependent pregnant women. Recent data, albeit preliminary, support the use of naltrexone in the treatment of alcohol-dependent pregnant women. Regarding opioid dependence meta-analyses do not clearly support the superiority of one substitute over the other during pregnancy owing to the presence of interfering factors (such as illicit drug use) in the studies conducted. Current results suggest that factors like the health status of the mother, the need for additional medications (e.g. treatment for HIV), comorbid drug dependence, and

  15. Effects of naltrexone on neural and subjective response to alcohol in treatment-seeking alcohol dependent patients

    PubMed Central

    Spagnolo, Primavera A.; Ramchandani, Vijay A.; Schwandt, Melanie L.; Zhang, Lishu; Blaine, Sara K.; Usala, Julie M.; Diamond, Kristie A.; Phillips, Monte J.; George, David T.; Momenan, Reza; Heilig, Markus

    2014-01-01

    Rationale Positively reinforcing properties of alcohol are in part mediated by activation of the ventral striatum (VS). Alcohol-induced release of endogenous opioids is thought to contribute to this response. Preclinical studies show that the opioid antagonist naltrexone (NTX) can block this cascade, but its ability to do so in treatment seeking alcoholics has not been examined. Objectives To study the effects of NTX on alcohol-induced VS activation and on amygdala response to affective stimuli in treatment seeking alcohol dependent inpatients. Methods Sixty-three treatment seeking alcoholics were randomized to receive NTX (50 mg) or placebo (PLC) daily. On day 7, participants underwent an alcohol cue reactivity session, and craving was measured using the Penn Alcohol Craving Scale. On day 9, participants received a saline infusion followed by an alcohol infusion and also viewed affective stimuli in an MR scanner. Results Irrespective of medication treatment condition, the alcohol infusion did not activate the VS in the alcohol dependent patients. Unexpectedly, VS activation was greater in NTX treated patients than in the PLC group. NTX treated patients also reported increased craving in response to alcohol cue exposure, and increased subjective response to alcohol (‘high’ and ‘intoxicated’) compared to PLC subjects. No significant effects of alcohol infusion on brain response to affective stimuli were in the NTX or placebo groups. Conclusions Unlike previous findings in social drinkers, a moderate level of intoxication did not activate the VS in treatment seeking alcoholics. This is likely to reflect tolerance to the positively reinforcing properties of alcohol in this clinical population. Our findings may help explain the efficacy of NTX to reduce heavy drinking, but not to maintain abstinence. PMID:25581657

  16. Alcoholics Anonymous and Relapse Prevention as Maintenance Strategies After Conjoint Behavioral Alcohol Treatment for Men: 18-Month Outcomes

    ERIC Educational Resources Information Center

    McCrady, Barbara S.; Epstein, Elizabeth E.; Kahler, Christopher W.

    2004-01-01

    Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after…

  17. Predicting Post-Treatment-Initiation Alcohol Use among Patients with Severe Mental Illness and Alcohol Use Disorders

    ERIC Educational Resources Information Center

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2009-01-01

    Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…

  18. In silico Models of Alcohol Dependence and Treatment.

    PubMed

    Kovatchev, Boris; Breton, Marc; Johnson, Bankole

    2012-01-01

    In this paper we view alcohol dependence and the response to treatment as a recurrent bio-behavioral process developing in time and propose formal models of this process combining behavior and biology in silico. The behavioral components of alcohol dependence and treatment are formally described by a stochastic process of human behavior, which serves as an event generator challenging the metabolic system. The biological component is driven by the biochemistry of alcohol intoxication described by deterministic models of ethanol pharmacodynamics and pharmacokinetics to enable simulation of drinking addiction in humans. Derived from the known physiology of ethanol and the literature of both ethanol intoxication and ethanol absorption, the different models are distilled into a minimal model (as simple as the complexity of the data allows) that can represent any specific patient. We use these modeling and simulation techniques to explain responses to placebo and ondansetron treatment observed in clinical studies. Specifically, the response to placebo was explained by a reduction of the probability of environmental reinforcement, while the effect of ondansetron was explained by a gradual decline in the degree of ethanol-induced neuromodulation. Further, we use in silico experiments to study critical transitions in blood alcohol levels after specific average number of drinks per day, and propose the existence of two critical thresholds in the human - one at 5 and another at 11 drinks/day - at which the system shifts from stable to critical and to super critical state indicating a state of alcohol addiction. The advantages of such a model-based investigation are that (1) the process of instigation of alcohol dependence and its treatment can be deconstructed into meaningful steps, which allow for individualized treatment tailoring, and (2) physiology and behavior can be quantified in different (animal or human) studies and then the results can be integrated in silico. PMID

  19. The relationship of alcohol use to weight loss in the context of behavioral weight loss treatment.

    PubMed

    Kase, Colleen A; Piers, Amani D; Schaumberg, Katherine; Forman, Evan M; Butryn, Meghan L

    2016-04-01

    Despite common wisdom that reducing alcohol intake will facilitate weight loss, little research has examined whether participants in behavioral weight loss treatments actually decrease their alcohol intake, or whether reduced alcohol intake relates to weight loss outcomes in this context. This study examined the relationship of alcohol use to energy intake excluding alcohol and to weight in 283 overweight and obese adults participating in a 26-session behavioral weight loss treatment. The majority of participants consumed low to moderate levels of alcohol at baseline. Participants who consumed alcohol at baseline meaningfully reduced their alcohol intake by end-of-treatment. Alcohol use did not relate to weight at baseline or end-of-treatment when controlling for relevant demographic variables, and change in alcohol use was unrelated to weight change in the overall sample during treatment. However, end-of-treatment alcohol intake did relate to end-of-treatment energy intake excluding alcohol. In addition, behavioral impulsivity and change in alcohol intake interacted to predict weight loss, such that decreases in alcohol intake were associated with greater percent weight loss at end-of-treatment for participants with higher levels of impulsivity. Alcohol consumption may lead to overeating episodes, and highly impulsive individuals may be at risk for increased energy intake during or after episodes of drinking. Therefore, the recommendation to reduce alcohol intake in the context of behavioral weight loss treatment seems warranted, particularly for individuals with high levels of impulsivity. PMID:26792773

  20. A Growing Concern: How to Provide Services for Children from Alcoholic Families.

    ERIC Educational Resources Information Center

    Waite, Barbara J.; Ludwig, Meredith J.

    This document, written for caregivers and professionals working in the fields of education, recreation, and health and social services, presents information about issues and strategies in the provision of services to children from alcoholic families. The first chapter discusses the effects of alcoholism on the family and reviews a whole system of…

  1. Choosing the right medication for the treatment of alcoholism.

    PubMed

    Pettinati, Helen M; Rabinowitz, Amanda R

    2006-10-01

    In the past decade, scientists have made important progress toward understanding the neurobiology underlying an alcohol disorder. This knowledge has led to the development of promising pharmacotherapies that target the neural pathways involved in the brain's reward center in such a way that the usual treatment response (via counseling) is substantially improved upon. There are now four US Food and Drug Administration (FDA)-approved pharmacotherapies for the treatment of alcohol dependence: disulfiram (Antabuse; Odyssey Pharmaceuticals, East Hanover, NJ), oral naltrexone (ReVia; Barr Pharmaceuticals, Inc., Pomona, NY), acamprosate (Campral; Forest Laboratories, Inc., New York, NY), and, as of April 2006, an extended-release (30-day) injectable suspension formulation of naltrexone (Vivitrol; Alkermes, Inc., Cambridge, MA). Other types of medications (eg, topiramate and quetiapine) are currently under investigation for the treatment of alcohol dependence. Research also has provided insights into best practices for prescribing the available medications. This report reviews the latest innovations in pharmacotherapy for the treatment of alcohol dependence, focusing on FDA-approved medications presently available to the treatment community. PMID:16968619

  2. Prognosis and treatment of patients with acute alcoholic hepatitis.

    PubMed

    Papastergiou, Vassilios; Burroughs, Andrew K; Tsochatzis, Emmanuel A

    2014-07-01

    Despite alcoholic hepatitis (AH) is the most acute manifestation of alcohol-related liver disease, its treatment remains controversial. Corticosteroids, given either as monotherapy or together with N-acetylecysteine, have been associated with a moderate short-term survival benefit in patients with severe disease. The Maddrey's discriminant function; Glasgow alcoholic hepatitis score; age, bilirubin, INR and creatinine score; and the Model for end-stage liver disease have been proposed for stratifying prognosis in AH enabling selection of the patients to treat. Definition of treatment non-responders using the Lille model after 7 days of therapy may prevent a detrimental impact of prolonged corticosteroids. Pentoxifylline is an effective alternative reducing the occurrence of hepatorenal syndrome. Emerging evidence supports use of liver transplantation in a strictly selected subset of corticosteroid non-responders. PMID:24716632

  3. [Cognitive impairments in alcohol dependence: From screening to treatment improvements].

    PubMed

    Cabé, N; Laniepce, A; Ritz, L; Lannuzel, C; Boudehent, C; Vabret, F; Eustache, F; Beaunieux, H; Pitel, A-L

    2016-02-01

    Alcohol-related cognitive impairments are largely underestimated in clinical practice, even though they could limit the benefit of alcohol treatment and hamper the patient's ability to remain abstinent or to respect his/her therapeutic contract. These neuropsychological deficits can impact the management of patients well before the development of the well-known Korsakoff's syndrome. Indeed, even in the absence of ostensible neurological complications, excessive and chronic alcohol consumption results in damage of brain structure and function. The frontocerebellar circuit and the circuit of Papez, respectively involved in motor and executive abilities and episodic memory, are mainly affected. Those brain dysfunctions are associated with neuropsychological deficits, including deficits of executive functions, episodic memory, social cognition, as well as visuospatial and motor abilities. Such cognitive disorders can interfere with the motivation process to abandon maladjusted drinking behavior in favor of a healthier lifestyle (such as abstinence or controlled alcohol consumption). They can also limit the patient's capacity to fully benefit from treatment (notably psychoeducation and cognitive-behavioural treatments) currently widely proposed in French Addiction departments. In addition, they may contribute to relapse which is multi-determinated. A neuropsychological assessment appears therefore crucial to take relevant clinical decisions. However, very few addiction departments have the human and financial resources to conduct an extensive neuropsychological examination of all patients with alcohol dependence. Some brief screening tools can be used, notably the MOntreal Cognitive Assessment and the Brief Evaluation of Alcohol-Related Neuropsychological Impairments, which has been especially designed to assess cognitive and motor deficits in alcoholism. These tools can be used by non-psychologist clinicians to detect alcohol-related cognitive deficits, which require

  4. Treatment of alcohol dependence: recent progress and reduction of consumption.

    PubMed

    Testino, G; Leone, S; Borro, P

    2014-12-01

    Alcohol dependence (AD) is a major public health problem. Currently, three drugs for the treatment of AD have been approved by both the European Medicines Agency (EMA) and the Food and Drug Administration (FDA): acamprosate, disulfiram, and oral naltrexone. The FDA also approved the use of long-acting injectable naltrexone. In Austria and in Italy sodium oxybate is also approved. The EMA's Committee for Medicinal Products for Human Use has recently granted marketing authorization for nalmefene for the reduction of alcohol consumption. Many patients, while accepting the problem, are unable or unwilling to completely stop consuming alcohol, leading to an inevitable deterioration over time of their psycho-physical state, and social and family relationships. It is appropriate to offer these patients the opportunity to significantly reduce their consumption of alcohol. The reduction may be an opportunity to prepare the individual for achieving complete abstinence. Abstinence should always be the main goal. Currently, nalmefene is the only drug that has been authorized for the reduction of alcohol consumption. Its association with psycho-social support is mandatory; it is taken on an "as-needed" basis, which should preferably be 1-2 hours before the possible intake of alcohol. The trials showed a significant reduction in alcohol consumption, which resulted in a significant reduction in morbidity and mortality. Reducing consumption allows a decrease in the progression of numerous alcohol-induced chronic diseases, as well as a reduction in psycho-physical damage, acts of violence, motor vehicle accidents, and accidents at work, which in turn means fewer healthcare costs. PMID:25392958

  5. Alcohol-Adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence.

    PubMed

    Walitzer, Kimberly S; Deffenbacher, Jerry L; Shyhalla, Kathleen

    2015-12-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the 6-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for 6 months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. PMID:26387049

  6. Does Disease Matter? Incorporating Solution-Focused Brief Therapy in Alcoholism Treatment.

    ERIC Educational Resources Information Center

    Osborn, Cynthia J.

    1997-01-01

    Surveyed alcoholism counselors (N=284) to determine whether the disease concept of alcoholism precludes acceptance and use of Solution-Focused Brief Therapy (SFBT) in alcoholism treatment. Results suggest that SFBT may be feasible for alcoholism treatment and that endorsement of the disease concept is compatible with the principles of SFBT. (EMK)

  7. Bipolar disorder and comorbid alcoholism: prevalence rate and treatment considerations.

    PubMed

    Frye, Mark A; Salloum, Ihsan M

    2006-12-01

    Classic Kraepelian observations and contemporary epidemiological studies have noted a high prevalence rate between bipolar disorder and alcoholism. The extent to which these two illnesses are comorbid (i.e., two distinct disease processes each with an independent course of illness), genetically linked, or different phenotypic expressions of bipolar illness itself continues to be investigated. It is increasingly clear that co-occurring alcohol abuse or dependence in bipolar disorder phenomenologically changes the illness presentation with higher rates of mixed or dysphoric mania, rapid cycling, increased symptom severity, and higher levels of novelty seeking, suicidality, aggressivity, and impulsivity. It is very encouraging that interest and efforts at evaluating pharmacotherapeutic compounds has substantially increased over the past few years in this difficult-to-treat patient population. This article will review the clinical studies that have evaluated the effectiveness of conventional mood stabilizers (lithium, carbamazepine, divalproex, and atypical antipsychotics) in the treatment of alcohol withdrawal and relapse prevention in patients with alcoholism and in the treatment of bipolar disorder with comorbid alcoholism. A number of add-on, adjunctive medications, such as naltrexone, acamprosate, topiramate, and the atypical antipsychotics quetiapine and clozapine, may be candidates for further testing. PMID:17156154

  8. Effect Size Estimates in Chemical Aversion Treatments of Alcoholism.

    ERIC Educational Resources Information Center

    Thurber, Steven

    1985-01-01

    Reports that aggregate studies on alcohol aversion therapy tended to support a moderate level of treatment impact that may have noteworthy practical import. Emetics appeared to generate fairly consistent findings; a paralysis-inducing chemical may produce variable results. (Author/NRB)

  9. An Examination of Family-Involved Approaches to Alcoholism Treatment.

    ERIC Educational Resources Information Center

    Chan, James G.

    2003-01-01

    Introduces the development and theoretical underpinnings of family-involved treatment for alcoholism. Describes several interventions from the family therapy literature with an emphasis on behavioral techniques. Outlines efficacy research and considers some problems with the family approach. (Contains 42 references.) (GCP)

  10. Process Model of Grief Therapy in an Alcohol Treatment Program.

    ERIC Educational Resources Information Center

    Martin, Sherri; Privette, Gayle

    1989-01-01

    Discusses a psychoeducational, experiential group for members of an alcohol treatment program which addressed loss, personal reaction to loss, and grief as a healing process. Explores the relationship between grieving and addiction, and presents the protocol for the group experience. (Author)

  11. The Effects of Drinking Goal on Treatment Outcome for Alcoholism

    ERIC Educational Resources Information Center

    Bujarski, Spencer; O'Malley, Stephanie S.; Lunny, Katy; Ray, Lara A.

    2013-01-01

    Objective: It is well known to clinicians and researchers in the field of alcoholism that patients vary with respect to drinking goal. The objective in this study was to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions. Method: Participants were 1,226…

  12. Alcohol

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Alcohol KidsHealth > For Teens > Alcohol Print A A A ... you can make an educated choice. What Is Alcohol? Alcohol is created when grains, fruits, or vegetables ...

  13. [Women in outpatient treatment for alcohol abuse: sociodemographic and clinical characteristics].

    PubMed

    Esper, Larissa Horta; Corradi-Webster, Clarissa Mendonça; Carvalho, Ana Maria Pimenta; Furtado, Erikson Felipe

    2013-06-01

    Quantitative and descriptive study aimed to identify sociodemographic and clinical characteristics of women undergoing outpatient treatment for alcohol abuse. Data were collected from medical records of women with alcohol-related disorders who were treated at a psychiatric outpatient service We performed a reading and descriptive analysis of such data. The sample was composed of 27 medical records, the average age of women was 50 years, mostly married (59.6%), not working (70.4%) with incomplete primary education (70.4%), with an alcoholic family (81.5%) and other psychiatric diagnoses (70.3%). Losses physical, social and emotional was the most common symptoms resulting from alcohol withdrawal syndrome (66.7%), family conflicts (72%) and "sadness" (79.2%). Family violence was recorded in 11 records (40.7%). There was low education, unemployment, psychiatric comorbidities and the presence of other family members with alcohol abuse as common characteristics. We emphasize the importance of professional knowledge about the peculiarities of female alcoholism for health activities more effective. PMID:24015467

  14. Client Evaluation of Treatment for Alcohol Use Disorder in COMBINE.

    PubMed

    Kirouac, Megan; Witkiewitz, Katie; Donovan, Dennis M

    2016-08-01

    Practitioners and researchers across disciplines have been interested in identifying variables that act as indicators of treatment success or failure and one straightforward approach to measuring treatment success is to assess client satisfaction with treatment. Existing measures of treatment satisfaction do not address the specific aspects relevant to alcohol use disorder (AUD) treatment. Researchers in the COMBINE Study developed a new measure of treatment satisfaction to assess satisfaction in AUD treatment: The Evaluation of Treatment (EOT) measure. The aims of the present study were to examine the factor structure of items from the EOT measure and to examine the association between the EOT measure and other measures of client engagement, as well as AUD treatment outcomes. We also extended the model to test for possible mediation effects of treatment evaluation on the relationship between client treatment engagement components and AUD treatment outcomes. Confirmatory factor analyses indicated a 6-factor model with a higher order treatment satisfaction factor provided an excellent fit to the data (χ2 (246)=499.44, p<0.001, CFI=0.99, TLI=0.98, RMSEA =0.040 (90% CI: 0.035, 0.045). Overall, the latent factor of treatment satisfaction was significantly associated with client engagement predictors and treatment evaluation significantly mediated the associations between both working alliance and treatment expectations in the prediction of alcohol-related problems and global severity. Findings suggest that client evaluations of treatment play a substantial role in predicting AUD treatment outcomes and should be considered in future treatment and research. PMID:27296660

  15. Associations of Personality with Alcohol Use Behaviour and Alcohol Problems in Adolescents Receiving Child Welfare Services

    ERIC Educational Resources Information Center

    Stewart, Sherry Heather; McGonnell, Melissa; Wekerle, Christine; Adlaf, Ed

    2011-01-01

    Four specific personality factors have been theorized to put adolescents at risk for alcohol abuse: hopelessness (HOP), anxiety sensitivity (AS), sensation seeking (SS), and impulsivity (IMP). We examined relations of these personality factors to various alcohol-related indices in a sample at high risk for alcohol problems--specifically, a child…

  16. Focus on alcoholic liver disease: from nosography to treatment.

    PubMed

    Streba, Letiția Adela Maria; Vere, Cristin Constantin; Streba, Costin Teodor; Ciurea, Marius Eugen

    2014-07-01

    Abusive alcohol intake currently ranks as a major cause of liver disease, and is associated with significant mortality worldwide. Alcoholic liver disease (ALD) generically defines liver abnormalities ranging from liver steatosis to the end-stages of disease such as liver cirrhosis. Information regarding the precise incidence and prevalence of ALD is still limited by a lack of large population-based studies and by the absence of large systematic reviews of all epidemiological data available. However, existing collected data show an overall increase in the number of alcohol abusers and alcohol-related liver disease. The burden exerted on medical systems worldwide is significant, with hospitalization and management costs rising constantly over the years. A great number of all cirrhosis-related deaths in Europe and a significant percentage worldwide are associated with alcohol consumption. The main possible risk factors for ALD are the amount and duration of alcohol abuse, patterns of drinking and the type of alcoholic beverage consumed. However, ALD does not progress to cirrhosis in all patients, therefore a series of additional factors are implicated. Even though insufficiently studied, genetic factors are generally regarded as highly important, and the presence of comorbidities and dietary habits seem to play a role in disease onset and progression. This lack of clear pathophysiological data further translates in the absence of definite treatment for ALD and shall prove challenging in the coming years. In this article, we aimed to briefly review epidemiologic data on the burden of ALD, risk factors, clinical and nosographic as well as therapeutic aspects of this disease. Without attempting to be exhaustive, this short topic highlight emphasizes each point and may serve as a general guidance tool in the complicated literature related to ALD. PMID:25009375

  17. Focus on alcoholic liver disease: From nosography to treatment

    PubMed Central

    Streba, Letiția Adela Maria; Vere, Cristin Constantin; Streba, Costin Teodor; Ciurea, Marius Eugen

    2014-01-01

    Abusive alcohol intake currently ranks as a major cause of liver disease, and is associated with significant mortality worldwide. Alcoholic liver disease (ALD) generically defines liver abnormalities ranging from liver steatosis to the end-stages of disease such as liver cirrhosis. Information regarding the precise incidence and prevalence of ALD is still limited by a lack of large population-based studies and by the absence of large systematic reviews of all epidemiological data available. However, existing collected data show an overall increase in the number of alcohol abusers and alcohol-related liver disease. The burden exerted on medical systems worldwide is significant, with hospitalization and management costs rising constantly over the years. A great number of all cirrhosis-related deaths in Europe and a significant percentage worldwide are associated with alcohol consumption. The main possible risk factors for ALD are the amount and duration of alcohol abuse, patterns of drinking and the type of alcoholic beverage consumed. However, ALD does not progress to cirrhosis in all patients, therefore a series of additional factors are implicated. Even though insufficiently studied, genetic factors are generally regarded as highly important, and the presence of comorbidities and dietary habits seem to play a role in disease onset and progression. This lack of clear pathophysiological data further translates in the absence of definite treatment for ALD and shall prove challenging in the coming years. In this article, we aimed to briefly review epidemiologic data on the burden of ALD, risk factors, clinical and nosographic as well as therapeutic aspects of this disease. Without attempting to be exhaustive, this short topic highlight emphasizes each point and may serve as a general guidance tool in the complicated literature related to ALD. PMID:25009375

  18. A psychotherapeutic approach to treatment of a population at high risk for alcoholism: adult children of alcoholics.

    PubMed

    Eve, S I

    1989-01-01

    It is estimated that there are between 25 and 28 million children of alcoholic parent(s) in the United States today. These individuals are at high risk for development of intrapsychic, interpersonal, and behavioural disorder, ie, developing alcoholism (40-60 per cent), becoming involved with an alcoholic (co-alcoholism), feeling a consistent sense of personal inadequacy or an inability to develop satisfying mutually supportive relationships. Major cognitive and emotional deficits appear to exist. Adult children of alcoholics who often experience many years of less-than-fruitful therapy report better results when alcoholic family issues have been adequately addressed. Developmental, existential and systems approaches may be well utilized, as well as non-verbal modalities, in treatment of adult children of alcoholics. Assessment, diagnosis and treatment issues particular to this population will be discussed as well as methods of working with specific barriers exhibited by children of alcoholics in the therapy setting. Implications of treatment will be discussed in relation to primary alcoholism prevention, relapse prevention and the effectiveness of alcoholism treatment programme staff. PMID:2509840

  19. Psychiatric advances in the understanding and treatment of alcohol dependence.

    PubMed

    Madden, J S

    1984-01-01

    Several psychiatric topics have been under recent investigation. Cerebral impairment is now known to occur in over half of alcoholic patients. Its improvement with abstinence and its interference with the considerable intellectual and volitional requirements needed by controlled drinking programmes point to abstinence as the necessary drinking goal when brain damage is suspected. A hereditary element to alcohol dependence has been suggested by several adoption and twin studies, but the many contradictions between research results emphasise that any genetic contribution is overshadowed by socio-cultural factors. Depression and anxiety are frequent accompaniments of alcoholism but are shown by investigations usually as results rather than causes of excessive drinking. The onset of depression with suicidal ideas secondary to alcoholism has been sensitively described, and attention drawn to its identification, potential risk, and prevention. Long-term drug treatments are little used at present, but several developments are feasible. They include an effective long-acting chemical deterrent; drugs to protect against organic damage; sobering agents; immunotherapy; chemical reversal of the neuroadaptive changes responsible for physical dependence; drugs to counteract dysphoria and craving produced by alcohol; pharmacological modification of reflex behaviour; and drugs for the abstinence syndrome and for mood disturbance that are not themselves liable to misuse of dependence. Finally, it is suggested that the syndrome of pathological intoxication is a fictitious state that should be discarded from the descriptive literature. PMID:6398077

  20. Alcohol and Drug Treatment: How It Works, and How It Can Help You

    MedlinePlus

    Alcohol and Drug Treatment How It Works, And How It Can Help You With the Criminal Justice ... positive change. Why get treatment? Using drugs or alcohol may have contributed to your arrest or re- ...

  1. 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as Their Problem

    MedlinePlus

    ... May 28, 2013 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as Their Problem ... in the United States. 1 When Asians and Pacific Islanders (APIs) go to treatment, alcohol is their ...

  2. The role of psychosocial treatments in pharmacotherapy for alcoholism.

    PubMed

    McCaul, Mary E; Petry, Nancy M

    2003-01-01

    Medication treatment for alcohol use disorders often includes a psychotherapy component. The most appropriate psychotherapy to use may depend upon characteristics of the patient, the medication, the setting, and the experiences of the provider. To date, little empirical research has investigated these issues with respect to outcomes in clinical trials that combine pharmacotherapy and psychotherapy. This paper reviews seven major types of psychotherapy for treatment of alcohol use disorders: brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, cue exposure therapy, behavioral treatments, behavioral marital therapy, and twelve-step therapy. The theoretical basis for and empirical evidence supporting the efficacy of the therapies are reviewed, with an emphasis on studies that provided pharmacotherapy in conjunction with psychotherapy. Directions for future research in this area are also suggested. PMID:14972779

  3. Treatment of Non-Alcoholic Fatty Liver Disease.

    PubMed

    Scherer, Antonia; Dufour, Jean-François

    2016-01-01

    Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of conditions from steatosis to cirrhosis and hepatocellular carcinoma. Steatosis is a benign reversible condition, which does not need treatment. Cirrhosis and hepatocellular carcinoma are the end stages of any chronic liver disease and do not have etiology-specific treatments. In this chapter, we will review treatment options for non-alcoholic steatohepatitis, which is the progressive form of NAFLD. Basically there are 2 strategies, the first of which is to address lifestyle and the second to use medication. The first approach is the most physiologic, the least expensive, but is also the most difficult to implement. The second approach, which should help patients who failed the first approach, is at the advanced clinical research stage. PMID:27548081

  4. American Indian/Alaska Native Alcohol-Related Incarceration and Treatment

    PubMed Central

    Feldstein, Sarah W.; Venner, Kamilla L.; May, Philip A.

    2010-01-01

    American Indian/Alaska Natives have high rates of alcohol-related arrests and are overrepresented in justice systems. To understand the relationship between alcohol dependence, treatment, and alcohol-related incarceration, this study queried American Indian/Alaska Natives currently in remission from alcohol dependence. Participants reported receiving 0 to 43 treatment experiences. Moreover, participants had a significantly greater number of alcohol-related incarcerations than all other treatments combined. These findings underline the importance of making alcohol treatment available within criminal justice settings. PMID:17602406

  5. Microbiota-based treatments in alcoholic liver disease

    PubMed Central

    Sung, Hotaik; Kim, Seung Woo; Hong, Meegun; Suk, Ki Tae

    2016-01-01

    Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease (ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcohol-induced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiota-based treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD. PMID:27547010

  6. Microbiota-based treatments in alcoholic liver disease.

    PubMed

    Sung, Hotaik; Kim, Seung Woo; Hong, Meegun; Suk, Ki Tae

    2016-08-01

    Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease (ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcohol-induced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiota-based treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD. PMID:27547010

  7. Alcohol and drug abusers' reasons for seeking treatment.

    PubMed

    Cunningham, J A; Sobell, L C; Sobell, M B; Gaskin, J

    1994-01-01

    Clients at two different treatment facilities were asked at assessment how influential each of 10 possible reasons were in their decision to change their alcohol or drug use. Clients at both facilities most often endorsed "weighing the pros and cons of drinking or drug use" and a "warning from spouse." Client's reasons for seeking treatment were also examined in relation to treatment compliance. Three reasons--"weighing the pros and cons," "hitting rock bottom," and experiencing a "major lifestyle change"--were predictive of treatment compliance. Clients who rated any of these reasons as influential were more likely to enter and complete treatment. Although more research is needed, knowledge of clients' reasons for seeking treatment might be useful in treatment matching. PMID:7701979

  8. Pharmacogenetics of alcohol, nicotine and drug addiction treatments.

    PubMed

    Sturgess, Jessica E; George, Tony P; Kennedy, James L; Heinz, Andreas; Müller, Daniel J

    2011-07-01

    The numerous premature deaths, medical complications and socio-economic repercussions of drug and alcohol addiction suggest that improvements in treatment strategies for addictive disorders are warranted. The use of pharmacogenetics to predict response to medication, side effects and appropriate dosages is relatively new in the field of drug addiction. However, increasing our understanding of the genetic factors influencing these processes may improve the treatment of addiction in the future. We examined the available scientific literature on pharmacogenetic advancements in the field of drug addiction with a focus on alcohol and tobacco to provide a summary of genes implicated in the effectiveness of pharmacotherapy for addiction. In addition, we reviewed pharmacogenetic research on cocaine and heroin dependence. Thus far, the most promising results were obtained for polymorphisms in the OPRM1 and CYP2A6 genes, which have been effective in predicting clinical response to naltrexone in alcoholism and nicotine replacement therapy in smoking, respectively. Opinions differ as to whether pharmacogenetic testing should be implemented in the clinic at this time because clinical utility and cost-effectiveness require further investigation. However, the data summarized in this review demonstrate that pharmacogenetic factors play a role in response to addiction pharmacotherapy and have the potential to aid in the personalization of addiction treatments. Such data may lead to improved cessation rates by allowing physicians to select medications for individuals based, at least in part, on genetic factors that predispose to treatment success or failure rather than on a trial and error basis. PMID:21362114

  9. Age of Alcohol-Dependence Onset: Associations with Severity of Dependence and Seeking Treatment

    ERIC Educational Resources Information Center

    Hingson, Ralph W.; Heeren, Timothy; Winter, Michael R.

    2007-01-01

    Objective: We explored whether people who become alcohol dependent at younger ages are more likely to seek alcohol-related help or treatment or experience chronic relapsing dependence. Methods: In 2001-2002 the National Institute on Alcohol Abuse and Alcoholism completed a face-to-face interview survey with a multistage probability sample of 43…

  10. Alcohol

    MedlinePlus

    ... Text Size: A A A Listen En Español Alcohol Wondering if alcohol is off limits with diabetes? Most people with diabetes can have a moderate amount of alcohol. Research has shown that there can be some ...

  11. Alcohol

    MedlinePlus

    If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...

  12. Drinking Alcohol Surrogates Among Clients of an Alcohol-Misuser Treatment Clinic in Novosibirsk, Russia

    PubMed Central

    BOBROVA, NATALIA; WEST, ROBERT; MALUTINA, DARYA; KOSHKINA, EVGENIA; TERKULOV, RAVIL; BOBAK, MARTIN

    2014-01-01

    A pilot study was conducted in the Russian city Novosibirsk during 2006–2007 with 40 participants sampled from clients admitted to health services for drinking-related problems to explore surrogates for alcoholic beverage drinking using semistructured interviews. Types of surrogates consumed and reasons for their consumption were investigated. Results revealed that the most prevalent reported surrogate used was industrial spirit. The main reasons for drinking surrogates were the high affordability and physical availability of surrogates combined with the need to relieve severe withdrawal symptoms. The study limitations are described, and suggestions for future research are made. PMID:20001282

  13. NCADI's 1995 National Directory of Drug Abuse and Alcoholism Treatment and Prevention Programs That Have a Special Program for American Indians/Alaska Natives.

    ERIC Educational Resources Information Center

    Vanderbilt, Rebecca, Comp.; Schacht, Robert M., Comp.

    This state-by-state directory lists over 500 alcohol and drug abuse treatment and prevention services that target American Indians and Alaska Natives. The directory was compiled from the website of the National Clearinghouse for Alcohol and Drug Information (NCADI). Their home page on the Internet is located at http://www.health.org/index.htm. The…

  14. Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

    PubMed

    Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

    2016-01-01

    primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD. PMID:26990264

  15. Advances in Medications and Tailoring Treatment for Alcohol Use Disorder

    PubMed Central

    Seneviratne, Chamindi; Johnson, Bankole A.

    2015-01-01

    Alcohol use disorder (AUD) is a chronic heritable brain disorder with a variable clinical presentation. This variability, or heterogeneity, in clinical presentation suggests complex interactions between environmental and biological factors, resulting in several underlying pathophysiological mechanisms in the development and progression of AUD. Classifying AUD into subgroups of common clinical or pathological characteristics would ease the complexity of teasing apart underlying molecular mechanisms. Genetic association analyses have revealed several polymorphisms—small differences in DNA—that increase a person’s vulnerability to develop AUD and other alcohol-related intermediate characteristics, such as severity of drinking, age of AUD onset, or measures of craving. They also have identified polymorphisms associated with reduced drinking. Researchers have begun utilizing these genetic polymorphisms to identify alcoholics who might respond best to various treatments, thereby enhancing the effectiveness of currently tested medications for treating AUD. This review compares the efficacy of medications tested for treatment of AUD with and without incorporating genetics. It then discusses advances in pre-clinical genetic and genomic studies that potentially could be adapted to clinical trials to improve treatment efficacy. Although a pharmacogenetic approach is promising, it is relatively new and will need to overcome many challenges, including inadequate scientific knowledge and social and logistic constraints, to be utilized in clinical practice. PMID:26259086

  16. Gabapentin Treatment for Alcohol Dependence: A Randomized Controlled Trial

    PubMed Central

    Mason, Barbara J.; Quello, Susan; Goodell, Vivian; Shadan, Farhad; Kyle, Mark; Begovic, Adnan

    2013-01-01

    -related symptoms of insomnia, dysphoria and craving, with a favorable safety profile. Increased implementation of pharmacological treatment of alcohol dependence in primary care may be a major benefit of gabapentin as a treatment option for alcohol dependence. PMID:24190578

  17. Severe alcoholic hepatitis-current concepts, diagnosis and treatment options

    PubMed Central

    Kim, Won; Kim, Dong Joon

    2014-01-01

    Alcoholic hepatitis (AH) is an acute hepatic manifestation occurring from heavy alcohol ingestion. Alcoholic steatohepatitis (ASH) is histologically characterized by steatosis, inflammation, and fibrosis in the liver. Despite the wide range of severity at presentation, those with severe ASH (Maddrey’s discriminant function ≥ 32) typically present with fever, jaundice, and abdominal tenderness. Alcohol abstinence is the cornerstone of therapy for AH and, in the milder forms, is sufficient for clinical recovery. Severe ASH may progress to multi-organ failure including acute kidney injury and infection. Thus, infection and renal failure have a major impact on survival and should be closely monitored in patients with severe ASH. Patients with severe ASH have a reported short-term mortality of up to 40%-50%. Severe ASH at risk of early death should be identified by one of the available prognostic scoring systems before considering specific therapies. Corticosteroids are the mainstay of treatment for severe ASH. When corticosteroids are contraindicated, pentoxifylline may be alternatively used. Responsiveness to steroids should be assessed at day 7 and stopping rules based on Lille score should come into action. Strategically, future studies for patients with severe ASH should focus on suppressing inflammation based on cytokine profiles, balancing hepatocellular death and regeneration, limiting activation of the innate immune response, and maintaining gut mucosal integrity. PMID:25349640

  18. Services for prisoners with alcohol-related problems: a survey of U.K. prisons.

    PubMed

    McMurran, M; Baldwin, S

    1989-09-01

    Offenders have been identified as heavy drinkers who admit to a relationship between drinking and offending. Many prisoners express a desire to reduce their alcohol consumption. The extent of alcohol interventions in U.K. prisons was unknown and so a postal survey was conducted to gather basic information about current work. Of all responding establishments, 91% claimed to provide services for prisoners with alcohol-related problems and 58% gave details of these services. Services are provided mainly by probation officers/social workers, prison officers and Alcoholics Anonymous. Group and individual interventions are described. Service development has been haphazard, lacking central co-ordination. A case is made for appointment of a central facilitator responsible for staff training, establishing a communications network, encouraging new interventions to match clients' needs, encouraging closer links with community workers and guiding evaluative research. PMID:2790268

  19. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Services of Other Federal Agencies § 17.83 Limitations on payment...

  20. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17.80 Section 17.80 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Services of Other Federal Agencies §...

  1. Belongingness--The Critical Variable in the Residential Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    Machell, David F.

    Many alcohol treatment programs have stressed a sense of belongingness as a means for successful treatment of alcoholics in a residential setting. An examination of the effectiveness of this strategy in highly structured and less structured programs involved 200 chronic, recidivistic male adult alcoholics in a residential program. Subjects were…

  2. Alcohol

    MedlinePlus

    ... Got Homework? Here's Help White House Lunch Recipes Alcohol KidsHealth > For Kids > Alcohol Print A A A Text Size What's in ... What Is Alcoholism? Say No en español El alcohol Getting the Right Message "Hey, who wants a ...

  3. Probiotics and Alcoholic Liver Disease: Treatment and Potential Mechanisms

    PubMed Central

    Li, Fengyuan; Duan, Kangmin; Wang, Cuiling; McClain, Craig; Feng, Wenke

    2016-01-01

    Despite extensive research, alcohol remains one of the most common causes of liver disease in the United States. Alcoholic liver disease (ALD) encompasses a broad spectrum of disorders, including steatosis, steatohepatitis, and cirrhosis. Although many agents and approaches have been tested in patients with ALD and in animals with experimental ALD in the past, there is still no FDA (Food and Drug Administration) approved therapy for any stage of ALD. With the increasing recognition of the importance of gut microbiota in the onset and development of a variety of diseases, the potential use of probiotics in ALD is receiving increasing investigative and clinical attention. In this review, we summarize recent studies on probiotic intervention in the prevention and treatment of ALD in experimental animal models and patients. Potential mechanisms underlying the probiotic function are also discussed. PMID:26839540

  4. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsomporn, Jureerat; Östlund, Gunnel

    2016-01-01

    Background Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers. PMID:27491962

  5. Factors influencing the implementation of a brief alcohol screening and educational intervention in social settings not specializing in addiction services.

    PubMed

    Patterson Silver Wolf Adelv Unegv Waya, David A

    2015-01-01

    Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers. PMID:25905766

  6. Factors influencing the implementation of a brief alcohol screening and educational intervention in social settings not specializing in addiction services

    PubMed Central

    Silver Wolf (Adelv unegv Waya), David A. Patterson

    2015-01-01

    Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers. PMID:25905766

  7. Supervised disulfiram as adjunct to psychotherapy in alcoholism treatment.

    PubMed

    Krampe, Henning; Ehrenreich, Hannelore

    2010-01-01

    Supervised intake of the alcohol deterrent (AD) disulfiram has proven to be an effective adjunct to biopsychosocial alcoholism therapy for more than 60 years. This article summarizes disulfiram literature between 1937 and 2000 and reviews 13 clinical trials of disulfiram in alcoholism treatment from the years 2000 to 2008. After giving an update of general safety issues and recent case reports concerning safety problems with disulfiram, we focus on the introduction of psychotherapeutic application of supervised disulfiram. The results of our review show: (1) Disulfiram proved to be an effective therapeutic tool in all clinical studies published from 2000 to 2008. (2) Comparisons with other pharmacological agents - naltrexone, acamprosate, topiramate and gamma-hydroxybutyrate - indicate that disulfiram was equal in two trials but superior in the majority of trials. (3) Therapy programs that make use of the psychological effects of supervised disulfiram have - independently of the dose - better results than programs that neglect psychological effects. As a consequence, we suggest that supervised low-dose disulfiram (not more than 100mg/d), will show highest success when it is carefully integrated into psychotherapeutic alcoholism therapy. The major program of psychotherapy with disulfiram comprises the steps "Initial psychoeducation about the effect of disulfiram and its therapeutic implications", "Advanced psychoeducation", and "Disulfiram as coping skill and extension of repertoire of coping skills". As psychological mechanisms of supervised disulfiram we suggest: (1) deterrence; (2) (auto)suggestion; (3) therapeutic ritual around (4) a frequently renewed active decision process; (5) continuous reinforcement of a sober lifestyle and development of new coping skills. PMID:20482514

  8. Diagnosis and Treatment of Alcoholic Hepatitis: A Systematic Review.

    PubMed

    Singal, Ashwani K; Kodali, Sudha; Vucovich, Lee A; Darley-Usmar, Victor; Schiano, Thomas D

    2016-07-01

    Alcoholic hepatitis (AH) occurs in about one-third of individuals reporting long-term heavy alcohol use. It is associated with high short-term mortality, economic burden, and hospital resources utilization. We performed this systematic review to (i) describe clinical characteristics and genomics associated with the risk of AH; (ii) discuss role and limitations of liver biopsy and prognostic scoring systems; (iii) summarize evidence regarding the currently available therapies including liver transplantation; and (iv) outline emerging therapies with areas of unmet need. Literature search was performed for studies published in English language (January 1971 through March 2016). The following search engines were used: PubMed, Elsevier Embase, PsycINFO, and Cochrane Library. For the treatment section, only randomized controlled studies were included for this review. A total of 138 studies (59 randomized, 22 systematic reviews or meta-analyses, 7 surveys or guidelines, 7 population-based, and 43 prospective cohorts) were cited. There are over 325,000 annual admissions with AH contributing to about 0.8% of all hospitalizations in the United States. Liver biopsy may be required in about 25 to 30% cases for uncertain clinical diagnosis. Corticosteroids with or without N-acetylcysteine remains the only available therapy for severe episodes. Data are emerging on the role of liver transplantation as salvage therapy for select patients. Abstinence remains the most important factor impacting long-term prognosis. Results from the ongoing clinical trials within the National Institute on Alcohol Abuse and Alcoholism-funded consortia are awaited for more effective and safer therapies. AH is a potentially lethal condition with a significant short-term mortality. A high index of suspicion is required. There remains an unmet need for noninvasive biomarkers for the diagnosis, and predicting prognosis and response to therapy. PMID:27254289

  9. Treatment of alcoholic violent offenders: ethics and efficacy.

    PubMed

    Chick, J

    1998-01-01

    The published literature tends to find that the outcome of mandatory treatment for alcohol dependence is no worse than that for 'voluntary' treatment. Supervised disulfiram has been shown to improve outcome in Court-referred patients. When offenders take treatment offered as part of probation or a deferred sentence, they choose to do so, rather than face a penalty. It is not a 'free' choice in the usual sense, but the outcome can be beneficial to the offender as well as to society and this helps to justify its use. Coping and social skills therapy have value, as probably have antipsychotic and antidepressant drugs in some cases. Supervised disulfiram has a role supported by controlled studies. PMID:9539172

  10. Age at Onset of Alcohol Use and Alcohol Use Disorder: Time-trend Study in Patients Seeking De-addiction Services in Kerala

    PubMed Central

    Nair, Unnikrishnan Reghukumaran; Vidhukumar, K.; Prabhakaran, Anil

    2016-01-01

    Background: Declining age at onset of alcohol consumption over years has been one of the alarming findings in the epidemiology of alcoholism. The study was done to examine whether there was a decline in the age at onset of alcohol use and use disorder in subjects categorized as birth cohorts over the last 60 years seeking de-addiction services from a teaching hospital. Materials and Methods: A time-trend study, based on data collected from records, was done among 700 randomly selected subjects seeking de-addiction services. The study was done in a Government Medical College. Besides birth year, family history of alcohol use disorder and psychiatric comorbidity were the main independent variables studied. Trend was tested by linear regression. Results: There was a significant linear decline in the age at onset of alcohol use and use disorder. The mean age at onset of alcohol use and alcohol use disorder declined from 24 to 17 years and 46 to 21 years, respectively, from the pre-1950 birth cohort to the post-1985 birth cohort. Surprisingly, there was a plateau for mean age at onset of alcohol use during 1960s. The trend was significant even after adjusting for variables related to age at onset of alcohol consumption. Conclusions: The trend of decreasing age at onset of alcohol use and alcohol use disorder over time has policy implications. Further studies are needed for exploring mediating or causal factors for the decline in the age at onset of alcohol use and use disorder. PMID:27570342

  11. Treatment of non‐alcoholic fatty liver disease

    PubMed Central

    Adams, L A; Angulo, P

    2006-01-01

    Non‐alcoholic fatty liver disease (NAFLD) is common and may progress to cirrhosis and its complications. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance and oxidative stress. Therefore, management entails identification and treatment of metabolic risk factors, improving insulin sensitivity, and increasing antioxidant defences in the liver. Weight loss and exercise improve insulin sensitivity. Bariatric surgery may improve liver histology in patients with morbid obesity. Insulin sensitising drugs showed promise in pilot trials as have a number of hepatoprotective agents. Further randomised, well controlled trials are required to determine the efficacy of these drugs. PMID:16679470

  12. Alcohol

    MedlinePlus

    ... as well as injuries, liver disease, heart disease, cancer, and other health problems. It can also cause problems at home, at work, and with friends. NIH: National Institute on Alcohol Abuse and Alcoholism

  13. Alcoholism.

    ERIC Educational Resources Information Center

    Caliguri, Joseph P., Ed.

    This extensive annotated bibliography provides a compilation of documents retreived from a computerized search of the ERIC, Social Science Citation Index, and Med-Line databases on the topic of alcoholism. The materials address the following areas of concern: (1) attitudes toward alcohol users and abusers; (2) characteristics of alcoholics and…

  14. [Alcohol consumption in administrative and service personnel in an Ecuadorian university].

    PubMed

    Bravo Ortiz, Carmita María; Marziale, Maria Helena Palucci

    2010-01-01

    The aim of this descriptive study was to characterize the consumption of alcohol among workers in the administrative and service sectors at an Ecuadorian university and to determine differences in consumption between the two groups of workers. The Alcohol Use Disorders Identification Test (AUDIT) was applied to 102 participants. The results showed that the service personnel consumed more alcohol than the administrative personnel with a mean total score of 7.26 against 1.84. The total prevalence of non-prejudicial consumption was 79.41%, prejudicial consumption 19.61% and dependency 0.98%. The total scores of 76.47% of the participants were within risk zone one; 18.63% risk zone two; 3.92% risk zone three; 0.98% risk zone four. In conclusion, due to the identification of hazardous consumption, it is necessary to implement a program of alcohol use prevention in the institution studied. PMID:20694416

  15. Cognitive Dysfunction, Locus of Control and Treatment Outcome among Chronic Alcoholics.

    ERIC Educational Resources Information Center

    Abbott, Max W.

    While alcoholism is no longer regarded as a unitary disorder, conventional measures of congition and personality have yet to be shown capable of consistently predicting clinical outcomes. To investigate cognitive dysfunction and locus of control as predictors of post treatment outcome in a large sample of alcoholics, 106 alcoholics (74 men, 32…

  16. Towards rational treatment of severe psoriasis in alcoholics: report of two cases.

    PubMed

    Aronson, Peter J; Malick, Farah

    2010-04-01

    Alcoholism is a risk factor in the worsening of psoriasis. The authors present two cases of flared severe psoriasis in alcoholic patients showing dramatic improvement of their skin disease using treatments directed towards correcting abnormalities commonly found as sequelae of alcoholism such as endotoxin production, low serum magnesium levels and elevated plasma homocysteine levels. PMID:20514802

  17. American Indian/Alaska Native Alcohol-Related Incarceration and Treatment

    ERIC Educational Resources Information Center

    Feldstein, Sarah W.; Venner, Kamilla L.; May, Philip A.

    2006-01-01

    American Indian/Alaska Natives have high rates of alcohol-related arrests and are overrepresented in justice systems. To understand the relationship between alcohol dependence, treatment, and alcoholrelated incarceration, this study queried American Indian/Alaska Natives currently in remission from alcohol dependence. Participants reported…

  18. A Randomized Trial of Individual and Couple Behavioral Alcohol Treatment for Women

    ERIC Educational Resources Information Center

    Mccrady, Barbara S.; Epstein, Elizabeth E.; Cook, Sharon; Jensen, Noelle; Hildebrandt, Thomas

    2009-01-01

    Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and…

  19. The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

    ERIC Educational Resources Information Center

    Baird, Francis X.; Frankel, Arthur J.

    2001-01-01

    Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

  20. Additional Treatment Services in a Cocaine Treatment Study: Level of Services Obtained and Impact on Outcome

    PubMed Central

    Worley, Matthew; Gallop, Robert; Gibbons, Mary Beth Connolly; Ring-Kurtz, Sarah; Present, Julie; Weiss, Roger D.; Crits-Christoph, Paul

    2009-01-01

    The objective of this study was to examine the level of additional treatment services obtained by patients enrolled in the NIDA Cocaine Collaborative Study, a multi-center efficacy trial of four treatments for cocaine dependence, and to determine whether these services impact treatment outcome. Cocaine-dependent patients (N = 487) were recruited at five sites and randomly assigned to six months of one of four psychosocial treatments. Assessments were made at baseline, monthly during treatment, and at follow-ups at 9, 12, 15, and 18 months post-randomization. On average, patients received little or no additional treatment services during active treatment (first 6 months), but the rate of obtaining most services increased during the follow-up phase (month 7 to 18). In general, the treatment groups did not differ in the rates of obtaining non-protocol services. For all treatment groups, patients with greater psychiatric severity received more medical and psychiatric services during active treatment and follow-up. Use of treatment services was unrelated to drug use outcomes during active treatment. However, during the follow-up period, increased use of psychiatric medication, 12-step attendance, and 12-step participation was related to less drug use. The results suggest that during uncontrolled follow-up phases, additional non-protocol services may potentially confound the interpretation of treatment group comparisons in drug use outcomes. PMID:18463998

  1. The Role of Family Members in the Treatment of Women Alcoholics.

    ERIC Educational Resources Information Center

    Tavarone, Antonia R.

    Alcoholism is frequently called a family disease; encouraging and even insisting that family members participate in the treatment of alcoholics has become routine practice in almost every treatment setting. This study examined the relationship between treatment participation by a family member and two measures of recovery for three birth cohorts…

  2. Ecological Momentary Assessment and Alcohol Use Disorder Treatment

    PubMed Central

    Morgenstern, Jon; Kuerbis, Alexis; Muench, Frederick

    2014-01-01

    The ability to capture real-time data on human behavior inexpensively, efficiently, and accurately holds promise to transform and broaden our understanding of many areas of health science. One approach to acquiring this type of real-time data is ecological momentary assessment (EMA). This method has been used to collect data in many domains of addiction research, including research on the treatment of alcohol use disorders (AUDs). Empirical evidence supports the hypothesis that use of EMA can improve the quality of AUD treatment research when compared with standard assessment methods because it provides more accurate reporting, allows investigators to examine the dynamic unfolding of the behavior change process at an individual level, and can be used to augment and improve clinical assessment and treatment. Overall, the existing literature provides strong support for the advantages of EMA when combined with standard assessment of addictive behaviors in general. Nevertheless, use of EMA in AUD treatment research thus far has been limited, especially in the area of research on mechanisms of behavior change. Existing research indicates, however, that EMA can be used to deliver tailored feedback as a novel and potentially transformative approach to improving AUD treatment. This research area clearly warrants additional future efforts. PMID:26259004

  3. [Guideline-oriented treatment of alcohol-related disorders].

    PubMed

    Mann, K; Hoch, E; Batra, A; Bonnet, U; Günthner, A; Reymann, G; Soyka, M; Wodarz, N; Schäfer, M

    2016-01-01

    Alcohol use disorders (e.g. abuse and dependence) account for a plethora of consequences for affected individuals and for a substantial proportion of the overall burden of disease for the community. To date, existing treatment options are either poorly known by doctors or they are not fully applied and only approximately 15% of potential patients are treated with a mean latent period of 10 years between early symptoms and the first intervention. So-called S3 treatment guidelines were recently developed to close this gap. Representatives of more than 50 learned societies, families and patients were involved. A systematic literature search from 2005 to 2012 was performed and more than 120 recommendations were made. Financing came exclusively from those societies and the academic and treatment institutes involved.This article summarizes the recommendations pertinent for psychiatrists and include early detection and intervention, acute withdrawal and long-term psychotherapy and pharmacotherapy. Classical and new treatment goals are discussed. If the new guidelines were properly applied an increase in patients receiving treatment to 30-40% could be expected, which would improve the quality of lives of affected persons and their families and in Germany would save several thousand lives per year. PMID:26670021

  4. Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

    PubMed

    Searby, Adam; Maude, Phil; McGrath, Ian

    2016-03-01

    Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements. PMID:26834037

  5. Pathways to Vulnerability for Alcohol Problem Severity in a Treatment-Seeking Sample

    PubMed Central

    Eddie, David; Epstein, Elizabeth E.; Cohn, Amy M.

    2014-01-01

    Objectives The present investigation examined the role of gender, family history of alcohol and drug use disorders, temperament, childhood behavior problems, and adult psychopathology, on adult alcohol use disorder (AUD) severity. Methods Structural equation modeling was used to examine multiple etiological pathways to adult alcohol use disorder (AUD) severity. Participants included 335 treatment-seeking males and females with current or lifetime DSM-III-R alcohol dependence (96%) or abuse (4%) enrolled in one of five treatment outcome studies. Extensive assessment at treatment entry used a mixture of retrospective and current self-report. Results Results identified two significant paths associated with a latent factor of adult alcohol use disorder severity at entry to treatment. In Path 1, male gender and family history of drug use disorder predicted greater childhood behavior problems, which predicted antisocial personality disorder (ASPD), borderline personality disorder (BPD), and anxiety disorders (ADs), with anxiety disorders leading directly to alcohol use disorder severity. In Path 2, family history of alcohol use disorder predicted difficult temperament in childhood, which predicted borderline personality disorder, major depressive disorder (MDD) and anxiety disorders; both major depressive disorder and anxiety disorders in turn predicted alcohol use disorder severity at treatment entry. Conclusions The present findings build on the literature on heterogeneity in developmental risk processes leading to the expression of adult alcohol use disorder symptomology among patients presenting for alcohol use disorder treatment. PMID:26170766

  6. Job Training and Employment Services for Homeless Persons with Alcohol and Other Drug Problems. A Technical Assistance Paper.

    ERIC Educational Resources Information Center

    Bennett, Gerald; And Others

    This report summarizes the relevant research that connects homelessness, alcohol and other drug abuse, and employment and job training services. It draws on the National Institute on Alcohol Abuse and Alcoholism and the Department of Labor demonstration projects as well as other programs to provide examples of various innovative programs across…

  7. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82...

  8. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82...

  9. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the... Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and the “Confidentiality of Certain Medical... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82...

  10. Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism.

    PubMed

    Krampe, Henning; Stawicki, Sabina; Hoehe, Margret R; Ehrenreich, Hannelore

    2007-01-01

    Alcohol dependence is a frequent, chronic, relapsing, and incurable disease with enormous societal costs. Thus, alcoholism therapy and research into its outcome are of major importance for public health. The present article will: (i) give a brief overview of the epidemiology, pathogenesis, and treatment outcomes of alcohol dependence; (ii) introduce the basic principles of outpatient long-term therapy of alcohol-dependent patients; and (iii) discuss in detail process-outcome research on Outpatient Long-term Intensive Therapy for Alcoholics (OLITA). This successful biopsychosocial approach to the treatment of alcoholism shows a 9-year abstinence rate of over 50%, a re-employment rate of 60%, and a dramatic recovery from comorbid depression, anxiety disorders, and physical sequelae. The outcome data are empirically based on treatment processes that have proven high predictive validity and give concrete information about where to focus the therapeutic efforts. Thus, process-outcome research on OLITA can serve for the development of new therapeutic guidelines on adapting individual relapse prevention strategies. PMID:18286800

  11. Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism

    PubMed Central

    Krampe, Henning; Stawicki, Sabina; Hoehe, Margret R.; Ehrenreich, Hannelore

    2007-01-01

    Alcohol dependence is a frequent, chronic, relapsing, and incurable disease with enormous societal costs. Thus, alcoholism therapy and research into its outcome are of major importance for public health. The present article will: (i) give a brief overview of the epidemiology, pathogenesis, and treatment outcomes of alcohol dependence; (ii) introduce the basic principles of outpatient long-term therapy of alcohol-dependent patients; and (iii) discuss in detail process-outcome research on Outpatient Long-term intensive Therapy for Alcoholics (OLITA). This successful biopsychosocial approach to the treatment of alcoholisms shows a 9-year abstinence rate of over 50%, a re-employment rate of 60%, and a dramatic recovery from comorbid depression, anxiety disorders, and physical sequelae. The outcome data are empirically based on treatment processes that have proven high predictive validity and give concrete information about where to focus the therapeutic efforts. Thus, process-outcome research on OLITA can serve for the development of new therapeutic guidelines on adapting individual relapse prevention strategies. PMID:18286800

  12. Treatment of non-alcoholic fatty liver disease

    PubMed Central

    Tolman, Keith G; Dalpiaz, Anthony S

    2007-01-01

    Non-alcoholic fatty liver disease, defined as the presence of macrovascular steatosis in the presence of less than 20 gm of alcohol ingestion per day, is the most common liver disease in the USA. It is most commonly associated with insulin resistance/type 2 diabetes mellitus and obesity. It is manifested by steatosis, steatohepatitis, cirrhosis, and, rarely, hepatocellular carcinoma. Hepatic steatosis results from an imbalance between the uptake of fat and its oxidation and export. Insulin resistance, predisposing to lipolysis of peripheral fat with mobilization to and uptake of fatty acids by the liver, is the most consistent underlying pathogenic factor. It is not known why some patients progress to cirrhosis; however, the induction of CYP 2E1 with generation of reactive oxygen species appears to be important. Treatment is directed at weight loss plus pharmacologic therapy targeted toward insulin resistance or dyslipidemia. Bariatric surgery has proved effective. While no pharmacologic therapy has been approved, emerging data on thiazolidinediones have demonstrated improvement in both liver enzymes and histology. There are fewer, but promising data, with statins which have been shown to be hepatoprotective in other liver diseases. The initial enthusiasm for ursodeoxycholic acid has not been supported by histologic studies. PMID:18516264

  13. Financing of substance abuse treatment services.

    PubMed

    Horgan, C M; Merrick, E L

    2001-01-01

    The financing of treatment for substance abuse problems has differed from the rest of financing of health care in part because of the dominant role of the public sector as the payer of services. Nonetheless, the rise of managed care has affected substance abuse treatment services as well as the rest of the health care system. Alternative payment mechanisms are one important component of some managed care approaches. Behavioral health carve-outs are another managed care development that has affected substance abuse services. In this chapter, salient features of financing for substance abuse treatment are reviewed within the conceptual framework of payers (purchasers and intermediaries), providers, and consumers. Existing literature on substance abuse treatment financing is summarized, while recognizing that much remains to be researched. PMID:11449744

  14. Rehabilitation of the Alcoholic. A Training Guide. A Report from the Study Group on Rehabilitation of the Alcoholic and Public Offender. Rehabilitation Services Series Number 69-11.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (DHEW), Washington, DC.

    The many difficulties involved in diagnosing, classifying and treating alcoholics comprise the bulk of the report's content. The very specific social and medical needs of the alcoholic, coupled with personal, social and treatment agency barriers, are viewed as the major feasibility (for treatment outcome) factors. The report recommends six major…

  15. Treatment for Alcohol Problems: Finding and Getting Help

    MedlinePlus

    ... plans for individuals without health insurance. An Ongoing Process Overcoming an alcohol use disorder is an ongoing ... overcoming problem drinking. Relapse Is Part of the Process Relapse is common among people who overcome alcohol ...

  16. The BRENDA model: integrating psychosocial treatment and pharmacotherapy for the treatment of alcohol use disorders.

    PubMed

    Starosta, Aron N; Leeman, Robert F; Volpicelli, Joseph R

    2006-03-01

    While the U.S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  17. The BRENDA Model: Integrating Psychosocial Treatment and Pharmacotherapy for the Treatment of Alcohol Use Disorders

    PubMed Central

    Starosta, Aron N.; Leeman, Robert F.; Volpicelli, Joseph R.

    2009-01-01

    While the U. S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  18. Identifying Alcoholism in Families Seeking Mental Health Treatment.

    ERIC Educational Resources Information Center

    Bayer, Gregory A.; Bayer, Marilyn A.

    A family system is intimately affected by the presence of an alcoholic within the system. One symptom of alcoholism is the development of elaborate defenses. In response to the defense of the alcoholic, each family member develops individual well established and unique defenses. The diagnosis of the defenses is essential in determining the nature…

  19. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  20. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  1. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  2. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  3. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  4. [Natural recovery and treatment recovery from drug and alcohol abuse].

    PubMed

    Pérez Gómez, Augusto; Sierra Acuña, Diana Raquel

    2007-01-01

    This study examines the concept of natural recovery (without formal treatment) from problems associated with alcohol, marijuana, cocaine and heroin abuse, each one alone or in any combination. Two groups of males (40 Ss between 18 and 60 years of age) and two groups of females (19 Ss between 18 and 55 years of age) with at least one year of abstinence were studied. The main issues considered were: reason for attending treatment or ceasing the use of substances, factors related to maintenance of abstinence, and difficulties and threats associated with abstinence. Several significant differences were found between groups with and without treatment, as well as between males and females, particularly regarding factors related to the maintenance of abstinence. In both cases family and affective links appear as the most relevant factors in the decision to stop using substances. On the other hand, commitment to one's goals and life project are the principal motives for maintaining abstinence or moderate consumption. This reflects the progressive transition from cognitive and emotional processes with external referents to processes with internal referents, associated with personal achievement. PMID:18173103

  5. Behavioral treatment of alcohol and drug abuse. What do we know and where shall we go?

    PubMed

    Hester, R K; Nirenberg, T D; Begin, A M

    1990-01-01

    Over the last 20 years there has been a substantial increase in the use of alcohol and drugs in industrialized nations and a concomitant shift in the emphasis of treatment for alcohol and drugs. Rather than seeking treatment for alcohol alone or a single class of drug, many individuals are seeking treatment for alcohol and/or a number of drugs. While theoreticians have been exploring the similarities in the addictive behaviors, clinical researchers are only just beginning to do so. Unfortunately, most treatment research has focused almost exclusively on alcohol abusers or drug abusers, with little research conducted to date with alcohol and drug abusers. Behavioral interventions developed for alcohol abuse are now being tested with drug abusers, and vice versa. The purpose of this chapter is fourfold: (1) to briefly discuss the similarities in the assessment of alcohol and drug abuse; (2) to describe behavioral interventions that have been supported by research and briefly review this treatment outcome research; (3) to discuss the theoretical similarities in behavioral interventions for alcohol and drug abuse; and (4) to make recommendations for future advancements in treatment and research. PMID:2185523

  6. Mental Health Experts’ Perspectives on Barriers to Dissemination of Couples Treatment for Alcohol Use Disorders

    PubMed Central

    Schonbrun, Yael Chatav; Stuart, Gregory L.; Wetle, Terrie; Glynn, Tiffany R.; Titelius, Elise N.; Strong, David

    2016-01-01

    Despite evidence supporting the efficacy of couples-based approaches to treating alcohol problems, provision of such treatments has been limited. To better understand the limited use of this treatment, the current study explored barriers to the adoption of couples treatment for alcohol use disorders. Experts in alcohol treatment, couples treatment, and behavioral couples treatment for alcohol problems (n = 12) were interviewed on this topic; interview transcripts were analyzed using grounded theory qualitative procedures. All mental health experts endorsed the perspective that implementation and acceptance of couples treatment posed difficulties for providers. Four themes (logistical barriers at the provider level, logistical barriers at the system levels, provider treatment preferences, and lack of appropriate training) were identified. Results from the current study provide guidance in addressing barriers to the adoption of couples-based treatments. PMID:22449088

  7. Does Individual Treatment for Alcoholic Fathers Benefit Their Children? A Longitudinal Assessment

    ERIC Educational Resources Information Center

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J.; Fals-Stewart, William

    2006-01-01

    Psychosocial adjustment in children of alcoholics (COAs; N = 125) was examined before and at 3 follow-ups in the 15 months after their fathers entered alcoholism treatment. Before their fathers' treatment, COAs exhibited greater overall and clinical-level symptomatology than children from the demographically matched comparison sample, but they…

  8. The Role of Therapeutic Alliance in Treatment for People with Mild to Moderate Alcohol Dependence

    ERIC Educational Resources Information Center

    Richardson, Deirdre F.; Adamson, Simon J.; Deering, Daryle E. A.

    2012-01-01

    In an exploratory study of Therapeutic Alliance (TA) in brief outpatient treatment for alcohol dependence the relationship was investigated between TA and treatment outcome (measured at 6 weeks and 6 months) for 69 alcohol dependent clients participating in a randomised control trial between Motivational Enhancement Therapy and Non Directive…

  9. International survey of diagnostic services for children with Fetal Alcohol Spectrum Disorders

    PubMed Central

    Peadon, Elizabeth; Fremantle, Emily; Bower, Carol; Elliott, Elizabeth J

    2008-01-01

    Background Early diagnosis and intervention for children with Fetal Alcohol Spectrum Disorder (FASD) reduces the risk of developing a range of secondary social, emotional and behavioural problems and provides an opportunity for prevention of further alcohol exposed pregnancies. The objective of this study was to describe specialist clinical service provision for the diagnosis and assessment of children exposed to alcohol in pregnancy. Methods Fetal Alcohol Spectrum Disorder (FASD) diagnostic clinics were identified through literature and internet searches. Clinics were sent a questionnaire asking for information on the clinic population, clinic staff, assessment process and other services provided. Results Questionnaires were completed for 34 clinics: 29 were in North America, 2 in Africa, 2 in Europe and 1 in South America. No clinics were identified in Asia or Australasia. There was a variety of funding sources, services offered, clinic populations, staff and methods of assessment. Thirty-three clinics had a multi-disciplinary team. In 32 clinics, at least one member of the team had specialist training in assessment of FASD. Neurobehavioural assessment was completed in 32 clinics. Eleven clinics used more than one set of diagnostic criteria or an adaptation of published criteria. Conclusion Diagnostic services are concentrated in North America. Most responding clinics are using a multidisciplinary approach with neurobehavioural assessment as recommended in published guidelines. Agreement on diagnostic criteria would enable comparison of clinical and research data, and enhance FASD research particularly for intervention trials. PMID:18412975

  10. Quality Assurance for Alcohol, Drug Abuse, and Mental Health Services: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Towery, O. B.; And Others

    This is a comprehensive bibliography for all those in the alcohol, drug abuse and mental health fields who are developing and implementing programs for assuring quality in the services they provide. A major problem is the newness of the language and the unfamilarity with procedures required by the government and others seeking accountability from…

  11. Alcohol and the law.

    PubMed

    Karasov, Ariela O; Ostacher, Michael J

    2014-01-01

    Society has had an interest in controlling the production, distribution, and use of alcohol for millennia. The use of alcohol has always had consequences, be they positive or negative, and the role of government in the regulation of alcohol is now universal. This is accomplished at several levels, first through controls on production, importation, distribution, and use of alcoholic beverages, and second, through criminal laws, the aim of which is to address the behavior of users themselves. A number of interventions and policies reduce alcohol-related consequences to society by regulating alcohol pricing, targeting alcohol-impaired driving, and limiting alcohol availability. The legal system defines criminal responsibility in the context of alcohol use, as an enormous percentage of violent crime and motor death is associated with alcohol intoxication. In recent years, recovery-oriented policies have aimed to expand social supports for recovery and to improve access to treatment for substance use disorders within the criminal justice system. The Affordable Care Act, also know as "ObamaCare," made substantial changes to access to substance abuse treatment by mandating that health insurance include services for substance use disorders comparable to coverage for medical and surgical treatments. Rather than a simplified "war on drugs" approach, there appears to be an increasing emphasis on evidence-based policy development that approaches alcohol use disorders with hope for treatment and prevention. This chapter focuses on alcohol and the law in the United States. PMID:25307602

  12. Dose Specific Effects of Olanzapine in the Treatment of Alcohol Dependence

    PubMed Central

    Littlewood, Rae A.; Claus, Eric D.; Arenella, Pamela; Bogenschutz, Michael; Karoly, Hollis; Feldstein Ewing, Sarah W.; Bryan, Angela D.; Hutchison, Kent E.

    2014-01-01

    Rationale It is well-established that the rewarding effects of alcohol are modulated by the mesolimbic dopaminergic system. Olanzapine, a D2 dopamine antagonist, has been shown to reduce alcohol craving and consumption. Objective To clarify whether olanzapine has clinical utility in the treatment of alcohol dependence, a 12-week, double-blind, randomized clinical trial was conducted. Methods One-hundred twenty-nine treatment-seeking alcohol dependent adults were randomly assigned to 12-weeks of olanzapine (5mg vs. 2.5mg) or placebo. Outcomes examined were average drinks per drinking day (DDD), proportion of drinking days to total days in treatment (PDD), alcohol craving, and impaired control over alcohol use. Mixed models were used to examine medication effects during the course of treatment on specified outcomes. Results All of the analyses indicated a main effect for time, such that there were reductions in alcohol use and craving and an increase in control over alcohol use across treatment conditions. Dose-response analyses indicated that, in comparison to placebo, participants in the 5mg group experienced reduced craving for alcohol and participants in the 2.5mg group decreased in PDD and increased in their control over alcohol use. Better control over alcohol use remained significant 6 months post-treatment for the 2.5mg group. Subjective experiences of the medication suggest that 2.5mg and 5mg were equally well-tolerated. Conclusions Results provide some support for the notion that dosage is an important consideration in relation to effectiveness; however, the cost-benefit balance does not support the clinical utility of olanzapine in treating alcohol dependence. PMID:25304864

  13. Dynamic Association between Negative Affect and Alcohol Lapses following Alcohol Treatment

    ERIC Educational Resources Information Center

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-01-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the…

  14. Safety and tolerability of gamma-hydroxybutyric acid in the treatment of alcohol-dependent patients.

    PubMed

    Beghè, F; Carpanini, M T

    2000-04-01

    Gamma-hydroxybutyric acid (GHB) has been in clinical use in Italy since 1991 for treatment of alcohol dependence. Results of phase III and phase IV studies have shown that the drug is effective and well tolerated in the treatment of alcohol withdrawal syndrome and in reducing alcohol consumption and alcohol craving. Pharmacosurveillance indicates that abuse of gamma-hydroxybutyric acid is a limited phenomenon in clinical settings when the drug is dispensed under strict medical surveillance and entrusted to a referring familiar member of the patient. PMID:10869863

  15. Alcohol.

    ERIC Educational Resources Information Center

    Schibeci, Renato

    1996-01-01

    Describes the manufacturing of ethanol, the effects of ethanol on the body, the composition of alcoholic drinks, and some properties of ethanol. Presents some classroom experiments using ethanol. (JRH)

  16. Effective Treatment in Home-Based Services.

    ERIC Educational Resources Information Center

    Simboli, Tim; Darou, Wes G.

    The use of home-based treatment programs has become increasingly popular over the last few years. Such a program is offered by the Youth Services Bureau of Ottawa-Carleton through its Detached Worker Program. This program uses paraprofessionals who employ an eclectic combination of behavioral, client-centered, family and reality therapies. Two…

  17. Topiramate Treatment of Alcohol Use Disorder in Veterans with PTSD: A Randomized Controlled Pilot Trial

    PubMed Central

    Batki, Steven L.; Pennington, David L.; Lasher, Brooke; Neylan, Thomas C.; Metzler, Thomas; Waldrop, Angela; Delucchi, Kevin; Herbst, Ellen

    2014-01-01

    Background The course of posttraumatic stress disorder (PTSD) is frequently and severely complicated by co-occurring alcohol use disorder (AUD), yet there are few reports of pharmacologic treatments for these co-morbid conditions. The objective of this pilot study was to obtain a preliminary assessment of the efficacy and safety of topiramate in reducing alcohol use and PTSD symptoms in veterans with both disorders. Methods This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot trial of flexible-dose topiramate up to 300mg/day in 30 veterans with PTSD and AUD. The primary outcome measure was frequency of drinking. Secondary outcomes consisted of other measures of alcohol use and PTSD symptom severity. Results Within-group analyses showed that topiramate treatment was associated with significant reductions in frequency and amount of alcohol use and alcohol craving from baseline through week 12. Between-group analyses showed that topiramate reduced frequency of alcohol use and alcohol craving significantly more than placebo and tended to reduce drinking amount. Topiramate treatment was also associated with decreased PTSD symptom severity and tended to reduce hyperarousal symptoms compared to placebo. Topiramate transiently impaired learning and memory, with significant recovery by the end of treatment. Conclusions These preliminary results indicate that in veterans with co-occurring PTSD and AUD, topiramate may be effective in reducing alcohol consumption, alcohol craving, and PTSD symptom severity – particularly hyperarousal symptoms.. Topiramate was associated with transient cognitive impairment but was otherwise well tolerated. PMID:25092377

  18. IS CIGARETTE SMOKING RELATED TO ALCOHOL USE DURING THE 8 YEARS FOLLOWING TREATMENT FOR ADOLESCENT ALCOHOL AND OTHER DRUG ABUSE?

    PubMed Central

    MYERS, MARK G.; DORAN, NEAL M.; BROWN, SANDRA A.

    2007-01-01

    Aims The present study examined the relationship between cigarette smoking and alcohol use outcomes over an 8-year period following treatment for adolescent alcohol and other drug (AOD) use disorders. Methods The present study was based on a sample of 166 adolescents recruited during inpatient AOD abuse treatment. Included in this study were 123 (74% of the full sample) participants, of whom 41% were female, 81% identified themselves as White and who averaged 15.9 years of age (SD = 1.3) when entering treatment. Data for the present study were drawn from interviews conducted at the time of treatment and 2-, 4-, 6- and 8-years post-treatment. Results Twenty six percent of participants had quit smoking for >1 year at the 8-year assessment, while 44% reported persistent smoking over time. Overall smoking rates decreased significantly over time. Subjects associated with the highest alcohol involvement trajectory reported significantly greater likelihood of persistent smoking as well as higher current smoking and cigarette consumption across time points. Conclusions The significant declines observed in smoking from adolescence into young adulthood were contrary to expectations, indicating that this behaviour may be less stable than previously thought among adolescent AOD abusers. Smoking involvement over time was greater within the highest alcohol use trajectory, consistent with previous evidence for a positive relationship between these behaviours. However, when compared with the general population smoking rates remained very high regardless of alcohol involvement. Thus, individuals treated for AOD abuse as adolescents remained at elevated risk for tobacco related disease regardless of post-treatment AOD use outcomes. PMID:17526632

  19. Examining Perceived Alcoholism Stigma Effect on Racial-Ethnic Disparities in Treatment and Quality of Life Among Alcoholics*

    PubMed Central

    Smith, Sharon M.; Dawson, Deborah A.; Goldstein, Risë B.; Grant, Bridget F.

    2010-01-01

    Objective: The aim of this study was to examine racial-ethnic differences in perceived stigmatization of former alcoholics and their effect on associations of race-ethnicity with treatment history and psychological function among lifetime alcoholics. Method: Logistic regression analyses were conducted using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of U.S. adults 18 years or older. Results: Stigma scores were lowest for Whites and Native Americans, higher for Blacks, and highest for Asians and Hispanics, both in the total population and among lifetime alcoholics. Neither race-ethnicity nor stigma was associated with treatment utilization. Psychological function was negatively associated with stigma, but the impact of stigma on racial-ethnic differences in psychological function fell short of statistical significance. Conclusions: Stigma may reduce quality of life among those with alcohol dependence, but there is no clear evidence that it affects racial-ethnic differences in quality of life. PMID:20230720

  20. Alcohol and Drug Abusers Entering Treatment: How Different Are They?

    ERIC Educational Resources Information Center

    Seraganian, Peter; And Others

    A major shift in drug abuse epidemiology has been witnessed in North America over the past decade. Although alcohol continues to be widely abused, usage of other substances has proliferated. While addicted individuals share some attributes, certain demographic, psychological, and cognitive characteristics may distinguish alcoholics from those who…

  1. 3 R's in the Marital Treatment of Alcohol Abuse.

    ERIC Educational Resources Information Center

    Schlesinger, Stephen E.

    Alcohol abuse imposes financial, social, and emotional burdens on drinkers and their families. Couples suffering from alcohol-related problems who seek therapy often have expectations of retribution, restitution, and refuge. Although thoughts of retribution are difficult to elicit in therapy, non-drinking spouses often expect to inflict pain on…

  2. Cost of specialized addiction treatment of clients with fetal alcohol spectrum disorder in Canada

    PubMed Central

    2013-01-01

    Background Individuals with Fetal Alcohol Spectrum Disorder (FASD) constitute a special population that may be at particularly high risk for substance use. The purpose of the current study was to estimate the utilization of specialized addiction treatment services (SATS) and the associated cost, as a part of the total cost of health care associated with FASD in Canada. Methods The current study was a modeling study. Data on SATS by lifetime mental disorder status were obtained from the Drug and Alcohol Treatment Information System (DATIS) in Ontario, Canada for 2010/11. The number of clients with FASD who received SATS in Ontario in 2010/11 was estimated, assuming that approximately 37% (confidence interval: 21.6%-54.5%) of individuals with FASD abuse or are addicted to alcohol and/or drugs and that their utilization rate of SATS is the same as those for people with a lifetime mental disorder. The data from DATIS was then extrapolated to the total Canadian population. Results The cost of SATS for clients with FASD in Canada in 2010/11 ranged from $1.65 million Canadian dollars (CND) to $3.59 million CND, based on 5,526 outpatient visits and 9,529 resident days. When the sensitivity analysis was performed the cost of SATS ranged from $979 thousand CND to $5.34 million CND. Conclusions Special attention must be paid to at-risk groups of individuals such as those with FASD, in order to reduce the likelihood of the development of co-morbid substance abuse problems, and thus, reducing the overall burden on Canadian society. PMID:23758674

  3. Nursing Care in Alcohol and Drug User Treatment Facilities.

    PubMed

    Naegle, Madeline A

    2015-01-01

    Registered and advanced practice nurses are employed in substance user treatment facilities across the US and in most industrialized countries. Patterns of employment and job descriptions for nurses, however, are highly inconsistent and seriously flawed. Many regulatory system, legislative and government agency factors and to some degree, the nursing profession itself, sustain the flaws and limit the delivery of comprehensive care. Competencies linked to addictions nursing best practices are often underutilized because of narrow job descriptions. This results in limited health and nursing service delivery to vulnerable populations receiving treatment in these government funded programs. This article highlights the increasing demand for the delivery of integrated care to psychiatric and substance using populations. The author considers factors which stake holders can influence to change flawed employment patterns and limited access to comprehensive care for substance users. PMID:26361920

  4. Change in Psychiatric Symptomatology after Benfotiamine Treatment in Males is a Function of Lifetime Alcoholism Severity

    PubMed Central

    Manzardo, Ann M.; Pendleton, Tiffany; Poje, Albert; Penick, Elizabeth C.; Butler, Merlin G.

    2015-01-01

    Background Severe alcoholism can be associated with significant nutritional and vitamin deficiency, especially vitamin B1 (thiamine) which is associated with serious illness and neurological deficits that influence mood and cognition. We previously reported reduced alcohol consumption among female but not male alcoholics after supplementation with the high potency thiamine analog benfotiamine (BF). As a follow-up, we have examined the relationship between lifetime alcoholism severity and psychiatric symptoms among the alcohol dependent men from this cohort and their response to BF treatment. Methods Eighty-five adult men (mean age = 48 ± 8 yrs) meeting DSM-IV-TR criteria for current alcohol dependence participated in a randomized, double-blind, placebo-controlled trial of 600 mg BF vs placebo (PL) for 6 months. Psychometric testing included a derived Lifetime Alcoholism Severity Score (AS), Symptom Checklist 90R (SCL-90R), and the Barratt Impulsivity Scale (BIS) at baseline and at 6 months with data analyzed using ANOVA and MANOVA modeling. Results Baseline SCL-90-R scale scores for men with high alcoholism severity (AS ≥ 24; N=46 HAS) were significantly greater than for men with low alcoholism severity (AS < 24; N=39 LAS), but BIS scores did not differ. MANOVA modeling identified a significant treatment effect (F=2.5, df=10, p<0.03) and treatment x alcoholism severity level interaction (F=2.5, dfnum=10, dfden=30, p<0.03) with SCL-90-R scores showing a reduction in symptoms among BF treated, high severity males. Conclustion BF appears to reduce psychiatric distress and may facilitate recovery in severely affected males with lifetime alcohol dependence and should be considered for adjuvant therapy in alcohol rehabilitation. PMID:25908323

  5. Treatment Engagement: Female Survivors of Intimate Partner Violence in Treatment for PTSD and Alcohol Use Disorder

    PubMed Central

    Myers, Ursula S.; Browne, Kendall C.; Norman, Sonya B.

    2016-01-01

    OBJECTIVE Treatment engagement rates are low for individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) across available interventions and treatment modalities. A better understanding of who does and does not engage in treatment can help improve retention, completion, and subsequent treatment outcomes. METHODS Forty female survivors of intimate partner violence with PTSD and AUD participated in a randomized controlled trial comparing twenty-five 90-minute sessions of either modified Seeking Safety or Facilitated twelve-step in a community-based outpatient clinic. This study examined differences in demographics and pre-treatment PTSD symptoms and alcohol use between participants who engaged in treatment (attended ≥ 6 sessions, n = 18) and those who dropped out (n = 22). RESULTS There were no significant differences in PTSD or AUD symptoms between treatment conditions. Women who engaged in therapy, versus those who did not, were significantly older (M = 46.2, SD = 9.14 vs. M = 38.95, SD =10.49, respectively; p = .027), and had fewer dependents (M = .17, SD = .38, range = 0–1 vs. M = .95, SD = 1.66, range = 1–7, respectively; p = .046). Greater avoidance/numbing PTSD symptoms (OR = 1.13, p = .028, 95% CI[1.02–1.25]) and more years of heavy drinking (OR = 1.04, p = 0.03, 95% CI[1.00–1.07]) were also significantly associated with treatment engagement. CONCLUSIONS This study replicates previous findings suggesting a need for additional retention strategies for younger women with dependents in comorbid PTSD and AUD treatment. This is an analysis of data collected as part of a clinical trial registered as NCT00607412, at www.clinicaltrials.gov. PMID:26515712

  6. Therapeutic Strategies for the Treatment of Alcoholic Hepatitis.

    PubMed

    Singal, Ashwani K; Shah, Vijay H

    2016-02-01

    Acute alcoholic hepatitis is a unique clinical syndrome among patients with chronic and active heavy alcohol use. Presenting with acute or chronic liver failure, a severe episode has a potential for 30 to 40% mortality at 1 month from presentation, if not recognized and left untreated. Alcoholic hepatitis patients need supportive therapy for abstinence and nutritional supplementation for those patients with markedly reduced caloric intake. Results of the recently published STOPAH (Steroids or Pentoxifylline for Alcoholic Hepatitis) Study showed only a benefit of corticosteroids on short-term mortality without any benefit of pentoxifylline. Neither of these two drugs impacts medium- and long-term mortality, which is mainly driven by abstinence from alcohol. With the emerging data on the benefits of liver transplantation, liver transplantation could be an important salvage option for a very highly select group of AH patients. More data are needed on the use of liver transplantation in AH as the basis for deriving protocols for selecting cases and for posttransplant management. Currently, many clinical trials are examining the efficacy and safety of new or repurposed compounds in severe AH. These drugs are targeted at various pathways in the pathogenesis of AH: the gut-liver axis, the inflammatory cascade, and liver injury. With increasing interest of researchers and clinicians, supported by funding from the National Institute on Alcohol Abuse and Alcoholism, the future seems promising for the development of effective and safe pharmacological interventions for severe AH. PMID:26870933

  7. Provider, Patient, and Family Perspectives of Adolescent Alcohol Use and Treatment in Rural Settings

    ERIC Educational Resources Information Center

    Gordon, Adam J.; Ettaro, Lorraine; Rodriguez, Keri L.; Mocik, John; Clark, Duncan B.

    2011-01-01

    Purpose: We examined rural primary care providers' (PCPs) self-reported practices of screening, brief interventions, and referral to treatment (SBIRT) on adolescent alcohol use and examined PCPs', adolescents', and parents' attitudes regarding SBIRT on adolescent alcohol use in rural clinic settings. Methods: In 2007, we mailed surveys that…

  8. Pomeroy House: A Residential Treatment Program for Recovering Alcoholic Mothers and Their Children.

    ERIC Educational Resources Information Center

    Norwood, Lucille

    Pomeroy House, a long-term residential treatment program in San Francisco, California, was created to help recovering alcoholic mothers and their children. Eight to 10 families stay at Pomeroy House for a minimum period of 6 months with extensions of up to 9 or 12 months, and the alcoholic mothers care for their children while recovering from…

  9. Alcohol Use, Psychopathology, and Treatment Utilization in a University Mental Health Clinic

    ERIC Educational Resources Information Center

    Seigers, Danielle K. L.; Carey, Kate B.

    2010-01-01

    In the general population, alcohol use disorders and psychiatric disorders co-occur. Despite ample evidence of the adverse effects of alcohol use on treatment outcomes, these relationships have not been examined among college students presenting at counseling centers. The purpose of this study was to assess the prevalence of hazardous drinking…

  10. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    ERIC Educational Resources Information Center

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  11. DUI/DWAI Offenders Compared to Clients Seen in an Outpatient Alcohol-Treatment Facility.

    ERIC Educational Resources Information Center

    Packard, Michele A.

    1987-01-01

    Examined client records to compare 50 subjects admitted to a drinking-driver program and 50 subjects admitted to an outpatient alcohol treatment clinic. Highly significant differences were found between groups on 10 of 12 drinking indices, suggesting that clients referred for alcohol-related traffic offenses represent a population different from…

  12. Longitudinal Risk Factors for Intimate Partner Violence among Men in Treatment for Alcohol Use Disorders

    ERIC Educational Resources Information Center

    Taft, Casey T.; O'Farrell, Timothy J.; Doron-Lamarca, Susan; Panuzio, Jillian; Suvak, Michael K.; Gagnon, David R.; Murphy, Christopher M.

    2010-01-01

    Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years.…

  13. The Development of a Broad Spectrum Treatment for Patients with Alcohol Dependence in Early Recovery

    ERIC Educational Resources Information Center

    Gulliver, Suzy Bird; Longabaugh, Richard; Davidson, Dena; Swift, Robert

    2005-01-01

    Estimates of the prevalence of alcohol dependence among Americans approach 14% (Read, Kahler, & Stevenson, 2001). Alcohol dependence was once considered among the most recalcitrant of problem behaviors, with only 20% to 30% attaining sustained abstinence (Hunt Barnett & Branch 1971). Although current definitions of treatment success now consider…

  14. A Guide for Starting a Specialty Training Clinic: An Alcohol Treatment Program as an Example

    PubMed Central

    Ladd, Benjamin O.; Glynn, Lisa Hagen; Fischer, Daniel J.; Owens, Mandy; Hallgren, Kevin A.; McLouth, Christopher J.; Monnig, Mollie A.; Campbell, William; McCrady, Barbara S.

    2013-01-01

    Since the Boulder conference more than 50 years ago, clinical psychology has been moving towards empirically based techniques and methods. Considerable research has been conducted and a multitude of studies have documented support for empirically supported treatments (ESTs). However, the literature on implementing ESTs in real-world settings is relatively limited. The absence of practical guidance poses a particular problem for students in clinical psychology training programs that emphasize training and competency in ESTs. This article describes the development of an alcohol specialty clinic within a clinical psychology training program from the first conceptualizations to establishment of a referral base and provision of services. At each step, integration of science and clinical practice is discussed. Future directions and suggestions for developing training clinics are provided. PMID:23704805

  15. Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatment.

    PubMed

    Watson, Bianca; Conigrave, Katherine M; Wallace, Cate; Whitfield, John B; Wurst, Friedrich; Haber, Paul S

    2007-05-01

    Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study. PMID:17454012

  16. Opioid antagonists for pharmacological treatment of alcohol dependence - a critical review.

    PubMed

    Soyka, Michael; Rösner, Susanne

    2008-11-01

    Alcohol dependence is a widespread psychiatric disorder. While relapse prevention therapy in alcoholism was exclusively dominated by social and psychological treatments for many years, in the last decades the benefits of pharmacological agents for the rehabilitation treatment in alcoholism have become increasingly evident. Naltrexone, an opiate receptor antagonist, blocks the pleasant and reinforcing effects of alcohol by preventing the stimulation of opioid receptors and the reduction of dopamine release in the ventral tegmental area (VTA). Clinical evidence about the effectiveness of the substance is not always consistent, but meta-analyses confirm naltrexone's effect on the risk of heavy drinking. Evidence about the abstinence-maintaining effects of the substance comes from a relatively small database and needs further investigation. The evaluation of differential effects of naltrexone depending on biological or psychological profiles, which could further enhance the effectiveness of treatments for alcohol dependence, remains a challenge. Nalmefene, another opioid antagonist, as well as naltrexone depot, a sustained release formulation of naltrexone, are further promising strategies for the treatment of alcohol dependence. The review at hand gives on overview of the current evidence on opioid antagonists for the treatment of alcohol dependence regarding the possible mechanism of action, the substances' safety profiles and their effectiveness. The corresponding evidence is critically reviewed taking into consideration the influence of the study design on the magnitude and consistency of effect sizes as well the impact of patient characteristics on the response to the treatment with opioid antagonists. Future studies on the role of different subtypes of alcoholics according to their genetic or psychological profile to explain or even predict the effects of opioid antagonists in the treatment of alcohol dependence are needed. PMID:19630726

  17. Review of outcome research on marital and family therapy in treatment for alcoholism.

    PubMed

    O'Farrell, Timothy J; Clements, Kahni

    2012-01-01

    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. PMID:22283384

  18. REVIEW OF OUTCOME RESEARCH ON MARITAL AND FAMILY THERAPY IN TREATMENT OF ALCOHOLISM

    PubMed Central

    O’Farrell, Timothy J.

    2011-01-01

    This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates our earlier review (XXXXXXX). 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 Community Reinforcement and Family Training (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: 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. PMID:22283384

  19. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder.

    PubMed

    Wang, Fang; Li, Ya; Zhang, Yu-Jie; Zhou, Yue; Li, Sha; Li, Hua-Bin

    2016-01-01

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s) and related mechanism(s) of action. PMID:26751438

  20. New diagnostic criteria for alcohol use disorders and novel treatment approaches – 2014 update

    PubMed Central

    Tyburski, Ernest M.; Sokolowski, Andrzej; Samochowiec, Jerzy

    2014-01-01

    The study is aimed at presenting new diagnostic and therapeutic proposals for patients with alcohol use disorders. The revised ICD-11 which is currently being updated is coming closer to American standards in disease classification. The latest update of the American DSM-5 has been a notable step forward as it integrates alcohol abuse and alcohol dependence into a single disorder called alcohol use disorder. Recent developments in research into diagnostic tools have brought changes in the approach to therapy. According to most international guidelines, the form of treatment should be customised to the individual patient, with consideration given to his/her mental and physical condition, personality and natural setting. A significant change is the recommendation of a harm reduction strategy as a useful alternative to total abstinence in alcohol dependence treatment for some patients. PMID:25624858

  1. Alcohol withdrawal

    MedlinePlus

    ... counseling to discuss the long-term issue of alcoholism Testing and treatment for other medical problems linked ... following organizations are good resources for information on alcoholism: Alcoholics Anonymous -- www.aa.org Al-Anon/Alateen -- ...

  2. Alcohol Screening and Brief Intervention in Workplace Settings and Social Services: A Comparison of Literature

    PubMed Central

    Schulte, Bernd; O’Donnell, Amy Jane; Kastner, Sinja; Schmidt, Christiane Sybille; Schäfer, Ingo; Reimer, Jens

    2014-01-01

    Background: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions takes place in this context. Methods: Update of two systematic reviews on ASBI effectiveness in workplaces, social service, and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in non-medical settings. Results: We found a limited number of randomized controlled trials in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest that a stepped and carefully tailored approach is likely to be required. Discussion: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions, and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance, and potential effectiveness of ASBI for different target groups, organizational frameworks, and professionals. PMID:25339914

  3. Use of low-energy laser as adjunct treatment of alcohol addiction.

    PubMed

    Zalewska-Kaszubska, Jadwiga; Obzejta, Dominik

    2004-01-01

    Auricular acupuncture is a medical method that has been used in the treatment of alcohol addiction. In our study we decided to intensify this method by additional biostimulation of the whole organism. The aim of this study was the therapy of patients with alcohol dependence syndrome. Fifty-three alcoholics were treated with two types of laser stimulation in four sessions. Each session consisted of 20 consecutive daily helium-neon laser neck biostimulations and 10 auricular acupuncture treatments with argon laser (every 2nd day). The Beck Depression Inventory-Fast Screen (BDI-FS) was used to assess their frame of mind before the session and after 2 months of treatment. Moreover, beta-endorphin plasma concentration was estimated five times using the radioimmunoassay (RIA) method. Improvement in BDI-FS and increase in, beta-endorphin level were observed. These results suggest that laser therapy can be useful as an adjunct treatment for alcoholism. PMID:15674998

  4. A Qualitative Investigation of Barriers to Entry into Couples Treatment for Alcohol Problems

    PubMed Central

    Schonbrun, Yael Chatav; Strong, David R.; Wetle, Terrie; Stuart, Gregory L.

    2011-01-01

    This study used qualitative methodology to evaluate barriers to entry into couples treatment for alcohol problems. Data were collected using semi-structured interviews. Patients were recruited from (1) treatment for primary substance use disorders, (2) treatment for psychiatric disorders (other than substance use disorders), and (3) court-mandated outpatient domestic violence programs. Mental health experts were recruited based on expertise in (1) couples treatment, (2) alcohol treatment, and (3) couples treatment for alcohol problems. Patients (N=57) met criteria for hazardous drinking, and were in committed romantic relationships. Partners (N=19) and mental health experts (N=12) also completed interviews. Interviews were analyzed using accepted qualitative strategies. Barriers to treatment entry were identified at the patient, partner, and couple level. Barriers identified included psychological barriers, alcohol illness factors, treatment preferences and beliefs, and interpersonal factors. Although many barriers are similar to those previously identified in individual alcohol treatment, barriers unique to couples treatment provide guidance for next directions for dissemination. PMID:21831561

  5. Treatment of Alcohol Withdrawal Syndrome with and without Dexmedetomidine

    PubMed Central

    Beg, Muna; Fisher, Sara; Siu, Dana; Rajan, Sudhir; Troxell, Lawrence; Liu, Vincent X

    2016-01-01

    Context: Studies suggest that dexmedetomidine—an intravenous central-acting α2-adrenergic agonist that effectively reduces anxiety among critically ill patients—is being used in patients with severe alcohol withdrawal. However, evidence supporting its use is limited, and it is not approved for this indication. Objective: To assess the effect of dexmedetomidine on severe alcohol withdrawal symptoms and to compare its use with benzodiazepines alone. Design: A retrospective, cohort study of 77 patients admitted to the adult medical intensive care unit with severe alcohol withdrawal between January 1, 2009, and October 31, 2013. Main Outcome Measures: The difference in lorazepam equivalents and Clinical Institute Withdrawal Assessment for Alcohol scores in the 24 hours before and after initiation of dexmedetomidine therapy. Results: The frequency of dexmedetomidine use increased dramatically between 2009 and 2013 (16.7% vs 82.4%; p = 0.01). Initiation of dexmedetomidine therapy was associated with significant improvements in Clinical Institute Withdrawal Assessment for Alcohol scores over corresponding 24-hour intervals (14.5 vs 8.5; p < 0.01). Benzodiazepine use also decreased, but the difference was not statistically significant at 24 hours (p = 0.10). Dexmedetomidine was well tolerated, requiring discontinuation of therapy in only 4 patients (10.5%). Dexmedetomidine use was also associated with significantly longer hospitalizations (p < 0.01). Conclusion: Dexmedetomidine initiation was associated with a reduction in short-term alcohol withdrawal symptoms in patients in the intensive care unit, with only a few patients experiencing adverse events. However, its use was also associated with longer hospitalizations. Further research is necessary to evaluate whether dexmedetomidine is efficacious or cost-effective in severe alcohol withdrawal. PMID:27168398

  6. [The addicted patient in anaesthesia -screening, diagnosis and treatment of alcohol use disorders].

    PubMed

    Neumann, Tim

    2015-06-01

    Patients consuming > 60g/d of alcohol (e.g. 1.5l of beer), are 2-5 times more likely to suffer post-operative complications such as infectious, bleeding or cardiac complications or an alcohol withdrawal syndrome. By screening and a systematic evaluation risk patients can be identified that may benefit from interventions such as counseling, brief interventions, abstinence, tailored anesthesia, prophylactic treatment of withdrawal symptoms, stress reduction, harm reduction, psychosocial therapy, addiction therapy, multidisciplinary treatment. PMID:26147412

  7. Efficacy of Medications Approved for the Treatment of Alcohol Dependence and Alcohol Withdrawal Syndrome in Female Patients: A Descriptive Review.

    PubMed

    Agabio, Roberta; Pani, Pier Paolo; Preti, Antonio; Gessa, Gian Luigi; Franconi, Flavia

    2016-01-01

    The aim of this study was to evaluate whether the number of women recruited for studies to establish the efficacy of medications approved for treatment of alcohol dependence (AD) and of alcohol withdrawal syndrome (AWS) is sufficient to reveal possible gender differences in the response to these medications and in suggesting the use of different doses in female patients. Our results show that the rates of women recruited for studies evaluating the efficacy of disulfiram (1%), benzodiazepines (3%), and anticonvulsants (13%) were too low to establish possible gender differences. The rates of women recruited for studies evaluating the efficacy of acamprosate (22%), naltrexone (23%), and nalmefene (30%) were higher and allowed evaluation of data obtained for female patients. Women receive medications for treatment of AD and/or AWS for which efficacy has been demonstrated in studies in which men were more largely represented. PMID:26314552

  8. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  9. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  10. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  11. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  12. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  13. The Alcohol Use and Associated Mental Health Problems of Student Service Members/Veterans in Higher Education

    ERIC Educational Resources Information Center

    Barry, Adam E.; Whiteman, Shawn; Wadswroth, Shelley Macdermid; Hitt, Stacie

    2012-01-01

    Aims: This study examined: (a) whether student service members/veterans attending college drank more frequently or in greater quantities than non-service peers; and (b) whether links between student service members/veterans' alcohol use and mental health-related outcomes differed from civilian students.Methods: Participants included 145 student…

  14. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems.

    PubMed

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2009-01-01

    We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed. PMID:18715745

  15. Socioeconomic characteristics of alcohol and other substance users, seeking treatment in Sikkim, North East India

    PubMed Central

    Pandey, Sunil Kumar; Datta, Debranjan; Dutta, Sanjiba; Verma, Yogesh; Chakrabarti, Amit

    2015-01-01

    Objectives: The present study was conducted to generate information for better understanding of socioeconomic and CAGE characteristics of alcohol and other substance users who were undergoing treatment in Sikkim. Subjects and Methods: Socioeconomic and CAGE questionnaire was administered to alcohol and other substance abusers of Sikkim (n = 241) who were undergoing treatment in different treatment centers of Sikkim. Information was collected on printed instrument after taking participant's consent and data was statistically analyzed. Results: Male participants (93.8%) outnumbered female (6.2%). Majority of the sample were either in the school dropout group or school completed (36.1%) group. Most of the samples were occupationally unemployed, urban residents, Nepali by ethnicity, single, and Hindu (48.5%) by religion. Minimum age for starting of alcohol and drug was 5 years and 7 years respectively. Knowledge about AIDS and its transmission was satisfactory. All the four CAGE characteristics were present in majority of samples. Conclusions: Climate, geographical location, wide and easy availability of alcohol in Sikkim make this state vulnerable for alcohol abuse. Alcohol drinking among parents, sibling and friends found to be important risk factor. Outreach to the community for better acceptability of treatment is an important area to fill the gap of treatment demand and treatment supply. PMID:25883520

  16. Providing Post-Treatment Support in an Outpatient Alcohol and Other Drug Treatment Context: A Survey of Client Opinion

    ERIC Educational Resources Information Center

    Pulford, Justin; Black, Stella; Wheeler, Amanda; Sheridan, Janie; Adams, Peter

    2010-01-01

    This paper presents findings from a survey that sought the post-treatment support preferences of a group of outpatient alcohol and other drug treatment clients. The client group (n = 83) were presented with six possible models of post-treatment support and were asked to express their level of interest in using or receiving each model and, if…

  17. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

    PubMed Central

    McCallum, Stacey L; Andrews, Jane M; Gaughwin, Matthew D; Turnbull, Deborah A; Mikocka-Walus, Antonina A

    2016-01-01

    Background Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. Methods Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0–40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. Results Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs’ understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients’ mental health needs. Conclusion While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have

  18. ALCOHOL USE DISORDERS IN THE ELDERLY: A BRIEF OVERVIEW FROM EPIDEMIOLOGY TO TREATMENT OPTIONS

    PubMed Central

    Caputo, Fabio; Vignoli, Teo; Leggio, Lorenzo; Addolorato, Giovanni; Zoli, Giorgio; Bernardi, Mauro

    2016-01-01

    Alcohol-use-disorders (AUDs) afflict 1–3% of elderly subjects. The CAGE, SMAST-G, and AUDIT are the most common and validated questionnaires used to identify AUDs in the elderly, and some laboratory markers of alcohol abuse (AST, GGT, MCV, and CDT) may also be helpful. In particular, the sensitivity of MCV or GGT in detecting alcohol misuse is higher in older than in younger populations. The incidence of medical and neurological complications during alcohol withdrawal syndrome in elderly alcoholics is higher than in younger alcoholics. Chronic alcohol abuse is associated with tissue damage to several organs. Namely, an increased level of blood pressure is more frequent in the elderly than in younger adults, and a greater vulnerability to the onset of alcoholic liver disease, and an increasing risk of breast cancer in menopausal women have been described. In addition, the prevalence of dementia in elderly alcoholics is almost 5 times higher than in non-alcoholic elderly individuals, approximately 25% of elderly patients with dementia also present AUDs, and almost 20% of individuals aged 65 and over with a diagnosis of depression have a co-occurring AUD. Moreover, prevention of drinking relapse in older alcoholics is, in some cases, better than in younger patients; indeed, more than 20% of treated elderly alcohol-dependent patients remain abstinent after four years. Considering that the incidence of AUDs in the elderly is fairly high, and AUDs in the elderly are still underestimated, more studies in the fields of epidemiology, prevention and pharmacological and psychotherapeutic treatment of AUDs in the elderly are warranted. PMID:22575256

  19. Q&A with Dr. Koob about Treatment for Alcohol Problems | NIH MedlinePlus the Magazine

    MedlinePlus

    ... A with Dr. Koob about Treatment for Alcohol Problems Past Issues / Winter 2015 Table of Contents George ... FDA-approved medications that can help curb alcohol problems? It may be because medications are still a ...

  20. General and Religious Coping Predict Drinking Outcomes for Alcohol Dependent Adults in Treatment

    PubMed Central

    Martin, Rosemarie A.; Ellingsen, Victor J.; Tzilos, Golfo K.; Rohsenow, Damaris J.

    2015-01-01

    Background Religiosity is associated with improved treatment outcomes among adults with alcohol dependence; however, it is unknown whether religious coping predicts drinking outcomes above and beyond the effects of coping in general, and whether gender differences exist. Methods We assessed 116 alcohol-dependent adults (53% women; mean age = 37, SD = 8.6) for use of religious coping, general coping and alcohol use within two weeks of entering outpatient treatment, and again 6 months after treatment. Results Religious coping at 6 months predicted fewer heavy alcohol use days and fewer drinks per day. This relationship was no longer significant after controlling for general coping at 6 months. Conclusion The relationship between the use of religious coping strategies and drinking outcomes is not independent of general coping. Coping skills training that includes religious coping skills, as one of several coping methods, may be useful for a subset of adults early in recovery. PMID:25662479

  1. Predicting the In-Hospital Responsiveness to Treatment of Alcoholics. Social Factors as Predictors of Outcome. Brain Damage as a Factor in Treatment Outcome of Chronic Alcoholic Patients.

    ERIC Educational Resources Information Center

    Mascia, George V.; And Others

    The authors attempt to locate predictor variables associated with the outcome of alcoholic treatment programs. Muscia's study focuses on the predictive potential of: (1) response to a GSR conditioning procedure; (2) several personality variables; and (3) age and IQ measures. Nine variables, reflecting diverse perspectives, were selected as a basis…

  2. Transcranial Magnetic Stimulation and Deep Brain Stimulation in the treatment of alcohol dependence

    PubMed Central

    Alba-Ferrara, L.; Fernandez, F.; Salas, R.; de Erausquin, G. A.

    2013-01-01

    Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of two neuromodulation techniques, namely repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), and their advantages and disadvantages compared to first-line pharmacological treatment for alcohol dependence. We also discuss rTMS and DBS targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as inter-individual variability factors influencing alcoholism prognosis. Lastly, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomical and neurodisruptive techniques optimizing the outcome. PMID:25598743

  3. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Medical treatment, care... Certain New Pension Recipients Medical and Related Services § 21.6240 Medical treatment, care and services... be furnished medical treatment, care and services which VA determines are necessary to develop,...

  4. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Medical treatment, care... Certain New Pension Recipients Medical and Related Services § 21.6240 Medical treatment, care and services... be furnished medical treatment, care and services which VA determines are necessary to develop,...

  5. 38 CFR 21.240 - Medical treatment, care and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Medical treatment, care... 38 U.S.C. Chapter 31 Medical and Related Services § 21.240 Medical treatment, care and services. (a) General. A Chapter 31 participant shall be furnished medical treatment, care and services which...

  6. 38 CFR 21.240 - Medical treatment, care and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Medical treatment, care... 38 U.S.C. Chapter 31 Medical and Related Services § 21.240 Medical treatment, care and services. (a) General. A Chapter 31 participant shall be furnished medical treatment, care and services which...

  7. 38 CFR 21.240 - Medical treatment, care and services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Medical treatment, care... 38 U.S.C. Chapter 31 Medical and Related Services § 21.240 Medical treatment, care and services. (a) General. A Chapter 31 participant shall be furnished medical treatment, care and services which...

  8. 38 CFR 21.240 - Medical treatment, care and services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Medical treatment, care... 38 U.S.C. Chapter 31 Medical and Related Services § 21.240 Medical treatment, care and services. (a) General. A Chapter 31 participant shall be furnished medical treatment, care and services which...

  9. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Medical treatment, care... Certain New Pension Recipients Medical and Related Services § 21.6240 Medical treatment, care and services... be furnished medical treatment, care and services which VA determines are necessary to develop,...

  10. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Medical treatment, care... Certain New Pension Recipients Medical and Related Services § 21.6240 Medical treatment, care and services... be furnished medical treatment, care and services which VA determines are necessary to develop,...

  11. 38 CFR 21.240 - Medical treatment, care and services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Medical treatment, care... 38 U.S.C. Chapter 31 Medical and Related Services § 21.240 Medical treatment, care and services. (a) General. A Chapter 31 participant shall be furnished medical treatment, care and services which...

  12. 38 CFR 21.6240 - Medical treatment, care and services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Medical treatment, care... Certain New Pension Recipients Medical and Related Services § 21.6240 Medical treatment, care and services... be furnished medical treatment, care and services which VA determines are necessary to develop,...

  13. 45 CFR 96.131 - Treatment services for pregnant women.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Treatment services for pregnant women. 96.131 Section 96.131 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The State is required to, in...

  14. Alcoholic pancreatitis: New insights into the pathogenesis and treatment.

    PubMed

    Clemens, Dahn L; Schneider, Katrina J; Arkfeld, Christopher K; Grode, Jaclyn R; Wells, Mark A; Singh, Shailender

    2016-02-15

    Acute pancreatitis is a necro-inflammatory disease of the exocrine pancreas that is characterized by inappropriate activation of zymogens, infiltration of the pancreas by inflammatory cells, and destruction of the pancreatic exocrine cells. Acute pancreatitis can progress to a severe life-threatening disease. Currently there is no pharmacotherapy to prevent or treat acute pancreatitis. One of the more common factors associated with acute pancreatitis is alcohol abuse. Although commonly associated with pancreatitis alcohol alone is unable to cause pancreatitis. Instead, it appears that alcohol and its metabolic by-products predispose the pancreas to damage from agents that normally do not cause pancreatitis, or to more severe disease from agents that normally cause mild pancreatic damage. Over the last 10 to 20 years, a tremendous amount of work has defined a number of alcohol-mediated biochemical changes in pancreatic cells. Among these changes are: Sustained levels of intracellular calcium, activation of the mitochondrial permeability transition pore, endoplasmic reticulum stress, impairment in autophagy, alteration in the activity of transcriptional activators, and colocalization of lysosomal and pancreatic digestive enzymes. Elucidation of these changes has led to a deeper understanding of the mechanisms by which ethanol predisposes acinar cells to damage. This greater understanding has revealed a number of promising targets for therapeutic intervention. It is hoped that further investigation of these targets will lead to the development of pharmacotherapy that is effective in treating and preventing the progression of acute pancreatitis. PMID:26909228

  15. Short-Term Group Treatment for Adult Children of Alcoholics.

    ERIC Educational Resources Information Center

    Cooper, Alvin; McCormack, WIlliam A.

    1992-01-01

    Adult children of alcoholics (n=24) were tested on measures of loneliness, anxiety, hostility, depression, and interpersonal dependency before and after participation in short-term group therapy. Highly significant test score changes supported effectiveness of individual therapy in short-term groups. (Author/NB)

  16. Alcoholic pancreatitis: New insights into the pathogenesis and treatment

    PubMed Central

    Clemens, Dahn L; Schneider, Katrina J; Arkfeld, Christopher K; Grode, Jaclyn R; Wells, Mark A; Singh, Shailender

    2016-01-01

    Acute pancreatitis is a necro-inflammatory disease of the exocrine pancreas that is characterized by inappropriate activation of zymogens, infiltration of the pancreas by inflammatory cells, and destruction of the pancreatic exocrine cells. Acute pancreatitis can progress to a severe life-threatening disease. Currently there is no pharmacotherapy to prevent or treat acute pancreatitis. One of the more common factors associated with acute pancreatitis is alcohol abuse. Although commonly associated with pancreatitis alcohol alone is unable to cause pancreatitis. Instead, it appears that alcohol and its metabolic by-products predispose the pancreas to damage from agents that normally do not cause pancreatitis, or to more severe disease from agents that normally cause mild pancreatic damage. Over the last 10 to 20 years, a tremendous amount of work has defined a number of alcohol-mediated biochemical changes in pancreatic cells. Among these changes are: Sustained levels of intracellular calcium, activation of the mitochondrial permeability transition pore, endoplasmic reticulum stress, impairment in autophagy, alteration in the activity of transcriptional activators, and colocalization of lysosomal and pancreatic digestive enzymes. Elucidation of these changes has led to a deeper understanding of the mechanisms by which ethanol predisposes acinar cells to damage. This greater understanding has revealed a number of promising targets for therapeutic intervention. It is hoped that further investigation of these targets will lead to the development of pharmacotherapy that is effective in treating and preventing the progression of acute pancreatitis. PMID:26909228

  17. Is there any progress in the treatment of non-alcoholic fatty liver disease?

    PubMed Central

    Tsochatzis, Emmanuel A; Papatheodoridis, George V

    2011-01-01

    Despite the fact that non-alcoholic fatty liver disease (NAFLD) and its severe clinical form, non-alcoholic steatohepatitis, are becoming increasingly prevalent in the industrialised countries, there are no licensed pharmacological treatments for them. Weight loss and life modifications, antioxidant therapies and insulin-sensitising agents are the current treatment strategies and have all been tested with inconclusive results. Low sample numbers, inadequate treatment duration and invalid surrogate markers for treatment response might all account for these results. As NAFLD is a systemic rather than a liver disease, future trials should address the patient as a whole and also address cardiovascular risk factors. PMID:21577310

  18. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  19. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  20. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  1. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  2. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  3. Service Engagement: Psychopathology, Recovery Style and Treatments

    PubMed Central

    Vender, Simone; Poloni, Nicola; Aletti, Francesca; Callegari, Camilla

    2014-01-01

    The aim of the present study is to evaluate how recovery style, a set of strategies used by patients to interact with services and therapists, and the severity of psychotic symptoms affect the quality/continuity of taking charge of each patient. 156 psychotic patients at different stages of illness were enrolled. Sociodemographic and clinical data were collected and integration/sealing-Over Scale, Recovery Style Questionnaire and Positive and Negative Syndrome Scale were administered. Patients were distinguished into four groups according to the type of treatment received: clinical package, hospital package, day-care package, and residential package. A positive correlation between the cost of psychiatric performance and psychopathological severity (measured with PANSS scores) was identified. No association emerged between ISOS/RSQ total scores and costs. The sanitary expenditure appears to be linked to positive psychotic symptoms while lower performances are given for the treatment of patients with predominant negative symptoms. Recovery style itself has not a direct influence on the quantity/quality of psychiatric services. PMID:24701559

  4. Serotonin's Complex Role in Alcoholism: Implications for Treatment and Future Research.

    PubMed

    Marcinkiewcz, Catherine A; Lowery-Gionta, Emily G; Kash, Thomas L

    2016-06-01

    Current pharmacological treatments for alcohol dependence have focused on reducing alcohol consumption, but to date there are few treatments that also address the negative affective symptoms during acute and protracted alcohol withdrawal which are often exacerbated in people with comorbid anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed to ameliorate these symptoms but can exacerbate anxiety and cravings in a select group of patients. In this critical review, we discuss recent literature describing an association between alcohol dependence, the SERT linked polymorphic region (5-HTTLPR), and pharmacological response to SSRIs. Given the heterogeneity in responsiveness to serotonergic drugs across the spectrum of alcoholic subtypes, we assess the contribution of specific 5-HT circuits to discrete endophenotypes of alcohol dependence. 5-HT circuits play a distinctive role in reward, stress, and executive function which may account for the variation in response to serotonergic drugs. New optogenetic and chemogenetic methods for dissecting 5-HT circuits in alcohol dependence may provide clues leading to more effective pharmacotherapies. Although our current understanding of the role of 5-HT systems in alcohol dependence is incomplete, there is some evidence to suggest that 5-HT3 receptor antagonists are effective in people with the L/L genotype of the 5-HTTLPR polymorphism while SSRIs may be more beneficial to people with the S/L or S/S genotype. Studies that assess the impact of serotonin transporter polymorphisms on 5-HT circuit function and the subsequent development of alcohol use disorders will be an important step forward in treating alcohol dependence. PMID:27161942

  5. Impact of a Quality Improvement Intervention to Increase Brief Alcohol and Drug Interventions on a Level I Trauma Service.

    PubMed

    Thomas, Princess; Seale, J Paul; Johnson, J Aaron; Dhabliwala, Jason; Kitchens, Debra; Okosun, Ike S; Stokes, Nathan A; Ashley, Dennis

    2016-05-01

    Screening and brief intervention (SBI) decreases alcohol use and related consequences among trauma patients. Although SBI is required in Level I and II trauma centers, implementation often is difficult. This study used the Plan-Do-Study-Act approach to identify and implement measures to increase the number of patients receiving SBI at a Level I trauma center. A multidisciplinary Quality Improvement Committee with representation from the Trauma Service and SBI Team met monthly during 2011. Stepwise interventions included identifying a resident "champion" responsible for screening, brief intervention, and referral to treatment, including an SBI report at monthly trauma conferences, and incorporating SBI into the trauma order set. Outcomes measures were number of patients screened, patients screening positive, and the number of patients receiving SBI. At baseline, 170 of 362 patients (47%) were screened, 68/170 (40%) had positive screens, and 30/68 (44% of those with positive screens) received SBI services. Quarter 2 saw increases in patients screened-275/437 (63%), patients screening positive (106/275; 39%) and those receiving SBI (60/106; 57%). Increases culminated in Quarter 4 with screening 401/466 (86%; P < 0.001) patients, 208/401 (52%; P < 0.001) patients screening positive, and 114 patients (55%; P = 0.296) receiving services. Use of similar quality improvement measures nationwide could improve rates of provision of this important service. PMID:27215730

  6. Understanding Disparities in Service Seeking Following Forcible Versus Drug- or Alcohol-Facilitated/Incapacitated Rape.

    PubMed

    Walsh, Kate; Zinzow, Heidi M; Badour, Christal L; Ruggiero, Kenneth J; Kilpatrick, Dean G; Resnick, Heidi S

    2016-09-01

    Victims of drug- or alcohol-facilitated/incapacitated rape (DAFR/IR) are substantially less likely to seek medical, rape crisis, or police services compared with victims of forcible rape (FR); however, reasons for these disparities are poorly understood. The current study examined explanatory mechanisms in the pathway from rape type (FR vs. DAFR/IR) to disparities in post-rape service seeking (medical, rape crisis, criminal justice). Participants were 445 adult women from a nationally representative household probability sample who had experienced FR, DAFR/IR, or both since age 14. Personal characteristics (age, race, income, prior rape history), rape characteristics (fear, injury, loss of consciousness), and post-rape acknowledgment, medical concerns, and service seeking were collected. An indirect effects model using bootstrapped standard errors was estimated to examine pathways from rape type to service seeking. DAFR/IR-only victims were less likely to seek services compared with FR victims despite similar post-rape medical concerns. FR victims were more likely to report fear during the rape and a prior rape history, and to acknowledge the incident as rape; each of these characteristics was positively associated with service seeking. However, only prior rape history and acknowledgment served as indirect paths to service seeking; acknowledgment was the strongest predictor of service seeking. Diminished acknowledgment of the incident as rape may be especially important to explaining why DAFR/IR victims are less likely than FR victims to seek services. Public service campaigns designed to increase awareness of rape definitions, particularly around DAFR/IR, are important to reducing disparities in rape-related service seeking. PMID:25846758

  7. An Update on Fetal Alcohol Syndrome-Pathogenesis, Risks, and Treatment.

    PubMed

    Gupta, Keshav K; Gupta, Vinay K; Shirasaka, Tomohiro

    2016-08-01

    Alcohol is a well-established teratogen that can cause variable physical and behavioral effects on the fetus. The most severe condition in this spectrum of diseases is known as fetal alcohol syndrome (FAS). The differences in maternal and fetal enzymes, in terms of abundance and efficiency, in addition to reduced elimination, allow for alcohol to have a prolonged effect on the fetus. This can act as a teratogen through numerous methods including reactive oxygen species (generated as by products of CYP2E1), decreased endogenous antioxidant levels, mitochondrial damage, lipid peroxidation, disrupted neuronal cell-cell adhesion, placental vasoconstriction, and inhibition of cofactors required for fetal growth and development. More recently, alcohol has also been shown to have epigenetic effects. Increased fetal exposure to alcohol and sustained alcohol intake during any trimester of pregnancy is associated with an increased risk of FAS. Other risk factors include genetic influences, maternal characteristics, for example, lower socioeconomic statuses and smoking, and paternal chronic alcohol use. The treatment options for FAS have recently started to be explored although none are currently approved clinically. These include prenatal antioxidant administration food supplements, folic acid, choline, neuroactive peptides, and neurotrophic growth factors. Tackling the wider impacts of FAS, such as comorbidities, and the family system have been shown to improve the quality of life of FAS patients. This review aimed to focus on the pathogenesis, especially mechanisms of alcohol teratogenicity, and risks of developing FAS. Recent developments in potential management strategies, including prenatal interventions, are discussed. PMID:27375266

  8. PERCEIVED BARRIERS TO TREATMENT FOR ALCOHOL PROBLEMS: A LATENT CLASS ANALYSIS

    PubMed Central

    Schuler, Megan S.; Puttaiah, Savitha; Mojtabai, Ramin; Crum, Rosa M.

    2015-01-01

    Objective Low rates of alcohol treatment seeking has been shown to be associated with perceived barriers to treatment, yet heterogeneity in patterns of perceived barriers have not been explored. We used data from a population-based sample of adults with alcohol abuse and dependence to: describe latent classes of perceived barriers to seeking alcohol treatment and identify characteristics associated with class membership. Methods Data are from the National Epidemiologic Survey on Alcohol and Related Conditions (2001-02). Analyses were restricted to treatment-naive adults with alcohol abuse or dependence with a perceived treatment need (N=1,053). Latent class analysis was performed to identify subgroups with respect to barriers to treatment; latent class regression was performed to identify variables associated with each subgroup. Results Two subgroups emerged: the low barriers class (87%), characterized primarily by attitudinal barriers, and the high barriers class (13%), characterized by significant attitudinal, financial, stigma and readiness for change barriers. In both classes, the most frequently endorsed barrier was the attitudinal belief that they should be “strong enough” to handle it on their own. Univariate analyses showed strong associations between membership in the high barriers class and comorbid psychiatric disorders, alcohol dependence (relative to abuse), and family history of alcohol problems; multivariate analyses found significant associations with lifetime anxiety disorder and education level. Conclusions Findings show that attitudinal barriers are most prevalent, and highlight the existence of a notable subgroup with multiple barriers, including financial and stigma-related barriers, who may require additional resources and support in order to enter treatment. PMID:26234326

  9. Obsessive-compulsive symptoms among alcoholics in outpatient treatment: Prevalence, severity and correlates.

    PubMed

    Campos, Luana Moraes; Yoshimi, Nicoli Tamie; Simão, Maria Odete; Torresan, Ricardo Cezar; Torres, Albina Rodrigues

    2015-09-30

    The literature on symptoms of obsessive-compulsive disorder (OCD) in alcoholic patients is scarce and such symptoms can go unnoticed, worsening the prognosis of alcoholism. The objectives were to estimate the prevalence and severity of obsessive-compulsive symptoms in alcoholics undergoing outpatient treatment and to assess sociodemographic and clinical correlates, including suicidal behaviors. The instruments used in this cross-sectional study were the Obsessive-Compulsive Inventory - Revised (OCI-R), the Short Alcohol Dependence Data and the Beck Depression Inventory. After descriptive analyses, bivariate analyses between the categorical ("probable OCD": OCI-R≥27) and dimensional (OCI-R total and subscales scores) outcomes and all explanatory variables were conducted. Eleven (20.4%) of the 54 alcoholic patients (37 men and 17 women) presented "probable OCD", which was associated with lower income, more severe dependence, depression, lifetime suicidal thoughts and plans and suicide attempts. OCI-R severity (mean 16.0) was associated with the same predictors and with psychiatric hospitalization. Suicidal behaviors were mainly associated with the Obsession, Hoarding and Washing subscales. It is essential to investigate and treat OCD symptoms in alcoholics, as they are associated with greater severity of dependence, depression and suicidal behaviors. Longitudinal studies are required to assess the impact of OCD treatment on the clinical course of alcoholism. PMID:26150309

  10. Behavioral couples treatment of alcohol and drug use disorders: current status and innovations.

    PubMed

    Epstein, E E; McCrady, B S

    1998-09-01

    Research suggests that Behavioral Couples Therapy (BCT), tailored to treat alcohol problems, produces significant reduction in alcohol consumption and improvement in marital functioning. Having established basic clinical protocols for Alcohol Behavioral Couples Therapy (ABCT) and provided support for their efficacy, clinical researchers around the country continue to develop and study new applications of the basic ABCT treatment models, such as adding relapse prevention or Alcoholics Anonymous components. Recent research supporting the heterogeneity in the population of individuals with alcohol problems has prompted some researchers on ABCT to consider additional adaptations of the treatment models for specific subgroups of alcoholics, and for particular individual and couples characteristics. Adaptation of ABCT to treat new populations such as drug abusers, female alcoholics, and problem drinkers is under investigation. The current article provides an overview of theoretical and clinical aspects of ABCT, and research on efficacy of the basic model and on areas of innovation and adaptation to new populations. Directions for future research on ABCT are suggested. PMID:9779329

  11. Gender Differences in Alcohol Treatment: An Analysis of Outcome from the COMBINE Study

    PubMed Central

    Greenfield, Shelly F.; Pettinati, Helen M.; O’Malley, Stephanie; Randall, Patrick K.; Randall, Carrie L.

    2010-01-01

    Background Relatively few studies have examined gender differences in the effectiveness of specific behavioral or pharmacologic treatment of alcohol dependence. The aim of this study is to assess whether there were gender differences in treatment outcomes for specific behavioral and medication treatments singly or in combination by conducting a secondary analysis of public access data from the national, multi-site NIAAA-sponsored COMBINE study. Methods The COMBINE study investigated alcohol treatment among eight groups of patients (378 women, 848 men) who received Medical Management with 16 weeks of placebo, naltrexone (100mg/day), acamprosate (3 grams/day), or their combination with or without a specialist-delivered Combined Behavioral Intervention. We examined efficacy measures separately for men and women, followed by an overall analysis that included gender and its interaction with treatment condition in the analyses. These analyses were done to confirm whether the findings reported in the parent trial were also relevant to women, and to more closely examine secondary outcome variables that were not analyzed previously for gender effects. Results Compared to men, women reported a later age of onset of alcohol dependence by approximately 3 years, were significantly less likely to have had previous alcohol treatment; and drank fewer drinks per drinking day. Otherwise, there were no baseline gender differences in drinking measures. Outcome analyses of two primary (percent days abstinent and time to first heavy drinking day) and two secondary (good clinical response and percent heavy drinking days) drinking measures yielded the same overall pattern in each gender as that observed in the parent COMBINE study report. That is, only the naltrexone by behavioral intervention interaction reached or approached significance in women as well as in men. There was a naltrexone main effect that was significant in both men and women in reduction in alcohol craving scores with

  12. [Treatment of chronic alcoholic pancreatitis with a new acid-resistant pancreatin product].

    PubMed

    Kempelen, I; Szilárd, M

    1995-09-17

    The authors summarised pathophysiology and therapy possibility of the chronic alcoholic pancreatitis. They introduce a new product of pancreatin use for treatment of chronic alcoholic pancreatitis. The aim of this prospective study was to asses the efficacy of this new drug in the treatment of chronic alcoholic pancreatitis. The treatment was carried out by new pancreatin product containing 10,000 FIP U lipase, 9000 FIP U amylase, and 500 FIP E protease. During the study 30 patients--suffering from alcoholic pancreatitis--were treated. They received, two tablets three times daily in a period of two weeks. The following parameters were observed and compared before and after the period of treatment: complaints of the patients, the characteristics of the stool (daily weight, frequency, fat contents, consistency) the change of the body weight and degree of abdominal pain. These parameters were compared using a score-system, before and after the period of treatment. The authors could analyse the data of 21 patients. It was proved that there was a significant decrease in frequency, daily weight and fat contents of the stool and in abdominal pain. There was not significant change in the body weight. The authors concluded that this new product is a good pancreatin preparation which is useful and suitable for effective treatment of chronic alcoholic pancreatitis, if the patient keeps abstinence. PMID:7566938

  13. Assessment and Treatment of Adolescent Substance Use Disorders: Alcohol Use Disorders.

    PubMed

    Margret, Cecilia Patrica; Ries, Richard K

    2016-07-01

    Alcohol drinking in childhood and adolescence is a serious public health concern. Adolescence is a vulnerable period for risk-taking tendencies. Understanding the influences of problematic alcohol use is important for evolving interventions. Alcohol use in early years foreshadows a lifetime risk for psychiatric and substance use disorders. Early screening and assessment can alter tragic sequelae. We discuss clinical aspects such as confidentiality, differential levels of care, and criteria for best fitting treatments. Given the prevalence of drinking and its impact on psychiatric and substance use disorders, the need for further study and prevention are emphasized. PMID:27338964

  14. Public spending for illegal drug and alcohol treatment in hospitals: an EU cross-country comparison

    PubMed Central

    2014-01-01

    Background In view of the current economic crisis and the resulting austerity measures being implemented by governments across Europe, public expenditure for substance abuse treatment has increasingly become a subject of discussion. An EU cross-country comparison would allow an estimation of the total amount of public resources spent on substance abuse treatment, compare various substance abuse treatment funding options, and evaluate the division of expenditures between alcohol and illegal drugs. The purpose of this study is to estimate the public spending of EU countries for alcohol and illegal drug abuse treatment in hospitals. Methods Our study uses a uniform methodology in order to enable valid cross-national comparisons. Our data are drawn from the Eurostat database, which provides anno 2010 data on government spending for the treatment of illegal drug and alcohol abuse in 21 EU member states. The cross-country comparison is restricted to hospitals, since data were unavailable for other types of treatment providers. The systematic registration of in- and outpatient data is essential to monitoring public expenditures on substance abuse treatment using international databases. Results Total public spending for hospital-based treatment of illegal drug and alcohol abuse in the 21 EU member states studied is estimated to be 7.6 billion euros. Per capita expenditures for treatment of illegal drug abuse vary, ranging from 0.1 euros in Romania to 13 euros in Sweden. For alcohol abuse, that figure varied from 0.9 euros in Bulgaria to 24 euros in Austria. These results confirm other studies indicating that public expenditures for alcohol treatment exceed that for illegal drug treatment. Conclusions Multiple factors may influence the number of hospital days for alcohol or illegal substance abuse treatment, and expenditures fluctuate accordingly. In this respect, we found a strong correlation between gross domestic product (GDP) per capita and public expenditures per

  15. Treatment Components and Their Relationships with Drug and Alcohol Abstinence.

    ERIC Educational Resources Information Center

    Orwin, Rob; Ellis, Bruce

    This study evaluates the effect of treatment components through a secondary analysis of data from the National Treatment Improvement Evaluation Study (NTIES). The study examines the relationship between treatment components, client-level factors, and treatment outcomes, and how these relationships vary by treatment modality. It seeks to understand…

  16. [Alcoholic liver disease: possibilities of diagnosis, treatment and rehabilitation in multidisciplinary hospital].

    PubMed

    Pavlov, A I; Beliakin, S A

    2014-03-01

    Tactics of alcoholic liver disease treatment is defined in accordance with lesion level. Differentiated approach to these patients can significantly improve the efficiency of diagnosis, treatment and rehabilitation. At the stage of cirrhosis it is necessary to focus on prevention and treatment of complications. Patients with compensated cirrhosis and subcompensated improved survival achievable Propafenone S-ademetionine (geptral, Geptor). The article presents the results of our study demonstrating a significant decrease in serum bilirubin in patients on background intravenous S-ademetionine. Practicability of stage system creation of medical rehabilitation of patients with alcoholic cirrhosis is approved. PMID:25046935

  17. [Study of a sample of alcoholic patients two years post-treatment].

    PubMed

    Avila Escribano, J J; Pérez Madruga, A; Rodríguez Treceño, M

    1994-01-01

    This survey analyzes the evolution of one sample of alcoholic patients two years after finishing treatment. Its target is to determine the percentage of patients that remain abstinent, their rate of retention, and what factors can have an influence on abstinence. In 1990, 72 alcoholic patients were treated in the Alcoholism Unit, who make up our study sample. The average age was 37.9 +/- 11.47 years old; 77.8% were diagnosed as being Alcohol-dependents and 22.2% as Alcohol-abusers; 19.4% dropped out the treatment early. In 1992 our sample of study was 53 patients (2 died and 17 refused to participate), of whom 77.7% were abstinent and 28.3% continued ingesting alcohol; the average abstinence was 22.92 +/- 8.73 months. An important finding of this study was that the diagnosis, sex, and treatment with aversives had not an influence on abstinence; however the percentage of abstinent patients in those who had attended Therapeutic Discussion Groups was significantly higher than in those who had not. PMID:8209713

  18. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    PubMed Central

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M.

    2016-01-01

    Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment. PMID:27065113

  19. The Promises and Pitfalls of Digital Technology in Its Application to Alcohol Treatment

    PubMed Central

    Muench, Frederick

    2014-01-01

    Individuals seeking to change their alcohol use form a heterogeneous group with varied treatment goals—including moderation and abstinence—that therefore requires flexible treatment options. The availability of alcohol in the United States, and the pervasive social pressure to drink, warrant treatments that support individuals outside the treatment environment and that foster coping and self-regulation in the face of these demands. Emerging digital technologies show promise for helping both to hone therapies to clients’ individual needs and to support clients in settings beyond the clinic. In the broader health care arena, digital health technologies (DHTs) are transforming how health professionals assess, prevent, and treat both physical and mental health problems. DHTs include assessments and interventions delivered via computer, Internet, mobile phone, and wireless or wearable device technologies. The emerging literature examining within-treatment and mobile DHTs highlights an opportunity to create personalized alcohol treatments for every person seeking care. Despite the promises DHTs may hold, however, there still are many potential risks to using them and a number of challenges regarding how to integrate them into treatment successfully. This article will review the current and potential advantages of DHTs in alcohol treatment and the technological, personal, organizational, and systemic limitations of integrating various technology-based assessment and intervention programs into care. PMID:26259008

  20. Less Directiveness by Therapists Improves Drinking Outcomes of Reactant Clients in Alcoholism Treatment

    ERIC Educational Resources Information Center

    Karno, Mitchell P.; Longabaugh, Richard

    2005-01-01

    In this study, the authors examined the impact of the interaction between clients' trait reactance and therapists' directiveness on the effectiveness of psychotherapy treatment for alcoholism. Ratings of videotaped treatment sessions were used to measure clients' reactance (N = 141) and therapists' directiveness. Models tested for the interaction…

  1. Joining Forces Rather than "Waging War:" A Commentary on Alcoholism Treatment.

    ERIC Educational Resources Information Center

    Schonfeld, Lawrence; Morosko, Thomas E.

    1988-01-01

    Suggests a method to encourage proponents of opposing models of alcoholism treatment to work together. Emphasizes relapse prevention skills; deemphasizes etiological arguments. Claims traditionalists and antitraditionalists can, by joining forces, create treatment programs which offer standard group processes, and new components for more specific…

  2. A Model for the Treatment of College Age Children of Alcoholics.

    ERIC Educational Resources Information Center

    McDermott, Diane; Winterowd, Carrie

    A session by session cognitive behavioral approach to group treatment for college age children of alcoholics was presented. Four groups ranging in size from four to eight persons participated in these semester-long sessions offered during one academic year through the counseling center at a major midwestern university. The treatment was comprised…

  3. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    ERIC Educational Resources Information Center

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  4. Can Assessment Reactivity Predict Treatment Outcome among Adolescents with Alcohol and Other Substance Use Disorders?

    ERIC Educational Resources Information Center

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The objectives of this paper are two-fold: to examine first, if the change from positive to negative alcohol and any other substance use status from baseline assessment to the onset of the first session (i.e., pre-treatment phase) occurs in adolescents, that is, Assessment Reactivity (AR); second, whether AR predicts treatment outcome.…

  5. Alcohol Treatment and Cognitive-Behavioral Therapy: Enhancing Effectiveness by Incorporating Spirituality and Religion

    ERIC Educational Resources Information Center

    Hodge, David R.

    2011-01-01

    Cognitive-behavioral therapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by…

  6. Medicaid-Covered Alcohol and Drug Treatment Use among People with Intellectual Disabilities: Evidence of Disparities

    ERIC Educational Resources Information Center

    Slayter, Elspeth

    2010-01-01

    For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for…

  7. The impact of smoking, alcohol consumption, and physical activity on use of hospital services.

    PubMed Central

    Haapanen-Niemi, N; Miilunpalo, S; Vuori, I; Pasanen, M; Oja, P

    1999-01-01

    OBJECTIVES: This study investigated the associations of smoking, excess alcohol consumption, and physical inactivity with the use of hospital care. METHODS: A cohort of 19- to 63-year-old Finnish men (n = 2534) and women (n = 2668) were followed prospectively for 16 years. Number of hospital days was extracted from the national hospital discharge registry, while data concerning exposure variables were derived from the baseline questionnaire. RESULTS: After adjustment for confounders, male smokers had 70% (95% confidence interval [CI] = 49%, 95%) and female smokers had 49% (95% CI = 29%, 71%) more hospital days due to my cause than did those who had never smoked. Men consuming a moderate amount of alcohol had 21% (95% CI = 10%, 31%) fewer hospital days due to any cause than did nondrinkers. Men who had the lowest energy expenditure during leisure-time physical activity had 36% (95% CI = 15%, 63%) more hospital days than the most active men. The figure for women was 23% (95% CI = 4%, 44%). CONCLUSIONS: Smoking was strongly associated with an increased use of hospital services. The associations of alcohol consumption and leisure-time physical activity with use of hospital care depended on the diagnosis under study. PMID:10224980

  8. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Contracts for outpatient services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Services of Other Federal Agencies § 17.82 Contracts for...

  9. UPDATE ON NEUROPHARMACOLOGICAL TREATMENTS FOR ALCOHOLISM: SCIENTIFIC BASIS AND CLINICAL FINDINGS

    PubMed Central

    JOHNSON, BANKOLE A.

    2008-01-01

    The past decade has seen an expansion of research and knowledge on pharmacotherapy for the treatment of alcohol dependence. The Food and Drug Administration (FDA)–approved medications naltrexone and acamprosate have shown mixed results in clinical trials. Oral naltrexone and naltrexone depot formulations have generally demonstrated efficacy at treating alcohol dependence, but their treatment effect size is small, and more research is needed to compare the effects of different doses on drinking outcome. Acamprosate has demonstrated efficacy for treating alcohol dependence in European trials, but with a small effect size. In U.S. trials, acamprosate has not proved to be efficacious. Research continues to explore which types of alcohol-dependent individual would benefit the most from treatment with naltrexone or acamprosate. The combination of the two medications demonstrated efficacy for treating alcohol dependence in one European study but not in a multi-site U.S. study. Another FDA-approved medication, disulfiram, is an aversive agent that does not diminish craving for alcohol. Disulfiram is most effective when given to those who are highly compliant or who are receiving their medication under supervision. Of the non-approved medications, topiramate is among the most promising, with a medium effect size in clinical trials. Another promising medication, baclofen, has shown efficacy in small trials. Serotonergic agents such as selective serotonin reuptake inhibitors and the serotonin-3 receptor antagonist, ondansetron, appear to be efficacious only among certain genetic subtypes of alcoholic. As neuroscientific research progresses, other promising medications, as well as medication combinations, for treating alcohol dependence continue to be explored. PMID:17880925

  10. Characteristics of Chinese and Korean Americans in outpatient treatment for alcohol use disorders: examining heterogeneity among Asian American subgroups.

    PubMed

    Park, So-Youn; Shibusawa, Tazuko; Yoon, Sung Min; Son, Haein

    2010-01-01

    This study examined characteristics between Chinese Americans and Korean Americans who received treatment for alcohol use problems, using case records of 103 Chinese Americans and 108 Korean Americans. Findings show that the majority of Chinese Americans and Korean Americans were referred for treatment by the legal system and denied having alcohol problems. Significant differences were found between the groups in income, education, and types and quantity of alcohol use. Participants from neither group attended Alcoholics Anonymous. The differences in characteristics between the two groups with underscore the importance of considering the heterogeneity of Asian Americans when designing intervention programs for alcohol problems. PMID:20509086

  11. Training nurses and nursing students about prevention, diagnoses, and treatment of fetal alcohol spectrum disorders.

    PubMed

    Zoorob, Roger J; Durkin, Kristy M; Gonzalez, Sandra J; Adams, Susie

    2014-08-01

    Alcohol consumption during pregnancy can result in birth defects known as fetal alcohol spectrum disorders. This study examined whether 1-h training sessions on alcohol screening, brief intervention, diagnoses, and treatment of fetal alcohol spectrum disorders could increase practical knowledge and confidence in nurses and student nurses. Data were collected from 420 nurses (n = 95) and student nurses (n = 325) in the southeastern United States, from 2009 to 2011. Pre- and post-test data were analyzed using chi-square tests and t-tests. The post-training response rate was 84%. Nurses were more likely to know what constitutes binge drinking, facial abnormalities associated with fetal alcohol syndrome, and criteria for diagnosis. Nurses were also more confident in educating about effects of prenatal alcohol use, identifying fetal alcohol spectrum disorders and utilizing resources. Training materials may need to be improved and/or longer training programs developed for student nurses, and nursing school programs should place more emphasis on educating and preparing student nurses regarding this topic area. PMID:24393607

  12. Baclofen for the Treatment of Alcohol Dependence and Possible Role of Comorbid Anxiety

    PubMed Central

    Morley, K.C.; Baillie, A.; Leung, S.; Addolorato, G.; Leggio, L.; Haber, P.S.

    2014-01-01

    Aim: To conduct a double-blind, placebo-controlled randomized clinical trial of baclofen in the treatment of alcohol dependence. Methods: Out of 69 participants consecutively screened, 42 alcohol-dependent patients were randomized to receive placebo, baclofen 30 mg/day or baclofen 60 mg/day for 12 weeks. All subjects were offered BRENDA, a structured psychosocial therapy for alcohol dependence that seeks to improve motivation for change, enhance strategies to prevent relapse and encourage compliance with treatment. Results: Intention-to-treat analyses revealed that alcohol consumption (heavy drinking days, drinks per drinking day) significantly reduced across all three groups during the treatment period. There were no statistically significant advantages to treatment on time to first heavy drinking day (relapse) (P = 0.08), nor time to first drink (lapse) (P = 0.18). A post hoc analysis stratifying according to whether there had been a comorbid anxiety disorder, revealed a beneficial effect of baclofen 30 mg/day versus placebo on time to lapse and relapse (P < 0.05). There was also a beneficial effect for baclofen 60 mg/day relative to placebo on time to relapse in this comorbid group (P < 0.05). Both doses of baclofen were well tolerated. There were no serious adverse events. Conclusions: In spite of the small sample for a 3-arm clinical trial, this study suggests a specific role of baclofen in alcohol-dependent individuals with comorbid anxiety. Replication in larger, fully-powered studies is required. PMID:25246489

  13. FGF21 treatment ameliorates alcoholic fatty liver through activation of AMPK-SIRT1 pathway.

    PubMed

    Zhu, Shenglong; Ma, Lei; Wu, Yunzhou; Ye, Xianlong; Zhang, Tianyuan; Zhang, Qingyang; Rasoul, Lubna Muhi; Liu, Yunye; Guo, Mo; Zhou, Bing; Ren, Guiping; Li, Deshan

    2014-12-01

    Fibroblast growth factor 21 (FGF21), a recently identified member of the FGF superfamily, is mainly secreted from the liver and adipose tissues and plays an important role in improving metabolic syndrome and homeostasis. The aim of this study is to evaluate the role of FGF21 in alcoholic fatty liver disease (AFLD) and to determine if it has a therapeutic effect on AFLD. In this paper, we tested the effect of FGF21 on alcohol-induced liver injury in a murine model of chronic ethanol gavage and alcohol-treated HepG2 cells. Male KM mice received single dose of 5 g/kg ethanol gavage every day for 6 weeks, which induced significant fatty liver and liver injury. The alcohol-induced fatty liver cell model was achieved by adding ethanol into the medium of HepG2 cell cultures at a final concentration of 75 mM for 9 days. Results showed that treatment with recombinant FGF21 ameliorated alcoholic fatty liver and liver injury both in a murine model of chronic ethanol gavage and alcohol-treated HepG2 cells. In addition, FGF21 treatment down-regulated the hepatic expression of fatty acid synthetic key enzyme, activated hepatic AMPK-SIRT1 pathway and significantly down-regulated hepatic oxidative stress protein. Taken together, FGF21 corrects multiple metabolic parameters of AFLD in vitro and in vivo by activation of the AMPK-SIRT1 pathway. PMID:25355486

  14. Social Support and Treatment Outcome in Alcohol Dependence Syndrome in Armed Forces

    PubMed Central

    Chauhan, Vinay Singh; Azad, Sudip

    2015-01-01

    Introduction Social factors play vital role in unfolding of alcohol use disorders in any given population. Several factors beyond the confines of treatment settings influence treatment outcome in alcohol dependence syndrome. Social support has positive effect in treatment outcome of alcohol dependence syndrome. This has not been much studied in India in past. Therefore we decided to study the perception of social support in cases of alcohol dependence syndrome admitted in a busy hospital in armed forces. Aim The aim was to study the perception of social support across relapsed and abstinent group and see if it reached any statistical proportion and also to see if any socio-demographic variables also affected perception of social support. Materials and Methods Fifty five consecutive male patients of alcohol dependent syndrome without a co-morbid neurological/psychiatric diagnosis were assessed for their perception of social support after taking informed consent. They were explained the procedure and their alcoholic milestones were recorded in specially designed pro-forma. Subjects were then divided in abstinent and relapsed group. Subsequently they were assessed for their perception of social support by administering Social provision scale and Social support questionnaire. Statistical Analysis Data were tabulated and statistically analysed by using chi square test, Mann Whitney U-Test and Rank ANOVA test where applicable p-value <.05 was taken as significant. Results Results indicated that perception of social support across abstinent (n=18) and relapsed (n= 37) group reached significant statistical proportion as measured by social provision scale and social support questionnaire. Duration of use, dependence and family history of alcoholism did not influence perception of social support across patient population. There was inverse relationship between patients with alcohol related problem and their perception of social support. Professional and qualified soldiers

  15. Habilitational treatment of a child with fetal alcohol syndrome: case report.

    PubMed

    Matijević, Valentina; Bartolović, Jelena; Crnković, Maja; Kosicek, Tena; Barisić, Irma

    2014-03-01

    Fetal alcohol syndrome is defined by a triad of symptoms such as facial dysmorphology, prenatal and postnatal growth deficiency, and central nervous system dysfunction. It is the result of teratogenic effects of alcohol consumption in pregnancy. The prevalence of fetal alcohol syndrome is 1 to 3 per 1000 live births. From the neurological point of view, there is a possibility of the central nervous system dysfunction. Structural disjunctions are the consequences of fine and gross motor dysfunction, oculomotor dysfunction, and difficulties in sensorimotor integration. From the functional point view, there are complex cognitive disorders and behavioral disorders, attention disorders and impulse control disorders, learning difficulties, and social communication and perception difficulties. This paper presents a case study of a boy diagnosed with fetal alcohol syndrome at the age of four, monitored by a team of experts including a physiatrist and neuropediatrician. The boy is also included in polyvalent habilitation treatment provided by a speech therapist, rehabilitator and psychologist. PMID:24974670

  16. [Treatment of alcoholism. Study of the efficacy of 4 therapeutic orientations].

    PubMed

    Miguez, H A

    1981-05-01

    The present survey studies, in a group of 145 alcoholics from the National Institute on Alcoholism in Costa Rica, the effectiveness of four therapeutic orientations in alcoholism: behavioral, psychosocial, occupational and multiple. The survey was carried out in a harmless population of alcoholics, and it aims to work out and to test treatment designs suitable to the uncovered level or prevention respecting to alcoholism, the secondary one. Each one of the groups receiving the diverse treatments stayed as in-patient under similar conditions. The treatment had a two-week duration; once finished, the patient was discharged and continued with a one-year follow-up. The outcomes are the following: 1. Treatment. The occupational and behavior-oriented treatments present a five months abstinence period as an estimate average effectiveness. The psychosocial-oriented treatments reach a seven months abstinence period. Its major effectiveness is due to the specific action this orientation develops on the patients having the worst prognosis. The integration, in a treatment, of orientations corresponding to different theoretical frames can determine reciprocal inhibition phenomena among orientations and lower the general effectiveness level. 2. Diagnosis. The personalities defined as depressive and paranoiac according to their prevailing basic anxiety, and the presence or absence of a conjugal tie holds an estimate link with the abstinence the patient showed when he was discharged from treatment. The prognosis value of this characteristic disappears when it is then direct object of a therapeutic orientation (psychosocial) given that this characteristics are sensitive to changes by action in a specific treatment. PMID:7348074

  17. Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders

    PubMed Central

    Witkiewitz, Katie; Finney, John W.; Harris, Alex H.S; Kivlahan, Daniel R.; Kranzler, Henry R.

    2015-01-01

    Background Over the past 60 years the view that “alcoholism” is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and non-pharmacological interventions for AUDs. Methods Narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs. Results Despite considerable improvements in the design of alcohol clinical trials over the past two decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy. Conclusions The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD. PMID:26250333

  18. Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence.

    PubMed

    Sinclair, Julia M A; Chambers, Sophia E; Shiles, Celia J; Baldwin, David S

    2016-07-01

    Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy. Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of AUD. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels; multiple physical comorbidities that may interfere with pharmacological effects, distribution and metabolism; and concomitant medication for the treatment of comorbid physical and psychiatric conditions. The five drugs, including an extended-release injectable suspension of naltrexone, have different safety profiles that need to be balanced with the treatment objective (initiation or continuation of abstinence, or reduction of drinking), individual patient preferences and comorbid conditions. Appropriate treatment will be based on the unique risk-benefit profile in each case. PMID:27023898

  19. Does Alcohol Consumption during Multidrug-resistant Tuberculosis Treatment Affect Outcome?

    PubMed Central

    Duraisamy, Karthickeyan; Mrithyunjayan, Sunilkumar; Ghosh, Smita; Nair, Sreenivas Achuthan; Balakrishnan, Shibu; Subramoniapillai, Jayasankar; Oeltmann, John E.; Moonan, Patrick K.; Kumar, Ajay M. V.

    2015-01-01

    Rationale India reports the largest number of multidrug-resistant tuberculosis cases in the world; yet, no longitudinal study has assessed factors related to treatment outcomes under programmatic conditions in the public sector. Objectives To describe demographic, clinical, and risk characteristics associated with treatment outcomes for all patients with multidrug-resistant tuberculosis registered in the Revised National Tuberculosis Control Programme, Kerala State, India from January 1, 2009 to June 30, 2010. Methods Cox regression methods were used to calculate adjusted hazard ratios with 95% confidence intervals (CIs) to assess factors associated with an unsuccessful treatment outcome. Measurements and Main Results Of 179 patients with multidrug-resistant tuberculosis registered, 112 (63%) had successful treatment outcomes (77 bacteriologically cured, 35 treatment completed) and 67 (37%) had unsuccessful treatment outcomes (30 died, 26 defaulted, 9 failed treatment, 1 stopped treatment because of drug-related adverse events, and 1 developed extensively drug-resistant tuberculosis). The hazard for unsuccessful outcome was significantly higher among patients who consumed alcohol during treatment (adjusted hazard ratio, 4.3; 95% CI, 1.1–17.6) than those who did not. Persons who consumed alcohol during treatment, on average, missed 18 more intensive-phase doses (95% CI, 13–22) than those who did not. Although many patients had diabetes (33%), were ever smokers (39%), or had low body mass index (47%), these factors were not associated with outcome. Conclusion Overall treatment success was greater than global and national averages; however, outcomes among patients consuming alcohol remained poor. Integration of care for multidrug-resistant tuberculosis and alcoholism should be considered to improve treatment adherence and outcomes. PMID:24735096

  20. The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.

    PubMed

    Kaczkurkin, Antonia N; Asnaani, Anu; Alpert, Elizabeth; Foa, Edna B

    2016-04-01

    Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD. PMID:26905901

  1. What the alcohol doctor ordered from the neuroscientist: Theragnostic biomarkers for personalized treatments.

    PubMed

    Heilig, Markus; Leggio, Lorenzo

    2016-01-01

    Major advances in the neuroscientific understanding of alcohol actions have so far not translated into measurably improved clinical outcomes in alcoholism. Future treatment development should be guided by accumulating insights into a diverse range of biological mechanisms that maintain the pathophysiology of alcoholism in different individuals, but also at different points in time within any given patient. This biological diversity calls for the development and use of biological markers predictive of treatment response in the individual case, at the specific stage of the disease, here called "theragnostics." As novel therapeutic mechanisms and molecules targeting these mechanisms are discovered, the use of theragnostics will be critical for their successful clinical development, as well as their optimal subsequent clinical use. During clinical development, lest theragnostics are utilized, efficacy signals will risk remaining undetected when diluted in study populations that are not appropriately selected. Similarly, for treatments that reach approval, clinical acceptance, and optimal use will require the proper identification of responsive patients. Here, we discuss desirable properties of theragnostic biomarkers in alcohol addiction using two examples: alcohol-induced activation of brain reward circuitry as assessed using positron emission tomography of functional magnetic resonance imaging; and central glutamate tone, as assessed using MR spectroscopy. PMID:26822368

  2. Critical thoughts on current rodent models for evaluating potential treatments of alcohol addiction and withdrawal

    PubMed Central

    Ripley, Tamzin L; Stephens, David N

    2011-01-01

    Despite years of neurobiological research that have helped to identify potential therapeutic targets, we do not have a reliable pharmacological treatment for alcoholism. There are a range of possible explanations for this failure, including arguments that alcoholism is a spectrum disorder and that different population subtypes may respond to different treatments. This view is supported by categorisations such as early- and late-onset alcoholism, whilst multifactorial genetic factors may also alter responsivity to pharmacological agents. Furthermore, experience of alcohol withdrawal may play a role in future drinking in a way that may distinguish alcoholism from other forms of addiction. Additionally, our neurobiological models, based largely upon results from rodent studies, may not mimic specific aspects of the human condition and may reflect different underlying phenomena and biological processes from the clinical pattern. As a result, potential treatments may be targeting inappropriate aspects of alcohol-related behaviours. Instead, we suggest a more profitable approach is (a) to identify well-defined intermediate behavioural phenotypes in human experimental models that reflect defined aspects of the human clinical disorder and (b) to develop animal models that are homologous with those phenotypes in terms of psychological processes and underlying neurobiological mechanisms. This review describes an array of animal models currently used in the addiction field and what they tell us about alcoholism. We will then examine how established pharmacological agents have been developed using only a limited number of these models, before describing some alternative novel approaches to achieving homology between animal and human experimental measures. LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue-4 PMID:21470204

  3. Estimation of Diagnosis and Treatment Costs of Non-Alcoholic Fatty Liver Disease: A Two-Year Observation

    PubMed Central

    Ghamar Chehreh, Mohammad Ebrahim; Vahedi, Mohsen; Pourhoseingholi, Mohammad Amin; Ashtari, Sara; Khedmat, Hossein; Amin, Mohsen; Zali, Mohammad Reza; Alavian, Seyed Moayed

    2013-01-01

    Background There are insufficient data available on utilization and health care costs of non-alcoholic fatty liver disease. The cost data for different health conditions and services is a major gap in Iranian health system. So this study is the primary or first step towards filling this gap. Objectives This study aims to estimate the diagnosis and treatment costs of Non-alcoholic Fatty Liver. Patients and Methods This cross-sectional study was conducted on 528 subjects. The subjects had been diagnosed with non-alcoholic fatty liver. All the subjects had been referred to the Tehran Fatty Liver Clinic, a clinic of the Baqiyatallah Research Center for Gastroenterology and Liver Diseases, in 2009 and they had been observed for 2 years to determine the frequency of health care utilization (physician visit, laboratory tests, medication and cost of sonography). The costs of diagnosis and treatment for each person were estimated in Purchasing Power Parity dollars (PPP$). Results The average total cost was 5,043 PPP$ per person in the 2 years of observation. Majority of these 528 patients (87.9%) had a BMI ≥ 25 (kg/m2). Also, 33.9% were diagnosed with comorbid diseases such as Diabetes Mellitus (DM), Coronary Artery Disease (CAD), hypertension (HTN) and hypothyroidism (HYPO). Conclusions The results confirmed that the total costs for non-alcoholic fatty liver among the Iranian adult urban population alone exceeded 1 billion PPP$ per year. These costs can be saved or reduced by effective disease management and early prevention. PMID:23914227

  4. Examining intensity and types of interagency collaboration between child welfare and drug and alcohol service providers.

    PubMed

    He, Amy S

    2015-08-01

    The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs. PMID:26188423

  5. 45 CFR 96.131 - Treatment services for pregnant women.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... areas, and frequent notification of availability of such treatment distributed to the network of community based organizations, health care providers, and social service agencies. (c) The State shall...

  6. Clinical practices in the pharmacological treatment of comorbid psychopathology in adolescents with alcohol use disorders.

    PubMed

    Clark, Duncan B; Wood, D Scott; Cornelius, Jack R; Bukstein, Oscar G; Martin, Christopher S

    2003-12-01

    This study examined the use of psychiatric medications in 277 adolescents in treatment for alcohol use disorders. Subjects were recruited from addictions treatment sites, psychiatric programs, and juvenile justice settings. Characteristics studied included the use of and indications for specific medications, changes in clinical practices from 1991 through 2000, and continuation of psychopharmacological treatment over a 1-year followup period. Among adolescents taking psychiatric medications at baseline (n = 51), indicated DSM-IV mental disorders were typically present, use of antidepressants was most common (n = 41), benzodiazepine prescription was rare, and about one third reported continuing pharmacological treatment at one-year followup. In those with comorbid major depressive disorder and alcohol use disorders (n = 110), antidepressant medication use increased significantly from 18% to 55% over the decade studied. The treatment setting did not significantly influence antidepressant prescribing practices. The common and increasing use of psychiatric medications in this population emphasizes the urgent need for empirically based clinical guidelines. PMID:14693259

  7. The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care

    PubMed Central

    Wolitzky-Taylor, Kate; Brown, Lily A.; Roy-Byrne, Peter; Sherbourne, Cathy; Stein, Murray B.; Sullivan, Greer; Bystritsky, Alexander; Craske, Michelle G.

    2014-01-01

    Objective The presence of anxiety disorders is associated with poorer alcohol use disorder treatment outcomes, but little is known about the impact of alcohol use problems on anxiety disorder treatment outcomes despite their high comorbidity. The current study examined the impact of alcohol use symptom severity on anxiety disorder treatment outcomes in a multi-site primary care effectiveness study of anxiety disorder treatment. Method Data came from the Coordinated Anxiety Learning and Management (CALM) effectiveness trial. Participants (N = 1004) were randomized to an evidence-based anxiety intervention (including cognitive behavioral therapy and medications) or usual care in primary care. Participants completed measures of alcohol use, anxiety, and depression a baseline, 6-mo, 12-mo, and 18-mo follow-up periods. Patients with alcohol dependence were excluded. Results There were no significant moderating (Treatment Group x Alcohol Use Severity) interactions. The majority of analyses revealed no predictive effects of alcohol use severity on outcome; however, alcohol problems at baseline were associated with somewhat higher anxiety and depression symptoms at the 18-mo follow-up. Conclusions These data indicate that patients with alcohol problems in primary care can be effectively treated for anxiety disorders. Baseline alcohol problems were associated with some poorer long-term outcomes, but this was evident across CALM and usual care. These findings provide preliminary evidence that there may be no need to postpone treatment of anxiety disorders until alcohol problems are addressed, at least among those who have mild to moderate alcohol problems. Replication with more severe alcohol use disorders is needed. PMID:25615523

  8. Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment.

    PubMed

    Delgadillo, Jaime; Gore, Stuart; Ali, Shehzad; Ekers, David; Gilbody, Simon; Gilchrist, Gail; McMillan, Dean; Hughes, Elizabeth

    2015-08-01

    Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n = 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n = 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24 weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio = 7.14, p = .04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p = .59) or in PDA (p = .08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups. PMID:25819701

  9. Alcohol consumption, illicit substances, and intimate partner violence in a sample of batterers in psychological treatment.

    PubMed

    Redondo Rodríguez, Natalia; Graña Gómez, José Luis

    2015-01-01

    The purpose of this study is to analyze the alcohol and illicit substance consumption characteristics in a sample of 572 batterers in treatment by court order. The results indicate that the prevalence of alcohol consumption in the past year was 89.3%, whereas within illicit substances, the prevalences were higher for cannabis (27.8%), followed by cocaine 20.3%). In order to analyze the possible effect of consumption on levels of perpetration and victimization of partner-aggression, the sample was divided into 4 groups: nonconsumers (16.3%), alcohol consumers (58.6%), illicit drug consumers (3.5%), and consumers of alcohol and illicit drugs (21.7%), finding that the groups of nonconsumers and alcohol consumers presented the lowest level of perpetration of psychological, physical, and sexual aggression and of victimization of psychological and physical aggression, whereas the group of consumers of alcohol and illicit drugs presented the highest levels. The results reveal the need to assess substance consumption when designing intervention protocols with batterers. PMID:25879475

  10. Initiation and retention in couples outpatient treatment for parents with drug and alcohol use disorders.

    PubMed

    Braitman, Abby L; Kelley, Michelle L

    2016-06-01

    The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy. Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported less intimate partner victimization, if they sought treatment for both alcohol and drug use disorder, if they were older when they first suspected a substance use problem, and if they were more obsessive-compulsive, more phobic anxious, less hostile, and experienced less somatization and less paranoid ideation. For women, treatment initiation was associated with less cohesion in their relationships, more somatization, and being older when they first suspected an alcohol or drug use problem. Trends were observed between women's treatment retention and being older, experiencing more somatization, and suspecting drug-related problems when they were younger; however, no predictors reached statistical significance for women. Results suggest that different factors may be associated with men and women's willingness to initiate and attend conjoint treatment for substance abuse. (PsycINFO Database Record PMID:27064819

  11. Within treatment therapeutic alliance ratings profiles predict posttreatment frequency of alcohol use

    PubMed Central

    Prince, Mark A.; Connors, Gerard J.; Maisto, Stephen A.; Dearing, Ronda L.

    2016-01-01

    While past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. 65 treatment-seeking alcohol dependent clients who participated in 12 weeks of individual outpatient treatment provided weekly TA ratings during treatment and reported on pre-treatment, during treatment, and post-treatment alcohol use. Latent profile analysis was conducted to discern distinct profiles of client and therapist ratings of therapeutic alliance with similar alliance characteristics. TA profiles were based on clients’ and therapists’ mean alliance rating, minimum alliance rating, maximum alliance rating, the range of alliance ratings, and the difference in session number between maximum and minimum alliance ratings. 1- through 4- class models were fit to the data. Model fit was judged by comparative fit indices, substantive interpretability, and parsimony. Wald tests of mean equality determined whether classes differed on follow-up percentage of days abstinent (PDA) at 4 months posttreatment. 3-profile solutions provided the best fit for both client and therapist ratings of the therapeutic alliance. Client alliance rating profiles predicted drinking in the follow-up period, but therapist rating profiles did not. These results suggest that distinct profiles of the therapeutic alliance can be identified and that client alliance rating profiles are associated with frequency of alcohol use following outpatient treatment. PMID:26999350

  12. The application of Bandura's self-efficacy theory to abstinence-oriented alcoholism treatment.

    PubMed

    Rollnick, S; Heather, N

    1982-01-01

    This paper explores the relevance of self-efficacy theory (Bandura, 1977b) to the process of abstinence treatment and the phenomenon of relapse. By distinguishing between the particular efficacy and outcome expectations created in treatment it is possible to clarify some of the problems encountered between clinicians and alcoholics. Bandura's theory also explains why some treatment methods might be more effective than others. Analysis of relapse suggests that while some of the expectations created in treatment might serve to promote abstinence, others might unwittingly precipitate relapse. The understanding of abstinence treatment could be enhanced by the testing of hypotheses which emerge from this analysis. PMID:7180618

  13. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  14. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...), you must avail yourself of appropriate treatment for your drug addiction or alcoholism at...

  15. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...), you must avail yourself of appropriate treatment for your drug addiction or alcoholism at...

  16. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  17. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  18. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...), you must avail yourself of appropriate treatment for your drug addiction or alcoholism at...

  19. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...), you must avail yourself of appropriate treatment for your drug addiction or alcoholism at...

  20. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...), you must avail yourself of appropriate treatment for your drug addiction or alcoholism at...

  1. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  2. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  3. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  4. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  5. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  6. Treatment-refractory substance use disorder: Focus on alcohol, opioids, and cocaine.

    PubMed

    Soyka, Michael; Mutschler, Jochen

    2016-10-01

    Substance use disorders are common, but only a small minority of patients receive adequate treatment. Although psychosocial therapies are effective, relapse is common. This review focusses on novel pharmacological and other treatments for patients with alcohol, opioid, or cocaine use disorders who do not respond to conventional treatments. Disulfiram, acamprosate, and the opioid antagonist naltrexone have been approved for the treatment of alcoholism. A novel, "as needed" approach is the use of the mu-opioid antagonist and partial kappa agonist nalmefene to reduce alcohol consumption. Other novel pharmacological approaches include the GABA-B receptor agonist baclofen, anticonvulsants such as topiramate and gabapentin, the partial nicotine receptor agonist varenicline, and other drugs. For opioid dependence, opioid agonist therapy with methadone or buprenorphine is the first-line treatment option. Other options include oral or depot naltrexone, morphine sulfate, depot or implant formulations, and heroin (diacetylmorphine) in treatment-refractory patients. To date, no pharmacological treatment has been approved for cocaine addiction; however, 3 potential pharmacological treatments are being studied, disulfiram, methylphenidate, and modafinil. Pharmacogenetic approaches may help to optimize treatment response in otherwise treatment-refractory patients and to identify which patients are more likely to respond to treatment, and neuromodulation techniques such as repeated transcranial magnetic stimulation and deep brain stimulation also may play a role in the treatment of substance use disorders. Although no magic bullet is in sight for treatment-refractory patients, some novel medications and brain stimulation techniques have the potential to enrich treatment options at least for some patients. PMID:26577297

  7. [The effectiveness of psychosocial treatment approaches for alcohol dependence--a review].

    PubMed

    Bottlender, M; Köhler, J; Soyka, M

    2006-01-01

    Treatment approaches which are used in the context of inpatient alcoholism treatment are frequently neither theoretically justified nor empirically examined. In view of the enormous method variety the necessity exists for the development of treatment guidelines in order to offer indicators of promising treatment achievement for practitioners and pension funds. In a first step, it must be examined which treatments are effective, which are ineffective and which are possibly even counter-productive. This article aims to give a comprehensive review of randomized-controlled studies/meta-analysis on the efficacy of different treatment approaches. This article reporting the literature review is part of a larger programme to develop clinical practice guidelines for rehabilitation which is supported in form, content and finance by the German Pension Institute for Salaried Employees (Bundesversicherungsanstalt für Angestellte, BfA). Summing up, treatment is effective compared to no treatment. Cognitive behavioural therapy included in a multimodal treatment program is effective. There are a number of treatment protocols for which controlled research has consistently found positive results like social skills training, community reinforcement approaches, behaviour contracting, motivation-enhancing treatment, and family/marital therapy. There is also a number of commonly used treatment approaches that brought neither a positive result or were counter productive like relapse prevention, non-behavioural marital therapy, and insight psychotherapy, confrontational counseling, education, relaxation training, and milieu therapy. Support for matching to a specific treatment is weak, but interventions against alcohol problems should be differentiated according to the severity of the alcohol problem. Since treatment evaluation is mainly accomplished in the US and supplying structures with respect to the US and Germany are substantially different, a generalized transmission of US

  8. Marital Therapy and Spouse Involvement in the Treatment of Depression, Agoraphobia, and Alcoholism.

    ERIC Educational Resources Information Center

    Jacobson, Neil S.; And Others

    1989-01-01

    Examines literature on marital therapy and spouse involvement as treatments for major psychopathology, focusing on depression, agoraphobia, and alcoholism. For each disorder, examines relation between marital dynamics and disorder and discusses empirical efforts to evaluate impact of marital therapy or spouse involvement on disorder. Summarizes…

  9. Integrated Psychosocial and Opioid-Antagonist Treatment for Alcohol Dependence: A Systematic Review of Controlled Evaluations

    ERIC Educational Resources Information Center

    Vaughn, Michael G.; Howard, Matthew O.

    2004-01-01

    Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist…

  10. Marital Violence in the Year before and after Spouse-Involved Alcoholism Treatment.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Choquette, Keith A.

    The Conflict Tactics Scale questionnaire on marital violence was administered to 29 alcoholics and their wives at entry to, and 1 year after, completing a behavioral marital therapy (BMT) treatment program. In the year prior to BMT, prevalence rates of any violent act, of minor to moderate violent acts, and of severe violent acts were five to six…

  11. Alternative Funding Resources Manual for Drug Abuse and Alcohol Treatment and Rehabilitation Programs.

    ERIC Educational Resources Information Center

    Bertagnoli, Cliff

    The purpose of this manual is to guide and assist alcohol and other drug abuse treatment programs to maximize cost recovery from third party reimbursements. It is intended to be a guide for planning and decision making rather than a resource manual. The text is based on the experiences of agencies in six states participating in a demonstration…

  12. Stability of Comorbid Psychiatric Diagnosis among Youths in Treatment and Aftercare for Alcohol Use Disorders

    ERIC Educational Resources Information Center

    Hawke, Josephine M.; Kaminer, Yifrah; Burke, Rebecca; Burleson, Joseph A.

    2008-01-01

    Objectives: To examine the stability of comorbid psychiatric diagnoses among a sample of 50 adolescents in cognitive-behaviorally-based treatment for alcohol and other substance use disorders (AOSUD). Methods: A standardized psychiatric interview was administered at baseline and 12 month later to obtain current comorbid psychiatric disorders. Chi…

  13. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    ERIC Educational Resources Information Center

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  14. Stopping smoking during first year of substance use treatment predicted 9-year alcohol and drug treatment outcomes

    PubMed Central

    Tsoh, Janice Y.; Chi, Felicia W.; Mertens, Jennifer R.; Weisner, Constance M.

    2010-01-01

    This study examined the association between stopping smoking at 1 year after substance use treatment intake and long-term substance use outcomes. Nine years of prospective data from 1,185 adults (39% female) in substance use treatment at a private health care setting were analyzed by multivariate logistic generalized estimating equation models. At 1 year, 14.1% of 716 participants who smoked cigarettes at intake reported stopping smoking, and 10.7% of the 469 non-smokers at intake reported smoking. After adjusting for sociodemographics, substance use severity and diagnosis at intake, length of stay in treatment, and substance use status at 1 year, those who stopped smoking at 1 year were more likely to be past-year abstinent from drugs, or in past-year remission of drugs and alcohol combined, at follow-ups than those who continued to smoke (OR = 2.4, 95% CI: 1.2 – 4.7 and OR = 1.6, 95% CI: 1.1 – 2.4, respectively). Stopping smoking at 1 year also predicted past-year alcohol abstinence through 9 years after intake among those with drug-only dependence (OR = 2.4, 95% CI: 1.2 – 4.5). We found no association between past-year alcohol abstinence and change in smoking status at 1 year for those with alcohol dependence or other substance use diagnoses when controlling for alcohol use status at 1 year. Stopping smoking during the first year after substance use treatment intake predicted better long-term substance use outcomes through 9 years after intake. Findings support promoting smoking cessation among smoking clients in substance use treatment. PMID:21050681

  15. Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment

    PubMed Central

    2013-01-01

    Background Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients’ experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland’s Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results We identified three overarching themes relevant to the purpose of this paper: (1) patients’ experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic

  16. Factors associated with probation officers' use of criminal justice coercion to mandate alcohol treatment.

    PubMed

    Polcin, Douglas L; Greenfield, Thomas K

    2003-08-01

    Alcohol problems are widespread among individuals in county criminal justice probation systems. However, it is unclear why only a small fraction of these problem drinkers receive treatment. In this study, self-administered questionnaires were mailed to 145 probation officers in nine California counties to identify factors that predicted probation officers' use of coercion to mandate alcohol treatment. The questionnaire measured characteristics of probation officers, characteristics of their caseloads, and perceptions about their departments. Principle components analysis combined some of the items into six factor-based scales. Multiple regression analyses identified two significant predictors of use of coercion into treatment: a belief that treatment was effective and a belief that one's peers in the department were using coercion frequently. Implications for increasing treatment entry of probationers with drinking problems include educating probation officers about the effectiveness of substance abuse treatment in general and about coerced treatment in particular. Probation departments are encouraged to develop management styles that facilitate shared normative beliefs about assessing and managing alcohol problems among probationers. PMID:14510045

  17. The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

    PubMed

    Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

    2015-05-01

    Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. PMID:25761920

  18. The Role of Expectation in the Therapeutic Outcomes of Alcohol and Drug Addiction Treatments

    PubMed Central

    Spagnolo, Primavera A.; Colloca, Luana; Heilig, Markus

    2015-01-01

    Throughout history, patient–physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. PMID:25761920

  19. Alcohol Abuse

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Fals-Stewart, William

    2003-01-01

    We received 38 controlled studies of marital and family therapy (MFT) in alcoholism treatment. 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, (a) Al-Anon facilitation and referral help family members cope better; (b)…

  20. HIV, Alcohol Dependence and the Criminal Justice System: A Review and Call for Evidence-Based Treatment

    PubMed Central

    Springer, Sandra A.; Azar, Marwan M.; Altice, Frederick L.

    2011-01-01

    People with both HIV and alcohol use disorders are disproportionately concentrated within the U.S. criminal justice system; approximately one-quarter of all people with HIV cycle through the system each year. HIV-infected prisoners with alcohol problems face many obstacles as they transition back to the community. Specifically, although they have impressive HIV treatment outcomes during the period of incarceration while they are free from alcohol, upon release, however, they face inordinate challenges including relapse to alcohol use resulting in significant morbidity and mortality. Randomized controlled trials affirm the role of pharmacotherapy using naltrexone (NTX) as the therapeutic option conferring the best treatment outcome for alcohol use disorders within the community. Absent from these trials were inclusion of prisoners or HIV-infected individuals. Relapse to alcohol use among HIV-infected prisoners is associated with reduced retention in care, poor adherence to antiretroviral therapy with consequential poor HIV treatment outcomes and higher levels of HIV risk behaviors. Untreated alcohol dependence, particularly for released HIV-infected prisoners, has both negative consequences for the individual and society and requires a concentrated effort and rethinking of our existing approaches for this vulnerable population. The specific aim of this manuscript is to review the existing literature regarding the relationship of HIV and treatment for alcohol use disorders in criminal justice populations in an effort to determine “best practices” that might effectively result in improved treatment of HIV and alcohol disorders for released prisoners. PMID:21171933

  1. Chronic Alcohol Treatment in Rats Alters Sleep by Fragmenting Periods of Vigilance Cycling in the Light Period with Extended Wakenings

    PubMed Central

    Mukherjee, Sanjib; Simasko, Steven M.

    2009-01-01

    Studies have shown that disturbed sleep produced by chronic alcohol abuse in humans can predict relapse drinking after periods of abstinence. How alcohol produces disturbed sleep remains unknown. In this study we used a novel analysis of sleep to examine the effects of alcohol on sleep patterns in rats. This analysis separates waking into multiple components and defines a period labeled vigilance cycling (VC) in which the rat rapidly cycles through various vigilance states. These VC episodes are separated by long duration wake periods (LDW). We find that 6 weeks of alcohol (6% in a liquid diet) caused fragmentation of extended VC episodes that normally occur in the light period. However, total daily amounts of slow-wave sleep (SWS) and rapid-eye movement sleep (REMS) remained constant. The daily amount of wake, SWS, and REMS remained constant because the alcohol treated rats increased the amount of VC in the dark period, and the sleep nature of VC in the dark period became more intense. In addition, we observed more wake and less REMS early in the light period in alcohol treated rats. All effects completely reversed by day 16 of alcohol withdrawal. Comparison of the effects of chronic alcohol to acute alcohol exposure demonstrated the effects of chronic alcohol are due to adaptation and not the acute presence of alcohol. The effects of chronic alcohol treatment in rats mimic the effects reported in humans (REMS suppression, difficulty falling asleep, and difficulty remaining asleep). PMID:19014977

  2. A randomized, controlled study of treatment for alcohol dependence in patients awaiting liver transplantation.

    PubMed

    Weinrieb, Robert M; Van Horn, Deborah H A; Lynch, Kevin G; Lucey, Michael R

    2011-05-01

    Alcohol is the second most common cause of cirrhosis necessitating liver transplantation in the United States, yet rates of posttransplant drinking approach 50% and no controlled clinical trials of alcoholism treatment exist in this population. Eligible patients were randomly assigned to receive Motivational Enhancement Therapy (MET), or referral to local treatment sources ("treatment as usual" [TAU]). Addictive behavior, mood states, and general health were compared. Candor concerning alcohol use was encouraged by keeping drinking questionnaires in confidence, except in medical emergencies. Ninety-one subjects were studied; 46 received MET, 45 received TAU, 29 proceeded to transplantation (MET, n = 13; TAU, n = 16). A total of 69 subjects completed 24 weeks of observation, and 25 subjects were assessed at 96 weeks. No difference in study attendance was observed, but significantly more MET subjects attended 1 or more treatment sessions. Twenty-three subjects (25% of sample) drank after randomization but before transplant. Excluding an extreme outlier, MET drinkers had significantly fewer drinks per drinking days than TAU drinkers. Neither treatment plan resulted in significant variances in measures of psychosocial health. In conclusion, although MET afforded no significant benefit over TAU for mood or general health outcomes, this study provides some degree of support for MET to limit the quantity and frequency of pretransplant alcohol consumption among liver transplant candidates with alcohol dependence. However, because of the limited number of study subjects, these data must be interpreted cautiously. Further research to validate our findings or to identify better methods to identify and intervene with patients at risk of pretransplant and posttransplant drinking should continue. PMID:21506242

  3. Assessment and treatment of insomnia in adult patients with alcohol use disorders.

    PubMed

    Brower, Kirk J

    2015-06-01

    Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications. This article focuses on assessing and treating insomnia that persists despite 4 or more weeks of sobriety in alcohol-dependent adults. Selecting among the various options for treatment follows a comprehensive assessment of insomnia and its multifactorial causes. In addition to chronic, heavy alcohol consumption and its effects on sleep regulatory systems, contributing factors include premorbid insomnia; co-occurring medical, psychiatric, and other sleep disorders; use of other substances and medications; stress; environmental factors; and inadequate sleep hygiene. The assessment makes use of history, rating scales, and sleep diaries as well as physical, mental status, and laboratory examinations to rule out these factors. Polysomnography is indicated when another sleep disorder is suspected, such as sleep apnea or periodic limb movement disorder, or when insomnia is resistant to treatment. Sobriety remains a necessary, first-line treatment for insomnia, and most patients will have some improvement. If insomnia-specific treatment is needed, then brief behavioral therapies are the treatment of choice, because they have shown long-lasting benefit without worsening of drinking outcomes. Medications work faster, but they generally work only as long as they are taken. Melatonin agonists; sedating antidepressants, anticonvulsants, and antipsychotics; and benzodiazepine receptor agonists each have their benefits and risks, which must be weighed and monitored to optimize outcomes. Some relapse prevention medications may also have sleep-promoting activity. Although it is assumed that treatment for insomnia will help prevent relapse, this has not been firmly established. Therefore

  4. How to have a high success rate in treatment: advice for evaluators of alcoholism programs.

    PubMed

    Miller, W R; Sanchez-Craig, M

    1996-06-01

    Two seasoned alcohol treatment researchers offer tongue-in-cheek advice to novice program evaluators faced with increasing pressure to show high success rates. Based on published examples, they advise: (1) choose only good prognosis cases to evaluate; (2) keep follow-up periods as short as possible; (3) avoid control and comparison groups; (4) choose measures carefully; (5) focus only on alcohol outcomes; (6) use liberal definitions of success; (7) rely solely upon self-report and (8) always declare victory regardless of findings. PMID:8696242

  5. [SEMERGEN positioning for the treatment of alcohol disorders in primary care].

    PubMed

    Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

    2015-12-01

    The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations. PMID:26710714

  6. Alcoholism and Minority Populations.

    ERIC Educational Resources Information Center

    Watts, Thomas D.; Wright, Roosevelt, Jr.

    1991-01-01

    Briefly discusses some aspects of the role of the state and the position of minorities in respect to alcoholism policies and services. Includes case study of a Black alcoholic. Refers readers to studies on Black alcoholism, Native American alcoholism, Hispanic alcoholism, and Asian-American alcoholism. (Author/NB)

  7. Unhealthy Alcohol Use.

    PubMed

    Holt, Stephen; Tetrault, Jeanette

    2016-08-01

    Unhealthy alcohol use is common and routine screening is essential to identify patients and initiate appropriate treatment. At-risk or hazardous drinking is best managed with brief interventions, which can be performed by any provider and are designed to enhance patients' motivations and promote behavioral change. Alcohol withdrawal can be managed, preferably with benzodiazepines, using a symptom-triggered approach. Twelve-step programs and provider-driven behavioral therapies have robust data supporting their effectiveness and patients with alcohol use disorder should be referred for these services. Research now support the use of several FDA-approved medications that aid in promoting abstinence and reducing heavy drinking. PMID:27373607

  8. Determining Ethyl Glucuronide Cutoffs When Detecting Self-Reported Alcohol Use In Addiction Treatment Patients

    PubMed Central

    Lowe, Jessica M.; McDonell, Michael G.; Leickly, Emily; Angelo, Frank A.; Vilardaga, Roger; McPherson, Sterling; Srebnik, Debra; Roll, John; Ries, Richard K.

    2015-01-01

    Background Ethyl glucuronide (EtG) is an alcohol biomarker with potential utility as a clinical research and alcohol treatment outcome. Debate exists regarding the appropriate cutoff level for determining alcohol use, particularly with the EtG immunoassay. This study determined the EtG immunoassay cutoff levels that most closely correspond to self-reported drinking in alcohol dependent outpatients. Methods Eighty adults with alcohol dependence and mental illness, taking part in an alcohol treatment study, provided urine samples three times per week for up to 16-weeks (1589 samples). Self-reported drinking during 120 hours prior to each sample collection was assessed. Receiver Operating Characteristic analyses were conducted to assess the ability of the EtG immunoassay to detect self-reported alcohol use across 24–120 hour time periods. Sensitivity and specificity of EtG immunoassay cutoff levels was compared in 100 ng/mL increments (100 ng/mL–500 ng/mL) across 24–120 hours. Results Over half (57%) of the 1589 samples indicated recent alcohol consumption. The EtG immunoassay closely corresponded to self-reported drinking from 24 (AUC=0.90, 95% CI:0.88, 0.92) to 120 hours (AUC=0.88, 95% CI:0.87, 0.90). When cutoff levels were compared across 24–120 hours, 100 ng/mL had the highest sensitivity (0.93–0.78) and lowest specificity (0.67–0.85). Relative to 100 ng/mL, the 200 ng/mL cutoff demonstrated a reduction in sensitivity (0.89–0.67), but improved specificity (0.78–0.94). The 300 ng/mL, 400 ng/mL, and 500 ng/mL cutoffs demonstrated the lowest sensitivity (0.86 to 0.33) and highest specificity (0.86–0.97) over 24 to 120 hours. Conclusions For detecting alcohol use for greater than 24 hours, the 200 ng/mL cutoff level is recommended for use as a research and clinical outcome. PMID:25866234

  9. Interleukin-6 and interleukin-8 production by mononuclear cells of chronic alcoholics during treatment.

    PubMed

    Martinez, F; Thomas, N M; Darban, H; Cox, T J; Wood, S; Watson, R R

    1993-12-01

    Chronic alcohol consumption has been associated with suppression of a number of immune parameters. This study was designed to investigate the relationship between chronic alcohol ingestion and cessation with respect to release of interleukin-6 (IL-6) and interleukin-8 (IL-8) using highly specific and sensitive ELISA assays, as well as a functional assay, natural killer cell cytotoxic activity. ELISAs were developed to determine the amount of IL-6 and IL-8 release by peripheral blood mononuclear cells (PBMCs). Two groups of subjects were recruited: young (18-22 years old), nonalcoholic users (controls) and long-term alcoholics (35-55 years old). Blood samples were collected at time 0 from all subjects and from alcoholics 28 days after treatment had begun and alcohol use had ceased. Then mitogen-stimulated release of cytokines by peripheral blood cells was determined. The abstaining controls, and the alcoholics, after 30 days of abstinence, tended to produce lower amounts of IL-6 and IL-8, although these differences were not statistically significant. Natural killer cell activity was not statistically different between the young groups, yet appeared to increase once alcohol use discontinued. Some of the cells from the controls (abstainers) were incubated with ethanol (EtOH). Its content in sealed wells was measured after the time of incubation of PBMCs. When EtOH was serially diluted in plates, some well-well diffusion was noted, but the maximum concentration of EtOH never fell below 0.3% from an initial concentration of 0.5%, and at no time was the EtOH concentration gradient completely lost, even after 66 hr of incubation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8116830

  10. The Added Risk of Opioid Problem Use among Treatment-Seeking Youth with Marijuana and/or Alcohol Problem Use

    PubMed Central

    Subramaniam, Geetha A; Ives, Melissa L.; Stitzer, Maxine L.; Dennis, Michael L.

    2009-01-01

    Objectives To determine the added risk of opioid problem use (OPU) in youth with marijuana/alcohol problem use (MAPU). Method 475 youth (ages 14–21 years) with OPU+MAPU were compared to a weighted sample of 475 youth with MAPU only (i.e., no OPU) before and after propensity score matching on gender, age, race, level of care, and weekly use of marijuana/alcohol. Youth were recruited from 88 drug treatment sites participating in eight Center for Substance Abuse Treatment funded grants. At treatment intake, participants were administered the Global Appraisal of Individual Need to elicit information on demographic, social, substance, mental health, HIV, physical and legal characteristics. Odds ratios with confidence intervals were calculated. Results The added risk of OPU among MAPU youth was associated with greater comorbidity: higher rates of psychiatric symptoms and trauma/victimization; greater needle-use and sex-related HIV-risk behaviors and greater physical distress. The OPU+MAPU group was less likely to be African American or other race and more likely to be age 15–17 years, Caucasian; report weekly drug use at home and among peers; engage in illegal behaviors and be confined longer; have greater substance abuse severity and poly drug use; and use mental health and substance abuse treatment services. Conclusions These findings expand on the existing literature and highlight the substantial incremental risk of OPU on multiple comorbid areas, among treatment-seeking youth. Further evaluation is needed to assess their outcomes following standard drug treatment and to evaluate specialized interventions for this subgroup of severely impaired youth. PMID:20403020

  11. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

    ERIC Educational Resources Information Center

    Rosen, Joshua B.; Olson, Mark H.; Kelly, Marianne

    2012-01-01

    Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving…

  12. Questioning the Value of Realism: Young Adults' Processing of Messages in Alcohol-Related Public Service Announcements and Advertising.

    ERIC Educational Resources Information Center

    Andsager, Julie L.; Austin, Erica Weintraub; Pinkleton, Bruce E.

    2001-01-01

    Finds that: (1) perceived realism and themes that students could identify with are important factors in increasing the salience and persuasiveness of alcohol-related public service announcements (PSAs) among undergraduate students; (2) realistic but logic-based PSAs were not as effective as unrealistic but enjoyable ads; and (3) low production…

  13. A History of Drug and Alcohol Block Grant Funding and Its Effects on Pennsylvania's Prevention Services System.

    ERIC Educational Resources Information Center

    Brown, Philip M.

    1986-01-01

    Examines the impact of the U.S. government's block grant fiscal policy on the funding policies and program services in drug and alcohol abuse prevention. Uses a case history of Pennsylvania's experience with block grant funding mandates to document the administrative and programmatic considerations affecting policy implementation at the state…

  14. Project Application Guidelines for Alcohol and Other Drug Abuse Program Funding. Student Services, Prevention, and Wellness Team. Bulletin No. 95202.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison. Bureau for Pupil Services.

    This publication provides information and application forms for alcohol and other drug abuse (AODA) funding. The contents include the following: Framework for Student Services, Prevention and Wellness; Abstracts of AODA Grants; Timetable for Grants; Criteria Applicable to all State AODA Grants; Criteria Specific to Aoda Program Grant; AODA…

  15. [Early detection, negotiation and treatment of alcohol use disorders in primary care].

    PubMed

    Reimer, J; Cimander, K F; Reimer, C

    2014-05-01

    Subjects with alcohol dependence or alcohol-related health problems frequently use the primary care system without receiving the correct diagnosis or specific interventions. Stigma, lack of knowledge and know-how with regards to diagnosis and treatment of alcohol-related disorders on the site of the health care professionals may contribute to the treatment gap. General anamnesis, clinical evaluation, and laboratory parameters can serve as indicators, and validated screening tests can further corroborate the hypothesis. However, a diagnosis should only be made according to ICD-10 criteria. Adequate counselling techniques substantially contribute to successful physician-patient interaction. Motivational Interviewing combines a positive, appreciative attitude with communicative techniques to create a motivation to change. It includes general approaches as open questions, appreciation of the patient, active listening, summarizing results as well as specific approaches such as change and confidence talk and dealing with resistance. Within a positive relationship, the conversation can lead to change. Brief interventions cover four to five sessions with a duration between five and sixty minutes. Brief interventions based on an empathic attitude und reflection of findings, a brief advice leaving the responsibility on the patient's side and supporting self-efficacy can improve alcohol-related disorders. The transtheoretical model of change may help the health care provider to adapt intervention strategies to the patient's state. Primary health care provides an adequate framework for screening, diagnosis and intervention for alcohol-related disorders with the aim of reduction or abstinence. Further institutions in addiction treatment such as self-help and clinical institutions may complement the treatment system. PMID:24760716

  16. Lactobacillus GG treatment ameliorates alcohol-induced intestinal oxidative stress, gut leakiness, and liver injury in a rat model of alcoholic steatohepatitis.

    PubMed

    Forsyth, Christopher B; Farhadi, Ashkan; Jakate, Shriram M; Tang, Yueming; Shaikh, Maliha; Keshavarzian, Ali

    2009-03-01

    oxidative stress and inflammation and preserved gut barrier function. Our study provides a scientific rationale to test probiotics for treatment and/or prevention of alcoholic liver disease in man. PMID:19251117

  17. The Basics of Alcohol Screening, Brief Intervention and Referral to Treatment in the Emergency Department

    PubMed Central

    Vaca, Federico E.; Winn, Diane

    2007-01-01

    Nearly eight million emergency department (ED) visits are attributed to alcohol every year in the United States. A substantial proportion is due to trauma. In 2005, 16,885 people were killed as a result of alcohol-related motor vehicle crashes. Patients with alcohol-use problems (AUPs) are not only more likely to drive after drinking but are also at greater risk for serious alcohol-related illness and injury. Emergency departments have an important and unique opportunity to identify these patients and intervene during the “teachable moment” of an ED visit. The American College of Emergency Physicians, Emergency Nurses Association, American College of Surgeons-Committee on Trauma, American Public Health Association, and the National Highway Traffic Safety Administration, have identified Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) as a pivotal injury- and illness-prevention strategy to improve the health and well-being of ED patients. We provide a general overview of the basis and need for integrating SBIRT into EDs. Models of SBIRT, as well as benefits and challenges to its implementation, are also discussed. PMID:19561690

  18. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence.

    PubMed

    Mutschler, J; Grosshans, M; Soyka, M; Rösner, S

    2016-07-01

    As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are attributable to patient awareness that the drug was consumed and the corresponding anticipation of an aversive reaction if combined with alcohol. This is in line with the findings of a recent meta-analysis that only showed significant effects for disulfiram in open-label trials. The authors of the meta-analysis conclude that due to expectations induced in both the treatment and placebo groups, blinded studies are incapable of distinguishing a difference between groups. The mediation of therapeutic effects through expectation has a number of consequences for clinical practice and future research on disulfiram. PMID:26987743

  19. Alcoholic hallucinosis.

    PubMed

    Bhat, Pookala S; Ryali, Vssr; Srivastava, Kalpana; Kumar, Shashi R; Prakash, Jyoti; Singal, Ankit

    2012-07-01

    Alcoholic hallucinosis is a rare complication of chronic alcohol abuse characterized by predominantly auditory hallucinations that occur either during or after a period of heavy alcohol consumption. Bleuler (1916) termed the condition as alcohol hallucinosis and differentiated it from Delirium Tremens. Usually it presents with acoustic verbal hallucinations, delusions and mood disturbances arising in clear consciousness and sometimes may progress to a chronic form mimicking schizophrenia. One such case with multimodal hallucinations in a Defence Service Corps soldier is presented here. PMID:24250051

  20. A smartphone application of alcohol resilience treatment for behavioral self-control training.

    PubMed

    Yu, Fei; Albers, Jörg; Gao, Tian; Wang, Minghao; Bilberg, Arne; Stenager, Elsebeth

    2012-01-01

    High relapse rate is one of the most prominent problems in addiction treatment. Alcohol Resilience Treatment (ART), an alcohol addiction therapy, is based on Cue Exposure Treatment, which has shown promising results in preliminary studies. ART aims at optimizing the core area of relapse prevention, and intends to improve patients' capability to withstand craving of alcohol. This method emphasizes the interplay of resilience and resourcefulness. It contains 6 sessions with different topics according to the stage of treatment circuit, and each session consists of 6 steps. Due to the purity and structure of the treatment rationale, it is realistic, reasonable and manageable to transform the method into a smartphone application. An ART app in Android system and an accessory of bilateral tactile stimulation were developed and will be used in a study with behavioral self-control training. This paper presents the design and realization of the smartphone based ART application. The design of a pilot study, which is to examine the benefits of a smartphone application providing behavioral self-control training, is also reported in this paper. PMID:23366304

  1. Self-Regulation, Daily Drinking, and Partner Violence in Alcohol Treatment-Seeking Men

    PubMed Central

    Schumacher, Julie A.; Coffey, Scott F.; Leonard, Kenneth E.; O’Jile, Judith R.; Landy, Noah C.

    2014-01-01

    This study builds on research identifying deficits in behavioral self-regulation as risk factors for intimate partner violence (IPV). It also builds on alcohol administration research identifying these deficits as moderators of the association between acute alcohol consumption and aggression in laboratory paradigms. Participants analyzed were 97 men seeking residential treatment for alcohol dependence who were involved in a current or recent heterosexual relationship of at least one year. Participants completed a self-report measure of impulsivity, neuropsychological tests of executive function, and computerized delay discounting and behavioral inhibition tasks. With the exception of the self-report measure of impulsivity, performance on measures of behavioral self-regulation was not associated with the occurrence or frequency of past year IPV in this sample. Similarly, self-reported impulsivity moderated the association between daily drinking and IPV in multivariate models controlling for daily drug use, but deficits in performance on other measures did not. Performance on a tower task moderated the association between daily drinking and the occurrence of IPV, but contrary to hypotheses, better task performance was associated with greater likelihood of IPV on drinking days. These results suggest that self-perceived impulsivity is a better predictor of IPV in alcohol treatment seeking men than deficits in performance on behavioral measures of delay discounting, behavioral inhibition, and executive function. PMID:23379612

  2. Hitting rock bottom? Resource loss as a predictor of alcoholism treatment completion.

    PubMed

    Gruszczyńska, Ewa; Kaczmarek, Małgorzata; Chodkiewicz, Jan

    2016-07-01

    Background Efforts to better understand the phenomenon of the 'bottom', the beginning of the process of turning away from alcohol, are important for both theoretical and practical goals. The conservation of resources theory by Hobfoll may represent a suitable framework to base these attempts around. Aim The aim of the study was to examine the role of resource loss in completing alcoholism treatment on the basis of Hobfoll's conservation of resources theory. Methods The study included 86 patients undergoing inpatient alcoholism treatment. An assessment of resource loss and gain during the previous year, as well as of the decisional balance regarding the pros and cons of drinking alcohol, took place at the beginning of therapy. Results The results of hierarchical binary logistic regression confirmed that resource loss was the only significant predictor of therapy completion, after adjustment for decisional balance, demographics and basic clinical data. Additionally, gender moderated the relationship between resource gain and therapy completion: while an increase in gain was related to a decreased chance of completing therapy in men, the opposite effect was noted in women. Conclusions Resource loss has more influence than decisional balance in predicting therapy completion, which can be translated into clinically valid recommendations based on gender differences. PMID:26813301

  3. Neural activation during processing of aversive faces predicts treatment outcome in alcoholism.

    PubMed

    Charlet, Katrin; Schlagenhauf, Florian; Richter, Anne; Naundorf, Karina; Dornhof, Lina; Weinfurtner, Christopher E J; König, Friederike; Walaszek, Bernadeta; Schubert, Florian; Müller, Christian A; Gutwinski, Stefan; Seissinger, Annette; Schmitz, Lioba; Walter, Henrik; Beck, Anne; Gallinat, Jürgen; Kiefer, Falk; Heinz, Andreas

    2014-05-01

    Neuropsychological studies reported decoding deficits of emotional facial expressions in alcohol-dependent patients, and imaging studies revealed reduced prefrontal and limbic activation during emotional face processing. However, it remains unclear whether this reduced neural activation is mediated by alcohol-associated volume reductions and whether it interacts with treatment outcome. We combined analyses of neural activation during an aversive face-cue-comparison task and local gray matter volumes (GM) using Biological Parametric Mapping in 33 detoxified alcohol-dependent patients and 33 matched healthy controls. Alcoholics displayed reduced activation toward aversive faces-neutral shapes in bilateral fusiform gyrus [FG; Brodmann areas (BA) 18/19], right middle frontal gyrus (BA46/47), right inferior parietal gyrus (BA7) and left cerebellum compared with controls, which were explained by GM differences (except for cerebellum). Enhanced functional activation in patients versus controls was found in left rostral anterior cingulate cortex (ACC) and medial frontal gyrus (BA10/11), even after GM reduction control. Increased ACC activation correlated significantly with less (previous) lifetime alcohol intake [Lifetime Drinking History (LDH)], longer abstinence and less subsequent binge drinking in patients. High LDH appear to impair treatment outcome via its neurotoxicity on ACC integrity. Thus, high activation of the rostral ACC elicited by affective faces appears to be a resilience factor predicting better treatment outcome. Although no group differences were found, increased FG activation correlated with patients' higher LDH. Because high LDH correlated with worse task performance for facial stimuli in patients, elevated activation in the fusiform 'face' area may reflect inefficient compensatory activation. Therapeutic interventions (e.g. emotion evaluation training) may enable patients to cope with social stress and to decrease relapses after detoxification. PMID

  4. Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth

    PubMed Central

    Ziemnik, Rosemary E.; Huang, Quian; Levy, Sharon

    2015-01-01

    BACKGROUND AND OBJECTIVE: Adolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group. METHODS: Cross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame. RESULTS: Of 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values < .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values < .05). CONCLUSIONS: Alcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk. PMID:26668849

  5. Vital Signs Screening for Alcohol Misuse in a Rural Primary Care Clinic: A Feasibility Study

    ERIC Educational Resources Information Center

    Seale, J. Paul; Guyinn, Monique R.; Matthews, Michael; Okosun, Ike; Dent, M. Marie

    2008-01-01

    Context: Alcohol misuse is more common in rural areas, and rural problem drinkers are less likely to seek alcohol treatment services. Rural clinics face unique challenges to implementing routine alcohol screening and intervention. Purpose: To assess the feasibility of using the single alcohol screening question (SASQ) during routine nursing vital…

  6. A Role for Cognitive Rehabilitation in Increasing the Effectiveness of Treatment for Alcohol Use Disorders

    PubMed Central

    Bates, Marsha E.; Buckman, Jennifer F.; Nguyen, Tam T.

    2013-01-01

    Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation. PMID:23412885

  7. Awareness and Treatment of Alcohol Dependence in Japan: Results from Internet-Based Surveys in Persons, Family, Physicians and Society

    PubMed Central

    Taguchi, Yurie; Takei, Yoshiyuki; Sasai, Ryoko; Murteira, Susana

    2014-01-01

    Aims: To understand current awareness of, and views on, treatment of alcohol dependence in Japan. Methods: (a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders). Results: We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20–25% of the AD and ADP persons would prefer to attempt to abstain, while 60–75% preferred ‘reduced drinking.’ A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal. Conclusion: AD and ADP persons in Japan have low ‘disease awareness’ defined as ‘understanding of signs, symptoms and consequences of alcohol use disorders,’ which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan. PMID:24893604

  8. Cognitive control network function in alcohol use disorder before and during treatment with lorazepam.

    PubMed

    Wilcox, Claire E; Mayer, Andrew R; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009-2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function. PMID:25290463

  9. [Use of associative cultures of cyanobacteria for tertiary treatment of sewage from yeast and alcohol plants].

    PubMed

    Koshel', M I; Zabolotna, G M; Kovyrzina, T V; Mendzhul, M I; Koltukova, N V

    2001-01-01

    The associative cultures of cyanobacteria were selected which may be used for development of technology of tertiary treatment of sewage for yeast and alcohol production plants. Growth parameters of associations were studied during periodic and continuous cultivation. When studying the influence of flowing speed for some exponents of treatment it was shown that cultivation of cyanobacteria should be carried out with the change of volume not more than 0.01 h. Final treatment 0.010 h-1 in order to return sewage to natural water reservoirs may be carried out by means of Oscillatoria sp. in bioponds. PMID:11785265

  10. Cognitive Control Network Function in Alcohol Use Disorder Before and During Treatment With Lorazepam

    PubMed Central

    Wilcox, Claire E.; Mayer, Andrew R.; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009–2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function. PMID:25290463

  11. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  12. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  13. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  14. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  15. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  16. Internet Therapy versus Internet Self-Help versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Blankers, Matthijs; Koeter, Maarten W. J.; Schippers, Gerard M.

    2011-01-01

    Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the…

  17. Motivation to change and treatment attendance as predictors of alcohol-use outcomes among project-based Housing First residents.

    PubMed

    Collins, Susan E; Malone, Daniel K; Larimer, Mary E

    2012-08-01

    Collins et al. (2012) indicated that time spent in a project-based Housing First (HF) intervention was associated with improved two-year alcohol-use trajectories among chronically homeless individuals with alcohol problems. To explore potential correlates of these findings, we tested the relative prediction of alcohol-use outcomes by motivation to change (MTC) and substance abuse treatment attendance. Participants (N=95) were chronically homeless individuals with alcohol problems receiving a project-based HF intervention in the context of a larger nonrandomized controlled trial (Larimer et al., 2009). Participants were interviewed regularly over the two-year follow-up. Treatment attendance and MTC were measured using items from the Addiction Severity Index and the SOCRATES, respectively. Alcohol-use outcomes included alcohol quantity, problems and dependence. Generalized estimating equation modeling indicated that MTC variables and not treatment attendance consistently predicted alcohol-use outcomes over the two-year follow-up. Findings suggest that the importance of motivation to change may outweigh treatment attendance in supporting alcohol behavior change in this population. PMID:22513197

  18. Moderating Effects of a Craving Intervention on the Relation between Negative Mood and Heavy Drinking Following Treatment for Alcohol Dependence

    ERIC Educational Resources Information Center

    Witkiewitz, Katie; Bowen, Sarah; Donovan, Dennis M.

    2011-01-01

    Objective: Negative affect is a significant predictor of alcohol relapse, and the relation between negative affect and drinking has been shown to be strongly mediated by alcohol craving. Thus, targeting craving during treatment could potentially attenuate the relation between negative affect and drinking. Method: The current study is a secondary…

  19. 78 FR 42530 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  20. 76 FR 26308 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Scientific Review Administrator, National Institutes On Alcohol Abuse & Alcoholism National, Institutes...

  1. 75 FR 10291 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism, Initial Review..., MBA, Scientific Review Officer, National Institute on Alcohol Abuse and Alcoholism, Office...

  2. 77 FR 70171 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review... Review Officer, National Institute ] on Alcohol Abuse & Alcoholism, National Institutes of Health,...

  3. 77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism...

  4. 77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism, Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  5. 75 FR 38533 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Alcohol Abuse and Alcoholism, Office of Extramural Activities, Extramural Project Officer, 5635...

  6. 76 FR 78014 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-15

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review...., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism, National Institutes...

  7. 75 FR 10808 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Officer, National Institute on Alcohol Abuse & Alcoholism, National Institutes of Health, 5635...

  8. 78 FR 42529 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review....D., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism,...

  9. 76 FR 77841 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  10. 75 FR 57473 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Officer, National Institute on Alcohol Abuse and Alcoholism, Office of Extramural Activities,...

  11. 75 FR 24961 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Extramural Activities, National Institutes of Health, National Institute on Alcohol Abuse & Alcoholism,...

  12. 75 FR 63494 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis..., Extramural Project Review Branch, EPRB, National Institute on Alcohol Abuse and Alcoholism,...

  13. How Imaging Glutamate, γ-Aminobutyric Acid, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal.

    PubMed

    Hillmer, Ansel T; Mason, Graeme F; Fucito, Lisa M; O'Malley, Stephanie S; Cosgrove, Kelly P

    2015-12-01

    Neuroimaging studies have dramatically advanced our understanding of the neurochemical basis of alcohol dependence, a major public health issue. In this paper, we review the research generated from neurochemical specific imaging modalities including magnetic resonance spectroscopy, positron emission tomography, and single-photon emission computed tomography in studies of alcohol dependence and withdrawal. We focus on studies interrogating γ-aminobutyric acid (GABA), glutamate, and dopamine, as these are prominent neurotransmitter systems implicated in alcohol dependence. Highlighted findings include diminished dopaminergic functioning and modulation of the GABA system by tobacco smoking during alcohol withdrawal. Then, we consider how these findings impact the clinical treatment of alcohol dependence and discuss directions for future experiments to address existing gaps in the literature, for example, sex differences and smoking comorbidity. These and other considerations provide opportunities to build upon the current neurochemistry imaging literature of alcohol dependence and withdrawal, which may usher in improved therapeutic and relapse prevention strategies. PMID:26510169

  14. Naltrexone long-acting formulation in the treatment of alcohol dependence.

    PubMed

    Johnson, Bankole A

    2007-10-01

    While oral naltrexone has a demonstrated ability to decrease alcohol reinforcement, it also has pharmacotherapeutic limitations, such as a small treatment effect size, adverse events, and plasma level fluctuations. The pharmacokinetic profile of naltrexone could be enhanced by intramuscular administration, which would sustain its release over several weeks and keep plasma levels relatively constant, ie, low enough to minimize side effects but high enough to reduce drinking. Vivitrex((R))/Vivitrol((R)) and Naltrel((R)) are injectable naltrexone depot formulations that have been tested as possible medications for treating alcohol dependence. Their adverse-event profiles appear to be less severe than that of oral naltrexone. Vivitrex((R))/Vivitrol((R)) has demonstrated efficacy at decreasing heavy drinking among alcohol-dependent males. Naltrel((R)) helped to promote abstinence and decrease the incidence of relapse in two samples of alcohol-dependent subjects. The data on a third formulation, Depotrex((R)), are still limited. All three formulations require further study of their efficacy. PMID:18472999

  15. Polyhydric alcohol protective effect on Rhizomucor miehei lipase deactivation enhanced by pressure and temperature treatment.

    PubMed

    Noël, Marilyne; Lozano, Pedro; Combes, Didier

    2005-10-01

    The influence of polyhydric alcohols (sorbitol, xylitol, erythritol, glycerol) on the thermal stability of Rhizomucor miehei lipase has been studied at high hydrostatic pressure (up to 500 MPa). In the absence of additives, a protective effect (PE) (the ratio between the residual activities determined at 480 MPa for the enzyme in the presence or absence of polyhydric alcohols) of low-applied pressures (from 50 MPa to 350 MPa) against thermal deactivations (at 50 degrees C and 55 degrees C) has been noticed. In the presence of additives, a strong correlation between PE and the total hydroxyl group concentration has been obtained, for the first time, under treatments of combining denaturing temperatures and high hydrostatic pressures. This relationship does not seem to be dependent on the nature polyhydric alcohols as the same effect could be observed with 1 M sorbitol and 2 M glycerol. This PE, against thermal and high pressure combined lipase deactivation, increases with polyhydric alcohol concentrations, and when temperature increases from 25 degrees C to 55 degrees C. PMID:16044285

  16. Experimental study of osthole on treatment of hyperlipidemic and alcoholic fatty liver in animals

    PubMed Central

    Song, Fang; Xie, Mei-Lin; Zhu, Lu-Jia; Zhang, Ke-Ping; Xue, Jie; Gu, Zhen-Lun

    2006-01-01

    AIM: To evaluate the effects of osthole on fatty liver, and investigate the possible mechanism. METHODS: A quail model with hyperlipidemic fatty liver and rat model with alcoholic fatty liver were set up by feeding high fat diet and alcohol, respectively. These experimental animals were then treated with osthole 5-20 mg/kg for 6 wk, respectively. Whereafter, the lipid in serum and hepatic tissue, and coefficient of hepatic weight were measured. RESULTS: After treatment with osthole the levels of serum total cholesterol (TC), triglyceride (TG), lower density lipoprotein-cholesterol (LDL-C), coefficient of hepatic weight, and the hepatic tissue contents of TC and TG were significantly decreased. The activity of superoxide dismutase (SOD) in liver was improved. In alcohol-induced fatty liver rats, the level of malondialdehyde (MDA) in liver was decreased. In high fat-induced fatty liver quails, glutathione peroxidase (GSH-PX) in liver was significantly improved. The histological evaluation of liver specimens demonstrated that the osthole dramatically decreased lipid accumulation. CONCLUSION: These results suggested that osthole had therapeutic effects on both alcohol and high fat-induced fatty liver. The mechanism might be associated with its antioxidation. PMID:16865778

  17. Southeast Asian Mental Health: Treatment, Prevention, Services, Training and Research.

    ERIC Educational Resources Information Center

    Owan, Tom Choken, Ed.

    This sourcebook contains 19 papers which discuss the mental health service needs of Southeast Asian refugees in the United States. The volume is divided into five sections: Treatment; Prevention; Services; Training; and Research. The papers (and their authors) are: (1) "Psychiatric Care for Southeast Asians: How Different Is Different?" (Tran Minh…

  18. Alcohol use in Polish 9/11 responders: implications for cross-cultural treatment.

    PubMed

    Katz, Craig L; Jutras-Aswad, Didier; Kiliman, Marta; Pilatowicz, Iwona; Akerele, Evaristo; Marrone, Kathryn; Ozbay, Fatih

    2012-01-01

    More than 35,000 individuals are estimated to have responded to the World Trade Center (WTC) site following the terrorist attacks of September 11, 2001. The federally funded WTC Medical Monitoring and Treatment Program (WTCMMTP) provides medical monitoring and occupational medicine treatment as well as counseling regarding entitlements and benefits to the workers and volunteers who participated in the WTC response. A major component of the WTCMMTP is the WTC Mental Health Program (WTCMHP), which offers annual mental health assessments and ongoing treatment for those found to have 9/11 associated mental health problems. In the program's 9.5 years of evaluating and treating mental health problems in thousands of Ground Zero responders, diversity in multiple domains (e.g., gender, family, profession and employment status, state of physical health, cultural identity, and immigration status) has been a hallmark of the population served by the program. To illustrate the types of issues that arise in treating this diverse patient population, the authors first present a representative case involving a Polish asbestos worker with an alcohol use disorder. They then discuss how accepted alcohol treatment modalities can and often must be modified in providing psychiatric treatment to Polish responders, in particular, and to foreign-born patients in general. Treatment modalities discussed include cognitive and behavioral therapy, relapse prevention strategies, psychodynamic therapy, motivational approaches, family therapy, group peer support, and pharmacotherapy. Implications for the practice of addiction psychiatry, cultural psychiatry, and disaster psychiatry are discussed. PMID:22261985

  19. Potential medications for the treatment of alcohol use disorder: An evaluation of clinical efficacy and safety.

    PubMed

    Litten, Raye Z; Wilford, Bonnie B; Falk, Daniel E; Ryan, Megan L; Fertig, Joanne B

    2016-01-01

    Alcohol use disorder (AUD), as currently defined in the Diagnostic and Statistical Manual, 5th Edition (DSM-5), is a heterogeneous disorder stemming from a complex interaction of neurobiological, genetic, and environmental factors. As a result of this heterogeneity, there is no one treatment for AUD that will work for everyone. During the past 2 decades, efforts have been made to develop a menu of medications to give patients and clinicians more choices when seeking a therapy that is both effective and which has limited side effects. To date, 3 medications have been approved by the US Food and Drug Administration (FDA) to treat alcohol dependence: disulfiram, naltrexone, and acamprosate. In addition to these approved medications, researchers have identified new therapeutic targets and, as a result, a number of alternative medications are now being evaluated for treatment of AUD in human studies. Although not approved by the FDA for the treatment of AUD, in some cases, these alternative medications are being used off-label by clinicians for this purpose. These potential medications are reviewed here. They include nalmefene, varenicline, gabapentin, topiramate, zonisamide, baclofen, ondansetron, levetiracetam, quetiapine, aripiprazole, and serotonin reuptake inhibitors. The effectiveness of these medications has been mixed-some show good efficacy with side effects that are mild to moderate in intensity; others have mixed or promising results but are awaiting findings from ongoing studies; and still others show poor efficacy, despite promising preliminary results. Medications development remains a high priority. Key initiatives for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) include supporting the discovery and development of more effective and safer medications, advancing the field of personalized medicine, and forging public and private partnerships to investigate new and more effective compounds. PMID:26928397

  20. Medications for Alcohol Use Disorder.

    PubMed

    Winslow, Bradford T; Onysko, Mary; Hebert, Melanie

    2016-03-15

    The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk alcohol use receive treatment. Three medications are approved by the U.S. Food and Drug Administration to treat alcohol use disorder: acamprosate, disulfiram, and naltrexone. Acamprosate and naltrexone reduce alcohol consumption and increase abstinence rates, although the effects appear to be modest. Disulfiram has been used for years, but evidence supporting its effectiveness is inconsistent. Other medications may be beneficial to reduce heavy alcohol use. The anticonvulsants topiramate and gabapentin may reduce alcohol ingestion, although long-term studies are lacking. Antidepressants do not decrease alcohol use in patients without mood disorders, but sertraline and fluoxetine may help depressed patients decrease alcohol ingestion. Ondansetron may reduce alcohol use, particularly in selected subpopulations. Further study is needed for genetically targeted or as-needed medications to reduce alcohol use. PMID:26977830

  1. Spirituality, Religiousness, and Alcoholism Treatment Outcomes: A Comparison between Black and White Participants

    PubMed Central

    Krentzman, Amy R.; Farkas, Kathleen J.; Townsend, Aloen L.

    2012-01-01

    This study addresses an unexplained finding in the alcoholism treatment field: despite the health and socioeconomic disparities that exist between blacks and whites at intake, blacks and whites achieve equivalent treatment outcomes. Using Project MATCH data, this study explores religiousness and spirituality as strengths in the African American community that may account in part for equivalent outcomes. Using binary logistic regression, this study found that as purpose in life increased, blacks were more likely to achieve sobriety than whites. This study provides evidence that purpose in life is a cultural strength and an advantage among blacks in achieving sobriety. PMID:22707846

  2. The Influence of Different Types of Alcoholic Beverages on Disrupting Highly Active Antiretroviral Treatment (HAART) Outcome

    PubMed Central

    Míguez-Burbano, María José; Lewis, John E.; Fishman, Joel; Asthana, Deshratn; Malow, Robert M.

    2009-01-01

    Aims: Studies have yielded conflicting results regarding alcohol's influence on HIV outcomes, particularly after highly active antiretroviral treatment (HAART). Discrepant findings may be related to confounding variables, including gender, patterns of alcohol abuse and type of alcohol beverage beyond the amount consumed. Methods: Using a cohort study, differences in HAART effectiveness after 24 weeks of therapy were compared as a function of amount and preference for alcohol, drinking only liquor (LI, n = 55) or only wine or beer (BW, n = 110). Given the critical role of thymus on HAART response, changes in thymus size, CD4s, naïve lymphocytes and viral loads were assessed. Results: After HAART, positive increases in both CD4s (+12 cell counts/mm3) and thymus size (+0.7 mm3) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (−4 CD4 cells/mm3 and −0.6 mm3 in thymus size). Women in the LI group exhibited significantly lower CD4 (163.4 ± 46.2) and naïve counts (178 ± 69.5) than LI men (CD4: 281.6 ± 203, P = 0.05; lymphocytes: 301.4 ± 198, P = 0.04). In adjusted regression models, the LI compared to the BW subgroup had greater odds of maintaining detectable viral loads (RR = 1.35, 95% CI 1.04–1.75; P = 0.03), increased thymus volumes (RR = 3.8, P = 0.04) and replenished naïve cells (RR = 13, P = 0.02). Conclusions: Liquor was associated with thymus deterioration and thus with poorer viro-immune outcomes after HAART. Subtyping participants by alcohol consumption patterns seems to be clinically relevant and needs to be accounted for in future studies. PMID:19454401

  3. Alcoholism treatment.

    PubMed

    1987-09-01

    In John Walsh's article "Some refuseniks see no glasnost" (News & Comment, 24 July, p. 356), the Committee for Concerned Scientists was incorrecty identified as the "Union" of Concerned Scientists. PMID:3629229

  4. Study Protocol: Screening and Treatment of Alcohol-Related Trauma (START) – a randomised controlled trial

    PubMed Central

    2012-01-01

    Background The incidence of mandibular fractures in the Northern Territory of Australia is very high, especially among Indigenous people. Alcohol intoxication is implicated in the majority of facial injuries, and substance use is therefore an important target for secondary prevention. The current study tests the efficacy of a brief therapy, Motivational Care Planning, in improving wellbeing and substance misuse in youth and adults hospitalised with alcohol-related facial trauma. Methods and design The study is a randomised controlled trial with 6 months of follow-up, to examine the effectiveness of a brief and culturally adapted intervention in improving outcomes for trauma patients with at-risk drinking admitted to the Royal Darwin Hospital maxillofacial surgery unit. Potential participants are identified using AUDIT-C questionnaire. Eligible participants are randomised to either Motivational Care Planning (MCP) or Treatment as Usual (TAU). The outcome measures will include quantity and frequency of alcohol and other substance use by Timeline Followback. The recruitment target is 154 participants, which with 20% dropout, is hoped to provide 124 people receiving treatment and follow-up. Discussion This project introduces screening and brief interventions for high-risk drinkers admitted to the hospital with facial trauma. It introduces a practical approach to integrating brief interventions in the hospital setting, and has potential to demonstrate significant benefits for at-risk drinkers with facial trauma. Trial Registration The trial has been registered in Australian New Zealand Clinical Trials Registry (ANZCTR) and Trial Registration: ACTRN12611000135910. PMID:23106916

  5. Comorbid Psychopathology and Alcohol Use Patterns among Methadone Maintenance Treatment Patients

    PubMed Central

    Moussas, Georgios; Fanouraki, Irene; Pachi, Argiro; Asomatou, Arezina; Drylli, Olga; Paschalakis, Georgios; Giotakis, Konstantinos; Dermatis, Georgios; Malliori, Meni

    2015-01-01

    130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was 6.9 ± 7.9. 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serious abuse/addiction. Scores on AUDIT scale were positively correlated with length of time on methadone treatment, but not with length of time on drug use or age of our participants. Positive correlations were observed among AUDIT and SCL-90R scores, namely, with global severity index score, positive symptom distress index, positive symptom total, and all primary symptom dimensions subscales except phobic anxiety. PMID:25878919

  6. TIMEVARYING PREDICTORS OF SMOKING CESSATION AMONG INDIVIDUALS IN TREATMENT FOR ALCOHOL ABUSE AND DEPENDENCE: FINDINGS FROM PROJECT MATCH

    PubMed Central

    FRIEND, KAREN B.; PAGANO, MARIA E.

    2008-01-01

    Aims Individuals in treatment for alcohol use disorders are more likely to die from cigarette use than from alcohol consumption. Advanced statistical methodologies that increase study power and clinical relevance have been advocated to examine the timevarying nature of substance use relapse and abstinence, including drinking and smoking. The purpose of this investigation was to examine timevarying factors that are associated with smoking cessation among smokers in the general population, including alcohol use, self-efficacy, and depression, to determine if they were also related to smoking cessation during and after treatment for alcohol use disorders. Methods Data were garnered from Project MATCH, a longitudinal prospective study of the efficacy of three behavioural treatments for alcohol use disorders. Timevarying covariate analyses were conducted to examine future smoking cessation. Results Results showed that greater self-efficacy regarding resisting temptations to drink and lower levels of depression were independently associated with increased likelihood of stopping smoking. In contrast, drinks per drinking day and confidence regarding not drinking did not demonstrate such associations. Conclusions Clinical implications of these findings suggest that interventions to help alcoholics in recovery avoid temptations to drink, as well as decrease depression, may be warranted. By using advanced statistical techniques, these results can help clinicians and organizations working with smokers in treatment for alcohol use disorders to make informed decisions regarding how best to use limited resources. PMID:17526633

  7. Development of Child-Teen Obesity Treatment Service Platform

    PubMed Central

    Lim, Kahyun; Lee, Byung Mun

    2016-01-01

    Objectives This study aimed to develop an effective and efficient obesity treatment and management service platform for obese children/teenagers. Methods The integrated smart platform was planned and established through cooperation with service providers such as hospitals and public health centers, obese children/teenagers who constitute the service's user base, and IT development and policy institutions and companies focusing on child-teen obesity management and treatment. Results Based on guidelines on intervention strategies to manage child-teen obesity, we developed two patient/parent mobile applications, one web-monitoring service for medical staff, one mobile application for food-craving endurance, and one mobile application for medical examinations. Conclusions The establishment of the integrated service platform was successfully completed; however, this study was restrictively to the hospital where the pilot program took place. The effectiveness of the proposed platform will be verified in the future in tests involving other organizations. PMID:27525166

  8. Combination drug treatment in patients with non-alcoholic fatty liver disease

    PubMed Central

    Filippatos, Theodosios D; Elisaf, Moses S

    2010-01-01

    Non-alcoholic fatty liver disease (NAFLD) includes simple steatosis, a benign condition, and non-alcoholic steatohepatitis, a condition that beyond TG accumulation also includes necroinflammation and fibrosis. An association between NAFLD and cardiovascular disease (CVD) has been recently suggested. NAFLD patients usually have an increased CVD risk profile. NAFLD is also associated with metabolic syndrome (MetS) and is considered as the hepatic component of MetS by some authors. Currently, the only established treatment of NAFLD is gradual weight loss. However, multifactorial treatment of NAFLD risk factors may be needed to reduce the increased CVD risk of NALFD patients. Drug combinations that include antiobesity drugs (such as orlistat and sibutramine) and target CVD risk factors may be a good approach to NAFLD patients. Our group has investigated the orlistat-fenofibrate combination treatment in obese patients with MetS and the orlistat-ezetimibe and sibutramine-antihypertensive combination treatment in obese patients with hyperlipidaemia with promising results in CVD risk factor reduction and improvement of liver function tests. Small studies give promising results but double-blind, randomized trials examining the effects of such multifactorial treatment in hard CVD endpoints in NAFLD patients are missing. PMID:21160985

  9. The Alcoholic Elderly Client: Assessment of Policies and Practices of Service Providers.

    ERIC Educational Resources Information Center

    Kola, Lenore A.; And Others

    1984-01-01

    Surveyed 88 aging agencies serving approximately 11,000 clients to assess their capabilities for serving elderly with alcohol problems. Alcoholism was not viewed as a major problem by agency administrators, but few policies and procedures for dealing with this population were extant. Discussed implications for policy and program development.…

  10. Alcohol and Health. Fifth Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report is divided into an overview of alcohol and health, and eight chapters which deal with various aspects of alcohol use and abuse. The epidemiology of alcohol abuse and alcoholism is discussed. Data are presented on self-reported consumption of alcohol among youths and adults; alcohol consumption during pregnancy; alcohol-related…

  11. The Use of a Modified Marathon in Conjunction with Group Counseling in Short-term Treatment of Alcoholics

    ERIC Educational Resources Information Center

    Gazda, G. M.; And Others

    1971-01-01

    Two conclusions drawn from the application of the modified marathon to a short term treatment center were that the modified marathon had the advantages of holding" alcoholics for treatment once they were sober and it enhanced the quality of typical group counseling and therapy treatment. (Author)

  12. The Westgate Service and Related Referral, Assessment, and Treatment Processes.

    PubMed

    Bennett, Alice L

    2015-12-01

    The formerly named "Dangerous and Severe Personality Disorder" (DSPD) units are no longer standalone services within the criminal justice system in England and Wales. These sites now provide personality disorder treatment services in the high-security prison estate as part of the new national Offender Personality Disorder (OPD) Pathway Strategy. The OPD Pathway intends to take responsibility for the assessment, treatment, and management of offenders who are likely to have a personality disorder and who present a high risk of re-offending (men and women) and serious harm to others (men). Further PD treatment and progression services are being commissioned in lower security prisons and in the community as part of the new PD Strategy. While the suitability criteria for the two male high-security PD treatment sites are the same, the individual units have their own assessment and treatment methods. This article aims to communicate the referral, assessment, and treatment methods employed within the prison-based Westgate Personality Disorder Treatment Service, HMP Frankland. PMID:24927739

  13. [Parenteral S-adenosylmethionine compared to placebos in the treatment of alcoholic liver diseases].

    PubMed

    Diaz Belmont, A; Dominguez Henkel, R; Uribe Ancira, F

    1996-01-01

    The improvements in the knowledge of the action of ethanol over the hepatic cell, its direct action over the cell, and the intracytoplasmatic structures membranes, point out the possibilities of use of sulfo-adenosil-L-metionina (SAMe); as an util drug inn the treatment of the altered metilation reactions, that take place in those membranes, facilitating their physiological functions. The primary end point in this study was to demonstrate the therapeutic worth os SAMe, by parenteral route in 45 patients with alcoholic liver disease, which were determined by clinical laboratory and hepatic function test, label qith 32 points or more of the discriminatory function index. Divided into two groups, placebo-SAMe, randomized, double blind. As well as total plasmatic and reduced glutation and lipoperoxidation index, indirect form as malondehaldehyde. Were determined at the first visit anf after 8 and 15 days of treatment. Comparing the results of both groups there were a significative favorable results for the group treatment with SAMe and this confirms the utility of this drug in the treatment of patients with alcoholic liver disease with a discriminatory function index (Maddrey index), of 32 points or more. PMID:8679834

  14. Incretin based therapies: A novel treatment approach for non-alcoholic fatty liver disease

    PubMed Central

    Blaslov, Kristina; Bulum, Tomislav; Zibar, Karin; Duvnjak, Lea

    2014-01-01

    Non-alcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome (MS). The current treatment of non-alcoholic fatty liver disease (NAFLD) principally includes amelioration of MS components by lifestyle modifications but the lack of success in their implementation and sustainment arises the need for effective pharmacological agent in fatty liver treatment. Incretins are gut derived hormones secreted into the circulation in response to nutrient ingestion that enhances glucose-stimulated insulin secretion. Glucagon-like peptide-1 (GLP-1) is the most important incretin. Its receptor agonist and inhibitors of dipeptidyl peptidase-4 (DPP-4) are used in treatment of type 2 diabetes mellitus. DPP-4 serum activity and hepatic expression are shown to be elevated in several hepatic diseases. There are several experimental and clinical trials exploring the efficacy of incretin based therapies in NAFLD treatment. They suggest that GLP-1 analogues might have beneficial effect on hepatic steatosis acting as insulin sensitizers and directly by stimulating GLP-1 receptors expressed on hepatocytes. The use of DPP-4 inhibitors also results in hepatic fat reduction but the mechanism of action remains unclear. There is growing evidence that incretin based therapies have beneficial effects on hepatocytes, however further study analysis are needed to assess the long term effect of incretin based therapies on NAFLD. PMID:24966606

  15. The effects of polyunsaturated fatty acids in alcohol dependence treatment - a double-blind, placebo-controlled pilot study

    PubMed Central

    2011-01-01

    Background The lipid fraction of cell membranes consists of polyunsaturated fatty acids (PUFAS), and chronic alcohol use alters it, modifying its permeability, what might contribute for the dysfunctional metabolism observed in the central nervous system of alcohol dependent patients. Therefore, the supplementation of PUFAS can be an important adjuvant in alcoholism treatment. Methods This was a placebo controlled, double blind, randomized study where, 80 alcohol dependent patients, according to DSM-IV, were allocated in four groups with 20 patient each: 'PUFAS', 'Naltrexone', 'Naltrexone + PUFAS' and 'Placebo'. Those substances were administered for 90 days and scales were applied to assess patients craving (OCDS) and alcohol dependence severity (SADD) at baseline and after 90 days. PUFAS serum levels were assessed before and after treatment by high performance liquid chromatography assay. Results Forty-three patients completed the trial. There was a significant improvement over time on drinking days, SADD and OCDS scores in all groups (p < 0.001). The drinking days comparison between groups did not show statistical significant difference. The same effect was observed for compulsion (OCDS) and severity of dependence scale (SADD). The serum levels of PUFAS increased in all the supplemented groups after treatment, although not significantly. Conclusions The oral supplementation of 2 g PUFAS for 3 months did not significantly differ from placebo in reducing the amount of alcohol ingestion, or OCDS and SADD scores in a group of alcohol dependent patient. Trial registration NCT01211769 PMID:21787433

  16. Implementing outside the box: Community-based social service provider experiences with using an alcohol screening and intervention

    PubMed Central

    Patterson Silver Wolf (Adelv unegv Waya), David A.; Ramsey, Alex T.; van den Berk-Clark, Carissa

    2014-01-01

    Objective The aim of this study is better understand perceptions of front-line social service workers who are not addiction specialists, but have to address addiction-related issues during their standard services. Method Six social service organizations implemented a validated alcohol assessment and brief education intervention. After a 3-month trial implementation period, a convenience sample of 64 front-line providers participated in six focus groups to examine barriers and facilitators to the implementation of an alcohol screening and brief intervention. Results Three themes emerged: (1) usefulness of the intervention, (2) intervention being an appropriate fit with the agency and client population, and (3) worker commitment and proper utilization during the implementation process. Conclusions A cross-cutting theme that emerged was the context in which the intervention was implemented, as this was central to each of the three primary themes identified from the focus groups (i.e., the usefulness and appropriateness of the intervention and the implementation process overall). Practitioner buy-in concerns also indicate the need for better addiction service training opportunities for those without addiction-specific educational backgrounds. Future research should assess whether targeted trainings increase addiction screening and education in social services settings. PMID:25798019

  17. Proximal vs. distal predictors of alcohol use disorders and treatment utilization in at-risk men in early middle age

    PubMed Central

    Feingold, Alan; Capaldi, Deborah M.; Owen, Lee D.

    2015-01-01

    Understanding factors that predict both development and treatment of alcohol misuse and its consequences can inform prevention and treatment efforts. This study used measures of both proximal (e.g., behaviors) and distal (e.g., traits) risk factors that were predicted to relate to both an alcohol use disorder (AUD) and to treatment utilization among AUD-diagnosed men to test the hypothesis that both type of factors predict AUDs but only proximal factors influence treatment-seeking. Analyses of variance with contrasts were used to compare the means for risk factors between men with an AUD and AUD-free men and—given an AUD diagnosis—between men who were treated for an AUD and untreated men (n = 181). As predicted, men with AUDs differed on a broad range of proximal and distal factors, including number of alcohol problems, alcohol-related influences of peers and partners, alcohol expectancies, familial factors, and psychopathology. As hypothesized, only proximal risk factors predicted treatment-seeking among the AUD men, particularly alcohol problems and related consequences. PMID:26072267

  18. PREDICTION OF SEROTONERGIC TREATMENT EFFICACY USING AGE OF ONSET AND TYPE A/B TYPOLOGIES OF ALCOHOLISM

    PubMed Central

    Roache, John D.; Wang, Yanmei; Ait-Daoud, Nassima; Johnson, Bankole A.

    2009-01-01

    Background Previously, we reported that ondansetron was efficacious at treating early-onset (≤25 years old) but not late-onset (≥26 years old) alcoholics in a double-blind, randomized, placebo-controlled clinical trial (n = 321 enrolled patients, 271 of them randomized). Randomized participants underwent 11 weeks of treatment with ondansetron (1, 4, or 16 µg/kg twice daily; n = 67, 77, and 71, respectively) or identical placebo (n = 56), plus weekly standardized group cognitive behavioral therapy. Methods For this study, we reanalyzed the original sample to determine whether the Type A/B typological classification predicts ondansetron treatment response. In this comparative analysis, k-means clustering was applied to 19 baseline measures of drinking behavior, psychopathology, and social functioning, similar to those used by Babor in the original typological derivation. A two-factor solution described robustly two groups phenomenologically consistent with Type A/B classification. Subjects were subdivided into early- and late-onset alcoholics. Results Seventy-two percent of Type B subjects had early-onset alcoholism; 67% of Type A subjects had late-onset alcoholism. The A/B typology better discriminated two clusters based upon baseline severity of alcoholism. There was a significant effect (p < 0.05) for Type B alcoholics to respond to ondansetron (4 µg/kg); however, Type A alcoholics receiving ondansetron showed no beneficial effect. Early-vs. late-onset classification predicted ondansetron response substantially better than Type A/B classification, which did not add to the prediction of treatment outcome. Further analyses showed that ondansetron was effective in the 33% of Type A alcoholics with early-onset alcoholism but ineffective in the 28% of Type B alcoholics with late-onset alcoholism. Conclusions Type A/B classification best discriminates alcoholic subtypes based upon baseline severity. Early- vs. late-onset classification is, however, a better

  19. Metabolites and biodegradation pathways of fatty alcohol ethoxylates in microbial biocenoses of sewage treatment plants

    SciTech Connect

    Steber, J.; Wierich, P.

    1985-03-01

    The biodegradation of fatty alcohol polyglycol ethers was studied by analyzing the /sup 14/C-labeled intermediates isolated from the effluent of a model continuous-flow sewage treatment plant after dosage of either alkyl- or heptaglycol-labeled stearyl alcohol ethoxylate (SA-7EO). In each case, uncharged and carboxylated (mainly dicarboxylated) polyethylene glycols constituted the most prominent metabolites. The results indicate that there is a faster degradation of the alkyl than the polyethylene glycol moiety and that there are two distinct primary degradation mechanisms acting simultaneously in microbial biocenoses: intramolecular scission of the surfactant as well as omega- and beta-oxidation of the alkyl chain. Characterization of the bulk of /sup 14/C-labeled metabolites as a homologous series of neutral and acidic polyglycol units and identification of several C2-fragments accounted for the depolymerization of the hydrophilic part of the surfactant by stepwise cleavage of ether-bound EO units; from additional degradation studies employing either neutral or carboxylated /sup 14/C-labeled polyethylene glycols as model metabolites, it was concluded that hydrolytic as well as oxidative cleavage of C2-units is involved. The simultaneous action of different degradation mechanisms indicates the involvement of several distinct bacterial groups in the biodegradation of fatty alcohol ethoxylates under environmental conditions.

  20. Varenicline effects on drinking, craving and neural reward processing among non-treatment-seeking alcohol-dependent individuals

    PubMed Central

    Schacht, Joseph P.; Anton, Raymond F.; Randall, Patrick K.; Li, Xingbao; Henderson, Scott; Myrick, Hugh

    2014-01-01

    Rationale The α4β2 nicotinic acetylcholine receptor partial agonist varenicline has been reported to reduce drinking among both heavy-drinking smokers and primary alcoholics, and this effect may be related to varenicline-mediated reduction of alcohol craving. Among smokers, varenicline has been reported to modulate cigarette cue-elicited brain activation in several reward-related areas. Objectives This pilot study tested varenicline’s effects on drinking, alcohol craving, and alcohol cue-elicited activation of reward-related brain areas among non-treatment-seeking alcohol-dependent individuals. Methods Thirty-five such individuals (mean age = 30, 57% male, 76% heavy drinking days in the past month, 15 smokers) were randomized to either varenicline (titrated to 2 mg) or placebo for 14 days, and were administered an alcohol cue reactivity fMRI task on day 14. A priori regions of interest (ROIs) were bilateral and medial orbitofrontal cortex (OFC), right ventral striatum (VS), and medial prefrontal cortex (mPFC). Results Despite good medication adherence, varenicline did not reduce heavy drinking days or other drinking parameters. It did, however, increase self-reported control over alcohol-related thoughts and reduced cue-elicited activation bilaterally in the OFC, but not in other brain areas. Conclusions These data indicate that varenicline reduces alcohol craving and some of the neural substrates of alcohol cue reactivity. However, varenicline effects on drinking mediated by cue-elicited brain activation and craving might be best observed among treatment-seekers motivated to reduce their alcohol consumption. PMID:24647921

  1. Treatment of Essential Tremor with Long-Chain Alcohols: Still Experimental or Ready for Prime Time?

    PubMed Central

    Haubenberger, Dietrich; Nahab, Fatta B.; Voller, Bernhard; Hallett, Mark

    2014-01-01

    Aim To review current literature on long-chain alcohols and their derivatives as novel pharmacotherapy for the treatment of essential tremor (ET). Background Currently available and recommended pharmacotherapies for ET are often limited by suboptimal treatment effects, frequent adverse effects, and drug interactions. While ethanol is reported to profoundly decrease tremor severity in the majority of patients with ET, preclinical experience suggests that long-chain alcohols such as 1-octanol might lead to a comparable tremor reduction without ethanol’s typical side effects of sedation and intoxication. Here, we review the literature on the first clinical trials on 1-octanol and its metabolite octanoic acid (OA) for the treatment of ET. Methods The literature on preclinical and clinical trials on long-chain alcohols as well as OA was reviewed and summarized, and an outlook given on next phases of development. Discussion 1-octanol was demonstrated to be safe and effective in a double-blind, placebo-controlled low-dose trial, and open-label data showed excellent tolerability and dose-dependent efficacy up to 128 mg/kg. Despite 1-octanol’s efficacy, its future viability as an effective therapy is limited by its pharmacological properties that require large volumes to be orally administered. Pharmacokinetic data indicate that OA is the active metabolite of 1-octanol. Preclinical efficacy data for OA are positive, and human pilot data demonstrated excellent safety as well as efficacy in secondary outcome measures of tremor amplitudes. OA also has more favorable pharmacological properties for drug delivery; hence, OA may be worth developing as a pharmaceutical. PMID:24587968

  2. Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders.

    PubMed

    Gilbert, Allison R; Morrissey, Joseph P; Domino, Marisa E

    2011-07-01

    OBJECTIVE: The current study examined whether clinical responses to an integrated treatment intervention among women with co-occurring disorders and histories of abuse varied according to their service use patterns at baseline. METHODS: Data were from a national, multi-site, integrated treatment intervention study in 1998-2003. Analyses included 999 study participants assigned to the integrated treatment group and who were symptomatic at baseline. Participants' baseline service use activity was characterized according to five distinct baseline service use clusters. Logistic regression models estimated study participants' odds of good clinical responses to integrated treatment at 12 months across the five service clusters. RESULTS: Participants with high levels of psychotropic medication and medical care use at baseline had significantly lower odds than low-intensity service users of having a good response to integrated treatment at 12 months on mental health, alcohol addiction, and posttraumatic stress measures. A majority of women in this group had serious medical illness or disability and were more likely than their counterparts with other service use patterns to have used homeless or domestic violence shelters. CONCLUSIONS: Women who used high levels of medication and medical services appear to have faced especially difficult barriers in responding well to integrated treatment. Careful assessments of their mental health, trauma, and medical treatment needs may be required as part of integrated treatment in an effort to improve their response to integrated treatment, clinical outcomes and well-being. This information can also be used to target integrated treatment to women who are likely to respond positively and achieve meaningful improvements in their functioning. PMID:22368532

  3. A Standardized Kudzu Extract (NPI-031) Reduces Alcohol Consumption in Non Treatment-Seeking Male Heavy Drinkers

    PubMed Central

    Lukas, Scott E.; Penetar, David; Su, Zhaohui; Geaghan, Thomas; Maywalt, Melissa; Tracy, Michael; Rodolico, John; Palmer, Christopher; Ma, Zhongze; Lee, David Y.-W.

    2012-01-01

    OBJECTIVE We previously demonstrated that short-term treatment with a standardized kudzu extract (NPI-031) reduced alcohol drinking by men and women in a natural setting. The present study was conducted in non treatment-seeking heavy drinkers to assess the safety and efficacy of four weeks of kudzu extract in an outpatient setting. METHOD This randomized between-subject, double-blind, placebo-controlled study involved two weeks of baseline, four weeks of treatment and two weeks of follow-up. Seventeen men (21–33 years) who reported drinking 27.6 ± 6.5 drinks/week with a diagnosis of alcohol abuse/dependence took either kudzu extract (250 mg isoflavones, t.i.d.) or matched placebo on a daily basis. They reported alcohol consumption and desire to use alcohol using a wrist actigraphy device; twice weekly laboratory visits were scheduled to monitor medication adherence and adverse events. RESULTS Medication adherence was excellent and there were no adverse events, changes in vital signs, blood chemistry, renal or liver function. There was no effect on alcohol craving, but kudzu extract significantly reduced the number of drinks consumed each week by 34–57%, reduced the number of heavy drinking days and significantly increased the percent of days abstinent and the number of consecutive days of abstinence. CONCLUSIONS A standardized formulation of kudzu extract produced minimal side effects, was well-tolerated and resulted in a modest reduction in alcohol consumption in young non treatment-seeking heavy drinkers. Additional studies using treatment-seeking alcohol-dependent persons will be necessary to determine the usefulness of this herbal preparation in reducing alcohol use in other populations. PMID:23070022

  4. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments

    PubMed Central

    Naqvi, Nasir H.; Morgenstern, Jon

    2015-01-01

    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of sub-cortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms. PMID:26259087

  5. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments.

    PubMed

    Naqvi, Nasir H; Morgenstern, Jon

    2015-01-01

    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms. PMID:26259087

  6. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    PubMed

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed. PMID:23582065

  7. Alcohol expectancy changes over a 12-week cognitive-behavioral therapy program are predictive of treatment success.

    PubMed

    Young, Ross McD; Connor, Jason P; Feeney, Gerald F X

    2011-01-01

    This study examines if outcome expectancies (perceived consequences of engaging in certain behavior) and self-efficacy expectancies (confidence in personal capacity to regulate behavior) contribute to treatment outcome for alcohol dependence. Few clinical studies have examined these constructs. The Drinking Expectancy Profile (DEP), a psychometric measure of alcohol expectancy and drinking refusal self-efficacy, was administered to 298 alcohol-dependent patients (207 males) at assessment and on completion of a 12-week cognitive-behavioral therapy alcohol abstinence program. Baseline measures of expectancy and self-efficacy were not strong predictors of outcome. However, for the 164 patients who completed treatment, all alcohol expectancy and self-efficacy factors of the DEP showed change over time. The DEP scores approximated community norms at the end of treatment. Discriminant analysis indicated that change in social pressure drinking refusal self-efficacy, sexual enhancement expectancies, and assertion expectancies successfully discriminated those who successfully completed treatment from those who did not. Future research should examine the basis of expectancies related to social functioning as a possible mechanism of treatment response and a means to enhance treatment outcome. PMID:20864294

  8. Outcomes with the ARISE approach to engaging reluctant drug- and alcohol-dependent individuals in treatment.

    PubMed

    Landau, Judith; Stanton, M Duncan; Brinkman-Sull, David; Ikle, David; McCormick, David; Garrett, James; Baciewicz, Gloria; Shea, Robert R; Browning, Ashley; Wamboldt, Frederick

    2004-11-01

    Our goal was to explore, through a Stage I NIH clinical study, the effectiveness of a manual-driven, timely response method for helping the "concerned other" get resistant substance abusers into treatment/self-help with minimum professional time/effort. A manual-driven protocol, "A Relational Sequence for Engagement (ARISE)," was applied with 110 consecutive, initial calls/contacts from concerned others; no cases excluded for research, refusal, or other reasons. The research was conducted at two upstate New York outpatient drug/alcohol clinics. Participants were concerned others who called regarding a cocaine, alcohol, or "other drug" abuser (N = 110); participating family/friends: 11 ARISE clinicians; and 110 substance abusers. ARISE is a graduated continuum starting with the least demanding option/stage, increasing effort as needed to engage substance abusers in treatment/self-help. Stage I: Coaching the concerned other to arrange a meeting of significant others, inviting the substance abuser; Stage II: 1 to 5 additional meetings (median = 2); Stage III: A modified Johnson "Intervention." Primary outcome variables were substance abuser engagement (or not) in treatment/self-help; days between first call and engagement; clinician time/effort. Predictors were concerned other, substance abuser, and clinician demographics; number of participants per case; and Collateral Addiction Severity Index. ARISE resulted in an 83% success rate (55% at Stage I). Median days to engagement was 7 (IQR = 2 to 14). Average total time (telephone, sessions) per case was 1.5 hours. Treatment/self-help chosen was 95% treatment and 5% self-help. Number of family/ friends involved correlated 0.69 with a success/efficiency index. Conclusions. A call from a family member or concerned other for help in getting a loved one into treatment is a rich opportunity for treatment professionals and agencies to engage substance abusers in treatment. These initial calls are similar to referral calls from

  9. [Acamprosate and psychosocial intervention. An integrative treatment approach for prevention of alcohol dependent patients in Switzerland].

    PubMed

    Fuchs, W J; Riebenfeld, D

    2002-04-24

    105 patients with severe alcohol dependence, who were treated in 13 centers in Switzerland, took part in this open study. The abstinence rate achieved under treatment with Acamprosat, which was used within the framework of established psychotherapeutic intervention programmes in which the doctors could choose between five different procedures, was determined over a period of 24 weeks. In addition, a sociodemographic profile was drawn up, a physical examination was carried out and data were collected on the safety aspect of Acamprosat. It was also of interest to ascertain whether, and if so how, the patients' quality of life changed under the treatment, and in what form they received psychosocial support. As supportive therapy almost two-thirds of the patients (63%) received individual psychotherapy, in 28% the doctor decided on cognitive behavioural therapy, in 4% a short intervention was carried out, in 4% group therapy and in 2% family therapy. In 85.7% of the patients the doctor continued with the initial form of psychotherapy, while in the remaining patients it was changed once. Due to the very uneven distribution a comparison of the outcome in regard to the concomitant therapy was rather problematical. Psychiatric problems (21%), polyneuritis (12%) and liver damage (10.6%)--all known complications of chronic alcohol abuse--were the most frequent concomitant diagnoses. Of the 91 patients who had remained abstinent for the first two weeks after the start of the study, 12.9% had a recurrence at the end of the study, 56% did not have a recurrence (they were abstinent, but did have a binge or a lapse) and 31.8% did not return for the control visits. When a recurrence did occur, however, significantly less alcohol was consumed than before the treatment. As a result of the combined intervention all the parameters relating to the quality of life that were documented in connection with the SF 36 showed improvement. With this study carried out in Switzerland, which is

  10. Knowledge, attitudes and practices of physicians in Tomsk Oblast Tuberculosis Services Regarding Alcohol Use Among Tuberculosis Patients in Tomsk, Russia

    PubMed Central

    Mathew, Trini A.; Shields, Alan L.; Imasheva, Aizhan; Shin, Sonya S.; Furin, Jennifer J.; Mishustin, Sergey P.; Peremitin, Gennady G.; Strelis, Aivar K.; Yanova, Galina V.; Greenfield, Shelly F.

    2010-01-01

    In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semi-structured interviews with 16 TB physicians and one addiction specialist. Interviews were audio-recorded, transcribed, translated, and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse, and physicians' knowledge, attitudes, and practices regarding these problems. Physicians described patients as largely pre-contemplative and reluctant in seeking treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk, Russia. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improve TB outcomes among patients with co-occurring AUDs. PMID:19768525

  11. Lactobacillus rhamnosus CCFM1107 treatment ameliorates alcohol-induced liver injury in a mouse model of chronic alcohol feeding.

    PubMed

    Tian, Fengwei; Chi, Feifei; Wang, Gang; Liu, Xiaoming; Zhang, Qiuxiang; Chen, Yongquan; Zhang, Hao; Chen, Wei

    2015-12-01

    Lactobacillus rhamnosus CCFM1107 was screened for high antioxidative activity from 55 lactobacilli. The present study attempted to explore the protective properties of L. rhamnosus CCFM1107 in alcoholic liver injury. A mouse model was induced by orally feeding alcohol when simultaneously treated with L. rhamnosus CCFM1107, the drug Hu-Gan- Pian (HGP), L. rhamnosus GG (LGG), and L. plantarum CCFM1112 for 3 months. Biochemical analysis was performed for both serum and liver homogenate. Detailed intestinal flora and histological analyses were also carried out. Our results indicated that the administration of L. rhamnosus CCFM1107 significantly inhibited the increase in the levels of serum aminotransferase and endotoxin, as well as the levels of triglyceride (TG) and cholesterol (CHO) in the serum and in the liver. Glutathione (GSH), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were elevated while the levels of malondialdehyde (MDA) were decreased. The enteric dysbiosis caused by alcohol was restored by increasing the numbers of both lactobacilli and bifidobacteria and decreasing the numbers of both enterococci and enterobacter. Histological analysis confirmed the protective effect of L. rhamnosus CCFM1107. Compared with the other lactobacilli and to the drug Hu-Gan-Pian, there is a high chance that L. rhamnosus CCFM1107 provides protective effects on alcoholic liver injury by reducing oxidative stress and restoring the intestinal flora. PMID:26626356

  12. Partner Violence Before and After Couples-Based Alcoholism Treatment for Male Alcoholic Patients: The Role of Treatment Involvement and Abstinence.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Murphy, Christopher M.; Stephan, Sharon H.; Fals-Stewart, William; Murphy, Marie

    2004-01-01

    This study examined partner violence before and after behavioral couples therapy (BCT) for 303 married or cohabiting male alcoholic patients and used a demographically matched nonalcoholic comparison sample. In the year before BCT, 60% of alcoholic patients had been violent toward their female partner, 5 times the comparison sample rate of 12%. In…

  13. Alcoholic cardiomyopathy

    PubMed Central

    Guzzo-Merello, Gonzalo; Cobo-Marcos, Marta; Gallego-Delgado, Maria; Garcia-Pavia, Pablo

    2014-01-01

    Alcohol is the most frequently consumed toxic substance in the world. Low to moderate daily intake of alcohol has been shown to have beneficial effects on the cardiovascular system. In contrast, exposure to high levels of alcohol for a long period could lead to progressive cardiac dysfunction and heart failure. Cardiac dysfunction associated with chronic and excessive alcohol intake is a specific cardiac disease known as alcoholic cardiomyopathy (ACM). In spite of its clinical importance, data on ACM and how alcohol damages the heart are limited. In this review, we evaluate available evidence linking excessive alcohol consumption with heart failure and dilated cardiomyopathy. Additionally, we discuss the clinical presentation, prognosis and treatment of ACM. PMID:25228956

  14. Syngas production by plasma treatments of alcohols, bio-oils and wood

    NASA Astrophysics Data System (ADS)

    Arabi, K.; Aubry, O.; Khacef, A.; Cormier, J.-M.

    2012-12-01

    Exploitation of forest resources for energy production includes various methods of biomass processing. Gasification is one of the ways to recover energy from biomass. The Syngas produced from biomass can be used to power internal combustion engines, or, after purification, to supply fuel cells. The paper is summarizing results obtained through a non thermal arc plasma reactor at laboratory scale. A stationary discharge (I = 150mA) is used to perform physical diagnostics and also chemical analysis. The arc is formed between two electrodes made of graphite. We first present results on plasma-steam reforming of alcohols and bio-oils mixed in water. The outlet gas compositions are given from various alcohols and-bio-oils obtained at different experimental conditions. The second part of the paper is dedicated to a direct plasma treatment of wood (beech) at laboratory scale. One of the electrodes is surrounded by wood. The final part of the paper is a general discussion about efficiencies and comparisons of plasma treatments presented. The results obtained are discussed by considering the steam reforming reactions and the water gas shift reaction.

  15. Focus on emerging drugs for the treatment of patients with non-alcoholic fatty liver disease

    PubMed Central

    Federico, Alessandro; Zulli, Claudio; de Sio, Ilario; Del Prete, Anna; Dallio, Marcello; Masarone, Mario; Loguercio, Carmela

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disorder in Western countries and is increasingly being recognized in developing nations. Fatty liver disease encompasses a spectrum of hepatic pathology, ranging from simple steatosis to non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and end-stage liver disease. Moreover, NAFLD is often associated with other metabolic conditions, such as diabetes mellitus type 2, dyslipidemia and visceral obesity. The most recent guidelines suggest the management and treatment of patients with NAFLD considering both the liver disease and the associated metabolic co-morbidities. Diet and physical exercise are considered the first line of treatment for patients with NAFLD, but their results on therapeutic efficacy are often contrasting. Behavior therapy is necessary most of the time to achieve a sufficient result. Pharmacological therapy includes a wide variety of classes of molecules with different therapeutic targets and, often, little evidence supporting the real efficacy. Despite the abundance of clinical trials, NAFLD therapy remains a challenge for the scientific community, and there are no licensed therapies for NAFLD. Urgently, new pharmacological approaches are needed. Here, we will focus on the challenges facing actual therapeutic strategies and the most recent investigated molecules. PMID:25492998

  16. Non-alcoholic fatty liver disease and diabetes: From physiopathological interplay to diagnosis and treatment

    PubMed Central

    Leite, Nathalie C; Villela-Nogueira, Cristiane A; Cardoso, Claudia R L; Salles, Gil F

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with diabetes mellitus and increasing evidence suggests that patients with type 2 diabetes are at a particularly high risk for developing the progressive forms of NAFLD, non-alcoholic steatohepatitis and associated advanced liver fibrosis. Moreover, diabetes is an independent risk factor for NAFLD progression, and for hepatocellular carcinoma development and liver-related mortality in prospective studies. Notwithstanding, patients with NAFLD have an elevated prevalence of prediabetes. Recent studies have shown that NAFLD presence predicts the development of type 2 diabetes. Diabetes and NAFLD have mutual pathogenetic mechanisms and it is possible that genetic and environmental factors interact with metabolic derangements to accelerate NAFLD progression in diabetic patients. The diagnosis of the more advanced stages of NAFLD in diabetic patients shares the same challenges as in non-diabetic patients and it includes imaging and serological methods, although histopathological evaluation is still considered the gold standard diagnostic method. An effective established treatment is not yet available for patients with steatohepatitis and fibrosis and randomized clinical trials including only diabetic patients are lacking. We sought to outline the published data including epidemiology, pathogenesis, diagnosis and treatment of NAFLD in diabetic patients, in order to better understand the interplay between these two prevalent diseases and identify the gaps that still need to be fulfilled in the management of NAFLD in patients with diabetes mellitus. PMID:25024596

  17. Profile of Class I Histone Deacetylases (HDAC) by Human Dendritic Cells after Alcohol Consumption and In Vitro Alcohol Treatment and Their Implication in Oxidative Stress: Role of HDAC Inhibitors Trichostatin A and Mocetinostat

    PubMed Central

    Yndart, Adriana; Muñoz, Karla; Atluri, Venkata; Samikkannu, Thangavel; Nair, Madhavan P.

    2016-01-01

    Epigenetic mechanisms have been shown to play a role in alcohol use disorders (AUDs) and may prove to be valuable therapeutic targets. However, the involvement of histone deacetylases (HDACs) on alcohol-induced oxidative stress of human primary monocyte-derived dendritic cells (MDDCs) has not been elucidated. In the current study, we took a novel approach combining ex vivo, in vitro and in silico analyses to elucidate the mechanisms of alcohol-induced oxidative stress and role of HDACs in the periphery. ex vivo and in vitro analyses of alcohol-modulation of class I HDACs and activity by MDDCs from self-reported alcohol users and non-alcohol users was performed. Additionally, MDDCs treated with alcohol were assessed using qRT-PCR, western blot, and fluorometric assay. The functional effects of alcohol-induce oxidative stress were measured in vitro using PCR array and in silico using gene expression network analysis. Our findings show, for the first time, that MDDCs from self-reported alcohol users have higher levels of class I HDACs compare to controls and alcohol treatment in vitro differentially modulates HDACs expression. Further, HDAC inhibitors (HDACi) blocked alcohol-induction of class I HDACs and modulated alcohol-induced oxidative stress related genes expressed by MDDCs. In silico analysis revealed new target genes and pathways on the mode of action of alcohol and HDACi. Findings elucidating the ability of alcohol to modulate class I HDACs may be useful for the treatment of alcohol-induced oxidative damage and may delineate new potential immune-modulatory mechanisms. PMID:27249803

  18. Effect of alcohol treatment on the performance of PTB7:PC71BM bulk heterojunction solar cells.

    PubMed

    Guo, Shuai; Cao, Biye; Wang, Weijia; Moulin, Jean-François; Müller-Buschbaum, Peter

    2015-03-01

    The effect of an environmentally friendly alcohol treatment on bulk heterojunction (BHJ) polymer solar cells using the low-bandgap copolymer based on thieno[3,4-b]thiophene-alt-benzodithiophene units and [6,6]-phenyl-C71-butyric acid methyl ester is systematically investigated. Different alcohols are tested, and besides the most commonly used methanol treatment, other alcohols such as ethanol, 2-propanol, and 1-butanol also improve the device performance to certain extents as compared to the untreated solar cells. Changes of the surface structure caused by the alcohol treatment are probed with atomic force microscopy, and the modification of inner film morphology is probed by time-of-flight-grazing incidence small-angle neutron scattering (TOF-GISANS). UV/vis measurements show that the thickness of all BHJ films remains unchanged by the different solvent treatments. Thus, the enhanced device performance induced by the alcohol treatments is correlated to the reconstruction of the inner film structures probed with TOF-GISANS and the modified energy levels at the interfaces between the BHJ layer and the aluminum electrodes, evident by the enhanced short-circuit current and open-circuit voltage of the I-V curves. PMID:25668222

  19. Problem Gambling Treatment within the British National Health Service

    ERIC Educational Resources Information Center

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study examines the…

  20. 78 FR 65347 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Abuse and Alcoholism, 5635 Fishers Lane (Teleconference), Rockville, MD 20855. Contact Person:...

  1. 78 FR 21615 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial ] Review... Foster, Ph.D., Scientific Review Administrator, National Institutes on Alcohol Abuse &...

  2. 78 FR 38353 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis Panel; Review of Applications on HIV- AIDS/Alcohol Comparative Effectiveness & Implementation...

  3. Lactobacillus rhamnosus GG treatment potentiates intestinal hypoxia-inducible factor, promotes intestinal integrity and ameliorates alcohol-induced liver injury.

    PubMed

    Wang, Yuhua; Kirpich, Irina; Liu, Yanlong; Ma, Zhenhua; Barve, Shirish; McClain, Craig J; Feng, Wenke

    2011-12-01

    Gut-derived endotoxin is a critical factor in the development and progression of alcoholic liver disease (ALD). Probiotics can treat alcohol-induced liver injury associated with gut leakiness and endotoxemia in animal models, as well as in human ALD; however, the mechanism or mechanisms of their beneficial action are not well defined. We hypothesized that alcohol impairs the adaptive response-induced hypoxia-inducible factor (HIF) and that probiotic supplementation could attenuate this impairment, restoring barrier function in a mouse model of ALD by increasing HIF-responsive proteins (eg, intestinal trefoil factor) and reversing established ALD. C57BJ/6N mice were fed the Lieber DeCarli diet containing 5% alcohol for 8 weeks. Animals received Lactobacillus rhamnosus GG (LGG) supplementation in the last 2 weeks. LGG supplementation significantly reduced alcohol-induced endotoxemia and hepatic steatosis and improved liver function. LGG restored alcohol-induced reduction of HIF-2α and intestinal trefoil factor levels. In vitro studies using the Caco-2 cell culture model showed that the addition of LGG supernatant prevented alcohol-induced epithelial monolayer barrier dysfunction. Furthermore, gene silencing of HIF-1α/2α abolished the LGG effects, indicating that the protective effect of LGG is HIF-dependent. The present study provides a mechanistic insight for utilization of probiotics for the treatment of ALD, and suggests a critical role for intestinal hypoxia and decreased trefoil factor in the development of ALD. PMID:22093263

  4. Outpatient Mental Health Services in Mozambique: Use and Treatments.

    PubMed

    Wagenaar, Bradley H; Cumbe, Vasco; Raunig-Berhó, Manuela; Rao, Deepa; Kohrt, Brandon A; Stergachis, Andy; Napúa, Manuel; Sherr, Kenneth

    2016-06-01

    To describe current outpatient mental health service use and treatments in Mozambique, the authors reviewed registry entries for 2,071 outpatient psychiatric visits at the Beira Central Hospital in Sofala Province from January 2012 to September 2014. Service use was most common for schizophrenia, followed by epilepsy, delirium, and organic behavioral disorders. Only 3% of consultations for schizophrenia were first-visit patients. Treatment seeking among women was more likely for mood and neurotic disorders and less likely for substance use disorders and epilepsy. First-generation antipsychotics, most often paired with promethazine, dominated treatment regimens. Evidence-based reforms are needed to improve identification of mood disorders and broaden care beyond severe mental disorders. PMID:26828400

  5. Risky Decision-Making but Not Delay Discounting Improves during Inpatient Treatment of Polysubstance Dependent Alcoholics

    PubMed Central

    De Wilde, Bieke; Bechara, Antoine; Sabbe, Bernard; Hulstijn, Wouter; Dom, Geert

    2013-01-01

    Background: High levels of impulsivity, characteristics of addicted patients, are known to be important predictors of relapse. However, so far, little is known about the stability or variability of two main components of impulsivity (delay discounting and decision-making). The present study examined the changes in impulsivity during the first week of an abstinence based, behavioral orientated inpatient treatment program. Method: Thirty-seven polysubstance dependent alcoholics completed the Delay Discounting Task (DDT), and the Iowa Gambling Task (IGT) using the original version with decks A′B′C′D′, and an alternative version with decks K′L′M′N′, for measuring decision-making, after 2 and 6 weeks of active treatment. Results: It was found that performances on the IGT changed during treatment while performances on the DDT did not (test-retest period: 4 weeks). Conclusion: The results provide preliminary evidence that improvements in decision-making might be related to treatment effects. All patients followed a highly structured cognitive-behavioral treatment program, which might have enhanced their executive functioning (coping skills training). PMID:24027538

  6. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    PubMed

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. PMID:20029212

  7. Staff Attitudes and Services Provided by Community-Based Organizations for Alcohol and Other Drug Users in Cape Town, South Africa: Implications for Training and Education

    ERIC Educational Resources Information Center

    Pasche, Sonja; Myers, Bronwyn; Louw, Johann

    2008-01-01

    Aims: The aims of this study were: (i) to describe the nature of and the extent to which community-based organizations (CBOs) in Cape Town provide services to people who have alcohol and other drug (AOD) problems; (ii) to examine the relationship between CBOs' attitudes towards individuals with AOD problems and the types of services provided; and…

  8. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    PubMed

    Goodman, Daisy

    2015-01-01

    Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. PMID:26769383

  9. State Resources and Services for Alcohol and Drug Abuse Problems. Fiscal Year 1985.

    ERIC Educational Resources Information Center

    Butynski, William; And Others

    This report presents and analyzes the results of the State Alcohol and Drug Abuse Profile data for the states' 1985 fiscal year (FY). Included is information from the 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. Highlights, an executive summary, an introduction, and a section on the study purpose and methodology…

  10. Alcohol and Health. Ninth Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report provides current information on the health consequences of using alcoholic beverages and a description on current research findings on alcohol abuse and alcoholism. The focus is on research advances since September, 1993. The chapters are as follows: (1) "Epidemiology of Alcohol Use and Alcohol-Related Consequences"; (2) "Genetic,…

  11. Alcohol and Health. Seventh Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report describes recent progress in knowledge on alcohol abuse and alcoholism. These topics are covered: (1) alcohol abuse and alcoholism, including drinking patterns, etiology, and alcohol dependence as a disease; (2) epidemiology, including morbidity and deaths; (3) genetics and environment, including twin and adoption studies, animal…

  12. Non-alcoholic fatty liver disease: What has changed in the treatment since the beginning?

    PubMed Central

    Baran, Bülent; Akyüz, Filiz

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) is an umbrella term to describe the entire spectrum of this common liver disease. In patients with NAFLD, especially those with non-alcoholic steatohepatitis (NASH), most often have one or more components of the metabolic syndrome, but this is not universal. Although most patients with NAFLD share many clinical features, only a subset of patients develops significant liver inflammation and progressive fibrosis. On the other hand, not all patients with NASH exhibit insulin resistance. NASH can be seen in patients who are lean and have no identifiable risk factors. Many clinical studies have tried numerous drugs and alternative medicine, however, investigators have failed to identify a safe and effective therapy for patients with NASH. As summarized, the heterogeneity of pathogenic pathways in individual patients with NASH may warrant the development of an individualized treatment according to the underlying pathogenic pathway. The differentiation of pathogenetic targets may require the development of diagnostic and prognostic biomarkers, and the identification of genetic susceptibilities. At present, evidence-based medicine provides only a few options including life-style modifications targeting weight loss, pioglitazone and vitamin E in non-diabetic patients with biopsy-proven NASH. PMID:25339808

  13. A Systematic Review of the Impact of Alcohol Use Disorders on HIV Treatment Outcomes, Adherence to Antiretroviral Therapy and Health Care Utilization *

    PubMed Central

    Azar, Marwan M.; Springer, Sandra A.; Meyer, Jaimie P.; Altice, Frederick L.

    2010-01-01

    Background Alcohol use disorders (AUDs) are highly prevalent and associated with non-adherence to antiretroviral therapy, decreased health care utilization and poor HIV treatment outcomes among HIV-infected individuals. Objectives To systematically review studies assessing the impact of AUDs on: (1) medication adherence, (2) health care utilization and (3) biological treatment outcomes among people living with HIV/AIDS (PLWHA). Data Sources Six electronic databases and Google Scholar were queried for articles published in English, French and Spanish from 1988 to 2010. Selected references from primary articles were also examined. Review Methods Selection criteria included: 1) AUD and adherence (N=20); 2) AUD and health services utilization (N=11); or 3) AUD with CD4 count or HIV-1 RNA treatment outcomes (N=10). Reviews, animal studies, non-peer reviewed documents and ongoing studies with unpublished data were excluded. Studies that did not differentiate HIV+ from HIV- status and those that did not distinguish between drug and alcohol use were also excluded. Data were extracted, appraised and summarized. Data Synthesis and Conclusions Our findings consistently support an association between AUDs and decreased adherence to antiretroviral therapy and poor HIV treatment outcomes among HIV-infected individuals. Their effect on health care utilization, however, was variable. PMID:20705402

  14. Insulin sensitizers for the treatment of non-alcoholic fatty liver disease

    PubMed Central

    Ozturk, Zeynel Abidin; Kadayifci, Abdurrahman

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the Western world and is closely associated with metabolic syndrome, which includes hypertension, central obesity, dyslipidemia and insulin resistance. NAFLD includes a wide spectrum of liver alterations, ranging from simple hepatic steatosis to variable degrees of fibrosis, cirrhosis and even hepatocellular carcinoma. Although the etiology and progression of the disorder remain poorly understood, insulin resistance is considered to play a pivotal role in the pathogenesis. Insulin sensitizers such as biguanides, thiazolidinediones (TZDs), glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors have been studied as therapeutic approaches for NAFLD in recent years. Metformin improves insulin sensitivity and serum alanine transaminase and aspartate transaminase (ALT/AST) levels in the majority of subjects; however, it has no significant effect on liver histology. TZDs improve insulin sensitivity, serum ALT/AST levels and histology in some cases, but there are some concerns about the safety of long-term therapy. Selection of appropriate patients for avoiding side effects and the treatment of underlying disease are the main points. These drugs are the best choice for the treatment of NAFLD in patients with type 2 DM who are also candidates for treatment with an insulin sensitizer. The present review provides an overview of insulin sensitizers in the treatment of NAFLD. PMID:24799988

  15. A systematic review of the effectiveness of naltrexone in the maintenance treatment of opioid and alcohol dependence.

    PubMed

    Roozen, Hendrik G; de Waart, Ranne; van der Windt, Danielle A W M; van den Brink, Wim; de Jong, Cor A J; Kerkhof, Ad J F M

    2006-07-01

    This systematic review summarises evidence of the effectiveness of naltrexone (NTX) and the added value of psychosocial treatment in the maintenance treatment of opioid and alcohol dependence. Studies were selected through a literature search conducted in March 2004. Seven opioid and seventeen alcohol studies were identified. When possible, meta-(regression) analyses were performed. There is lack of evidence about the effectiveness of NTX in the maintenance treatment of opioid dependence. There is evidence for the effectiveness and applicability of NTX in the management of alcohol dependence. The opioid studies combined NTX with a variety of psychosocial interventions, which plagued the evaluation of their value. Concomitant psychosocial interventions used in the alcohol studies were mainly cognitive behavioural, which seems to be more effective than NTX combined with supportive therapy. Available data do not allow firm conclusions regarding the added effect of psychosocial interventions. However, the data suggest that a combination of naltrexone with cognitive behavioural relapse prevention therapy is beneficial in alcohol dependent patients. PMID:16361086

  16. Naltrexone treatment produces dose-related effects on food and water intake but daily alcohol consumption is not affected.

    PubMed

    Juárez, Jorge; Barrios De Tomasi, Eliana

    2008-08-01

    There is evidence that naltrexone, an opioid antagonist, affects alcohol and food consumption. Though food intake is inherently involved when naltrexone effects on alcohol consumption have been studied, the differential effect of this opioid antagonist on both food and alcohol intake has not yet been reported. The present study analyzed the effect of a single daily dose of naltrexone on alcohol, food and water intake when these substances were available on a continuous basis. Wistar male rats were treated with s.c. injections of either naltrexone (2 or 10 mg/kg/day/rat) or a saline solution, 0.2 ml/day/rat for 7 days. This period was followed by a lapse of 7 days with no treatment (PT period), and this sequence of naltrexone or saline treatment followed by a period without treatment was repeated four times. Neither 2 mg/kg nor 10 mg/kg of naltrexone affected alcohol consumption, though the higher dose of naltrexone (10 mg/kg) increased food intake with respect to both the PT periods and the saline group and decreased water consumption with respect to the corresponding PT periods. Naltrexone at 2 mg/kg produced a decrease in food intake but only with respect to the PT periods. These results suggest that the effects of a single dose of naltrexone on alcohol consumption may not be evident when 24-h access to alcohol is assessed; however, naltrexone may produce different dose-related effects on food and water intake, suggesting that they may be mediated by distinct opioid system mechanisms. PMID:18681987

  17. Insomnia, alcoholism and relapse.

    PubMed

    Brower, Kirk J

    2003-12-01

    Insomnia and alcoholism are significantly associated in community surveys and patient samples. Insomnia occurs in 36-72% of alcoholic patients and may last for weeks to months after initiating abstinence from alcohol. Some correlates of insomnia in alcoholic patients are identical to those observed in non-alcoholic insomniacs, including anxiety and depression, tobacco smoking, and the use of alcohol to aid sleep. Other studies suggest that as the severity of alcoholism increases, so does the likelihood of insomnia in alcoholic patients. In the sleep laboratory, alcoholic patients who complain of insomnia have disrupted sleep continuity when compared to alcoholic patients without insomnia complaints. Recently sober alcoholics are also more likely than non-alcoholics to have sleep-disordered breathing and increased periodic leg movements, which might contribute to insomnia in some alcoholic patients. The co-occurrence of insomnia and alcoholism is clinically significant because alcoholism can exacerbate the adverse consequences of insomnia (e.g. mood changes and performance decrements) and because insomnia among patients entering treatment for alcoholism has been significantly associated with subsequent alcoholic relapse. Baseline polysomnographic correlates of subsequent relapse include prolonged sleep latency, decreased sleep efficiency and total sleep time, increased rapid eye movement sleep pressure, and decreased slow wave sleep. Whether treatment of insomnia in alcoholic patients reduces relapse rates is unknown, but preliminary treatment guidelines that accommodate the special characteristics of alcoholic patients are provided, with a goal to reduce daytime impairment and psychological distress. PMID:15018094

  18. Environmental Management: An Approach to Alcohol and Other Drug Prevention. Prevention Updates

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, 2002

    2002-01-01

    Most campus alcohol and other drug (AOD) programs include prevention, intervention, and treatment services designed to address individual students' knowledge of the consequences of alcohol and other drug use, to improve their skills in resisting such behavior, or to address existing problematic use of or addiction to alcohol or other drugs.…

  19. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  20. Accessibility to tuberculosis treatment: assessment of health service performance.

    PubMed

    Arakawa, Tiemi; Arcêncio, Ricardo Alexandre; Scatolin, Beatriz Estuque; Scatena, Lúcia Marina; Ruffino-Netto, Antônio; Villa, Tereza Cristina Scatena

    2011-01-01

    The aim of this study was to assess the accessibility of patients to the treatment of tuberculosis in Ribeirão Preto, countryside of São Paulo State. Evaluation study type, with a quantity approach. Interviews with 100 patients initiated on anti-tuberculosis chemotherapy between 2006-2007 were conducted, using a structured questionnaire based on the Primary Care Assessment Tool (PCAT). Data were analyzed through variance analysis. There was a positive feedback regarding to organizational accessibility, however, the performance of health services has been unsatisfactory in providing transportation vouchers and in addressing the need to use transport for displacement to the health unit, resulting in indirect costs to patients. The services with the highest number of patients treated were those with higher irregularity in the conduct of home visits, showing that the availability of resources (human, material and time) and the organization of care may influence the accessibility to treatment. PMID:21876953

  1. The setting of a botulinum toxin treatment service.

    PubMed

    Cavallini, Maurizio

    2014-05-01

    The administration of botulinum toxin is an activity performed mostly by a specialist service for the management of a wide range of neurological conditions. For therapeutic purposes botulinum toxin type A is used, although in selected patients who develop antibodies specific for the serotype A botulinum toxin B can be used for the treatment. Hereby, we describe the organizational arrangements for the botulinum toxin treatment service at the Department of Neurology of Hospital Cardinal Massaia based in Asti. The diseases most frequently treated are movement disorders (primary and secondary focal dystonia, blepharospasm, facial emispasmo) spasticity and, more recently, chronic migraine. In particular, the latter application is one of the most promising expansions of the use of this drug in the few past years, although a larger number of patients are required to determine its efficacy and the related tolerability profile. PMID:24867836

  2. Pediatric non alcoholic fatty liver disease: more on novel treatment targets

    PubMed Central

    2013-01-01

    The mainstay treatment of non alcoholic fatty liver disease (NAFLD) based on weight loss and/or lifestyle changes is most often unsuccessful at all ages, thus requiring the implementation of pharmacological strategies. Targeting insulin resistance and oxidative stress has recently proven unsatisfactory. Among a number of proposed innovative approaches targeting novel pathomechanisms, probiotics appear an interesting and reasonable option acting on gut-liver axis malfunction through the modulation of diet-driven, obesogenic, and inflammatory intestinal microbiota. A combined multiple pharmacological therapy directed simultaneously towards novel and old pathomechanisms (including, e.g., insulin resistance, oxidative stress, gut-liver axis, apoptosis) along with lifestyle interventions however might be necessary both in adult and pediatric NAFLD therapy. PMID:23870449

  3. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease

    PubMed Central

    Bradford, V; Dillon, JF; Miller, MH

    2014-01-01

    The burden of non-alcoholic fatty liver disease (NAFLD) worldwide is a significant clinical and public health issue, affecting approximately one third of the Western population. This review assesses the effect and impact lifestyle interventions have on the treatment of this common condition. We review studies comparing the effect of calorie restriction and exercise programs, as well as comparison of lifestyle intervention with pharmaceutical intervention. Both calorie restriction and exercise programs are shown to be beneficial in improving features of metabolic syndrome and surrogate markers of NAFLD. The paucity of studies using histological improvement hinders the ability to conclude a benefit on improvement of histological NAFLD, although this is shown in a small number of studies. There is a need to extend the intervention period to show a sustained improvement with intervention as most studies have a follow up period of 12 months of less. PMID:24826079

  4. Therapist Competence and Treatment Adherence for a Brief Intervention addressing Alcohol and Violence among Adolescents

    PubMed Central

    Resko, Stella M.; Walton, Maureen A.; Chermack, Stephen T.; Blow, Frederic C.; Cunningham, Rebecca M.

    2011-01-01

    This study examines therapist competency and treatment adherence for a brief intervention addressing alcohol misuse and violent behaviors among adolescents aged 14–18. Three observational measures of fidelity were used by independent raters to evaluate 60 therapist-delivered sessions (m=32.5 minutes). Individual items from the Content Adherence scale, the Global Rating of Competence (GROMIT) and Self Exploration and Change Talk (SECT) demonstrated fair to excellent inter-rater reliability (intraclass correlations ranged from .40 to 1.0). Principal components analysis (PCA) was utilized to identify the underlying factor structure of the Content Adherence and GROMIT. Parallel analysis suggested the extraction of three components for the Content Adherence reflecting the three distinct goals for each segment of the intervention. Two components were identified for the GROMIT representing the general spirit of motivational interviewing and empowerment. Findings provide support for the fidelity instruments adapted for this study and offer direction for future training and clinical supervision. PMID:22119182

  5. Treatment for comorbid borderline personality disorder and alcohol use disorders: A review of the evidence and future recommendations

    PubMed Central

    Gianoli, Mayumi O.; Jane, J. Serrita; O’Brien, Erin; Ralevski, Elizabeth

    2013-01-01

    There is a high degree of comorbidity between borderline personality disorder (BPD) and alcohol use disorders (AUDs) including alcohol abuse (AA) and dependence (AD). There is some evidence that this pattern of comorbidity may be associated with poorer prognosis. Although there are many different psychotherapeutic and pharmacological treatments for BPD and AUDs when they occur alone, there are very few treatment options when they occur together. The objective of this paper was to review the existing treatment options—both psychotherapeutic and pharmacological—for patients with dual diagnoses of BPD and AUDs and to explore alternative treatment options that warrant further study. There have been a number of studies that have examined the efficacy of specific psychotherapies targeting drinking among patients with comorbid BPD; however, their efficacy in reducing BPD symptoms is unknown. There are also three psychotherapies that were specifically developed for patients with BPD and SUDs, but only one of these (Dynamic Deconstructive Psychotherapy) has been tested among patients with dual diagnoses of BPD and AUDs. Research on pharmacotherapy for dual diagnoses of BPD and AUD is scarce, and no study has yet explored medication options that can concurrently manage symptoms of BPD and decrease alcohol consumption. Interestingly, there is growing evidence that anticonvulsants and second generation antipsychotics, the recent medications of choice for the management of anger in BPD, may also reduce alcohol craving and consumption. Although premature, these findings are encouraging especially for this population of patients for whom treatment options are very limited. PMID:22686496

  6. Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon

    2009-01-01

    Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…

  7. Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community

    PubMed Central

    Brooks, Alyssa Todaro; Krumlauf, Michael; Fryer, Craig S.; Beck, Kenneth H.; Yang, Li; Ramchandani, Vijay A.; Wallen, Gwenyth R.

    2016-01-01

    Aims This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status. Methods This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants’ scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone). Results Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point. Conclusions This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions. PMID:27571353

  8. Propofol for Treatment of Refractory Alcohol Withdrawal Syndrome: A Review of the Literature.

    PubMed

    Brotherton, Amy L; Hamilton, Eric P; Kloss, H Grace; Hammond, Drayton A

    2016-04-01

    The authors evaluated all available evidence on the use of propofol as an adjuvant for the treatment of resistant alcohol withdrawal syndrome (AWS) in comparison to other therapies. A comprehensive PubMed search (1966-December 2015) was conducted using the search terms propofol, alcohol withdrawal, and drug therapy. Articles were cross-referenced for other citations. Clinical studies, case series, and case reports published in the English language assessing the use of propofol in adult patients for treatment of AWS were reviewed for inclusion. Propofol is a sedative-hypnotic that exerts its actions through agonism of GABAA receptors at a different binding site than benzodiazepines and reduces glutamatergic activity through N-methyl-d-aspartase (NMDA) receptor blockade. Dosages from 5 to 100 μg/kg/minute reduced AWS symptoms with frequent development of hypotension and requirement for mechanical ventilation. Patients on propofol often experienced longer durations of mechanical ventilation and length of stay, which may be attributed to more-resistant cases of AWS. When propofol was compared with dexmedetomidine as adjuncts in AWS, both agents showed similar benzodiazepine- and haloperidol-sparing effects. Dexmedetomidine was associated with more numerical rates of bradycardia, while propofol was associated with more numerical instances of hypotension. Dexmedetomidine was used more frequently in nonintubated patients. The available data assessing the utility of propofol for AWS exhibited significant heterogeneity. Propofol may be useful in a specific population of patients with AWS, limited to those who are not clinically responding to first-line therapy with benzodiazepines. Specifically, propofol should be considered in patients who are refractory to or not candidates for other adjuvant therapies, patients already requiring mechanical ventilation, or those with seizure activity or refractory delirium tremens. In severe, refractory AWS, adjuvant therapy with

  9. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    PubMed

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets. PMID:16752110

  10. Is peripheral alcohol injection of value in the treatment of trigeminal neuralgia? An analysis of 100 cases.

    PubMed

    Shah, S A; Khan, M N; Shah, S F; Ghafoor, A; Khattak, A

    2011-04-01

    This retrospective study assessed the effectiveness and complications of peripheral alcohol injections in the management of trigeminal neuralgia (TN). 100 patients were analyzed who received 250 peripheral alcohol injections from June 2004 to January 2010. The duration of effect of alcohol blocks, the effect of repeated administration, and complications associated with alcohol injections were examined. The distal injection technique was applied. The branch of the nerve was identified and confirmed. After carefully anesthetizing the nerve with local anesthesia, 1-1.5 ml of absolute alcohol was injected depending on the nerve involved. Pain relief lasted for a mean of 14.13 ± 8.66 months. There was a fall in the duration of effect with subsequent injections. No serious complications were reported. Only 3% patients presented with non-neuralgic pain, swelling, burning sensation, trismus, dysesthesia, soreness, infection and the expected loss of sensation along the branch involved in TN. The combination of efficacy and reduced morbidity makes this procedure preferable for the treatment of TN. Alcohol injections are useful in those who are refractory to drug therapy, the elderly, medically compromised patients, unwilling to undergo neurosurgical procedures and in whom surgery is delayed for any reason. PMID:21168309

  11. Meeting the needs of women who use drugs and alcohol in North-east India – a challenge for HIV prevention services

    PubMed Central

    2012-01-01

    Background The North-east Indian states of Manipur and Nagaland consistently report relatively high HIV prevalence. The targeted HIV prevention interventions in these two states are mostly delivered by non-government organizations (NGOs), and prevention of HIV transmission by injecting drug use is their main focus. Most injecting drug users (IDUs) are male, and the services are primarily tailored to meet their needs, which are not necessarily the same as those for women. This qualitative study describes the health service needs of women who use drugs and alcohol in Manipur and Nagaland, with the goal of identifying strategies and activities that can be implemented by NGOs wanting to improve their reach among vulnerable women. Methods In 2009-10, semi-structured in-depth interviews were conducted with 27 key informants and nine focus group discussions (FGDs) with women who use drugs and alcohol, and two FGDs with male IDUs. The thematic areas covered included: the context of female drug and alcohol use; drug and alcohol use patterns; HIV risk behaviours; barriers and facilitators of service use; perceived health needs; and expressed health service needs. The data were recorded, transcribed, translated and thematically analysed. Results The most problematic substance for women from Nagaland was alcohol, and for women from Manipur it was heroin. The most commonly identified health problems were primarily related to the women’s drug and alcohol use, reproductive health and mental health. Other problems of major concern included social exclusion, violence, children’s welfare, and financial difficulties. The expressed service needs of these women were women-only integrated health services, women-only detoxification and rehabilitation services, mental health services, desensitization of mainstream health workers, free access to medicines, assistance to meet basic needs, and a safe place for engaging in sex work. Conclusion The expressed health and other service needs

  12. [Normative definition of staff requirement for a guideline-adherent inpatient qualified detoxification treatment in alcohol dependence].

    PubMed

    Kiefer, F; Koopmann, A; Godemann, F; Wolff, J; Batra, A; Mann, K

    2016-03-01

    The central element of the "qualified withdrawal treatment" of alcohol dependence is - in addition to physical withdrawal treatment - psychotherapy. The treatment of the underlying addictive disorder that is displayed by intoxication, harmful behaviour and withdrawal symptoms is only possible with a combination of somatic and psychotherapeutic treatment elements. The successfully established multimodal therapy of the "qualified alcohol withdrawal treatment", postulated in the current S3-Treatment Guidelines, requires a multi-disciplinary treatment team with psychotherapeutic competence. The aim of the present work is to calculate the normative staff requirement of a guideline-based 21-day qualified withdrawal treatment and to compare the result with the staffing regulations of the German Institute for Hospital Reimbursement. The present data support the hypothesis that even in the case of a hundred per cent implementation of these data, adequate therapy of alcohol-related disorders, according to the guidelines, is not feasible. This has to be considered when further developing the finance compensation system based on the described superseded elements of the German Institute for Hospital Reimbursement. PMID:26842899

  13. Trajectories of Drinking Urges During Individual- and Couple-based Cognitive-Behavioral Treatment for Alcohol Use Disorders

    PubMed Central

    Hallgren, Kevin A.; Owens, Mandy D.; Brovko, Julie M.; Ladd, Benjamin O.; McCrady, Barbara S.; Epstein, Elizabeth E.

    2016-01-01

    Individuals receiving treatment for alcohol use disorders (AUDs) often experience urges to drink, and reductions in drinking urges during cognitive-behavioral therapy (CBT) predict better treatment outcomes. However, little previous work has examined patterns of daily drinking urges during treatment. The present study examined patterns of change in daily drinking urges among participants in two randomized clinical trials of males (N = 80 with 4401 daily recordings) and females (N = 101 with 8011 daily recordings) receiving individual- or couples-based CBT. Drinking urges were common during treatment, occurring on 45.1% percent of days for men and 44.8% for women. Drinking urges and alcohol use for both genders decreased substantially during the course of treatment. Both genders had increases in drinking urges as more time elapsed since attending a treatment session. For men, this increase was most pronounced at the beginning of treatment, but for women it was most pronounced near the end of treatment. Alcohol use and drinking urges were both more likely to occur on weekends. The results suggest that these times may lead to higher risk for drinking, and clients may benefit from high-risk planning that is focused on these times.

  14. Coupled electron beam radiation and MBR treatment of textile wastewater containing polyvinyl alcohol.

    PubMed

    Sun, Weihua; Chen, Jun; Chen, Lujun; Wang, Jianlong; Zhang, Yongming

    2016-07-01

    Advanced oxidation processes (AOP) can be combined with biological treatments for recalcitrant organic pollutant decomposition. However, there has been no thorough investigation on the coupling of AOPs and membrane bioreactors (MBR) to treat polymer organic pollutants. This study proposes a new AOP that couples electron beam (EB) radiation and MBR treatment. This method was applied to treat real textile effluents containing polyvinyl alcohol (PVA). During the stable operation stage, 31 ± 7% (n = 28) COD was removed by the EB-MBR process. COD removal was enhanced to 45% at the end of the research period without process optimization. In addition, both the membrane flux and activated sludge system exhibited good stability. Only a 2% membrane flux decreased was observed after a 46 d operation period. PVA radiolysis and biofacies analysis mechanisms are also discussed. By contrast, PVA degradation using only the MBR treatment was ineffective in this study. This ineffectiveness was caused by membrane interception and floccule formation by PVA and activated sludge. PMID:27107385

  15. Oxidative Mineralization and Characterization of Polyvinyl Alcohol Solutions for Wastewater Treatment

    SciTech Connect

    Oji, L.N.

    2003-08-07

    Photochemical and ultrasonic treatment of polyvinyl alcohol (PVA), derived from PVA fabric material, with hydrogen peroxide was evaluated as a primary method for PVA mineralization into simpler organic molecules. PVA-based waste streams have been found to be compatible with nuclear process wastewater treatment facilities only when solubilized PVA is more than 90 percent mineralized with hydrogen peroxide. No undesirable solid particles are formed with other nuclear process liquid waste when they are mixed, pH adjusted, evaporated and blended with this type of oxidized PVA waste streams. The presence of oxidized PVA in a typical nuclear process wastewater has been found to have no detrimental effect on the efficiency of ion exchange resins, inorganic, and precipitation agents used for the removal of radionuclides from nuclear waste streams. The disappearance of PVA solution in hydrogen peroxide with ultrasonic/ ultraviolet irradiation treatment was characterized by pseudo-first-order reaction kinetics. Radioactive waste contaminated PVA fabric can be solubilized and mineralized to produce processible liquid waste, hence, no bulky solid waste disposal cost can be incurred and the radionuclides can be effectively recovered. Therefore, PVA fabric materials can be considered as an effective substitute for cellulose fabrics that are currently used in radioactive waste decontamination processes.

  16. A pharmaceutical industry perspective on the economics of treatments for alcohol and opioid use disorders

    PubMed Central

    Gastfriend, David R

    2014-01-01

    Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence-based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA-approved addiction pharmacotherapies (oral naltrexone, extended-release naltrexone, acamprosate, disulfiram, buprenorphine, buprenorphine/naloxone, and methadone) are intended for use in conjunction with psychosocial management, not as stand-alone therapeutics; hence, pharmacotherapy costs must offer benefits in addition to abstinence alone or psychological therapy. Patient persistence is problematic, and (despite its cost) extended-release pharmacotherapy may be associated with lower or no greater total healthcare cost, mostly due to reduced hospitalization. The reviewed studies use rigorous case-mix adjustment to balance treatment cohorts but lack the randomization that clinical trials use to protect against confounding. Unlike trials, however, these studies can offer generalizability to diverse populations, providers, and payment models—and are of particular salience to payers. PMID:25236185

  17. Design, Synthesis and Biological Evaluation of Aminoalkylindole Derivatives as Cannabinoid Receptor Ligands with Potential for Treatment of Alcohol Abuse

    PubMed Central

    Vasiljevik, Tamara; Franks, Lirit N.; Ford, Benjamin M.; Douglas, Justin T.; Prather, Paul L.; Fantegrossi, William E.; Prisinzano, Thomas E.

    2013-01-01

    Attenuation of increased endocannabinoid signaling with a CB1R neutral antagonist might offer a new therapeutic direction for treatment of alcohol abuse. We have recently reported that a mono-hydroxylated metabolite of the synthetic aminoalkylindole cannabinoid JHW-073 (3) exhibits neutral antagonist activity at CB1Rs and thus may serve as a promising lead for the development of novel alcohol abuse therapies. In the current study, we show that systematic modification of an aminoalkylindole scaffold identified two new compounds with dual CB1R antagonist/CB2R agonist activity. Similar to the CB1R antagonist/inverse agonist rimonabant, analogues 27 and 30 decrease oral alcohol self-administration, without affecting total fluid intake and block the development of alcohol-conditioned place preference. Collectively, these initial findings suggest that design and systematic modification of aminoalkylindoles such as 3 may lead to development of novel cannabinoid ligands with dual CB1R antagonist/CB2R agonist activity with potential for use as treatments of alcohol abuse. PMID:23631463

  18. Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease

    PubMed Central

    Di Minno, Matteo Nicola Dario; Russolillo, Anna; Lupoli, Roberta; Ambrosino, Pasquale; Di Minno, Alessandro; Tarantino, Giovanni

    2012-01-01

    Non-alcoholic fatty liver disease (NAFLD) has been recognized as a major health burden. It is the most important cause of chronic liver disease and a major independent cardiovascular risk factor. Lacking a definite treatment for NAFLD, a specific diet and an increase in physical activity represent the most commonly used therapeutic approaches. In this review, major literature data about the use of omega-3 polyunsaturated fatty acids (n-3 PUFAs) as a potential treatment of NAFLD have been described. n-3 PUFAs, besides having a beneficial impact on most of the cardio-metabolic risk factors (hypertension, hyperlipidemia, endothelial dysfunction and atherosclerosis) by regulating gene transcription factors [i.e., peroxisome proliferator-activated receptor (PPAR) α, PPARγ, sterol regulatory element-binding protein-1, carbohydrate responsive element-binding protein], impacts both lipid metabolism and on insulin sensitivity. In addition to an enhancement of hepatic beta oxidation and a decrease of the endogenous lipid production, n-3 PUFAs are able to determine a significant reduction of the expression of pro-inflammatory molecules (tumor necrosis factor-α and interleukin-6) and of oxygen reactive species. Further strengthening the results of the in vitro studies, both animal models and human intervention trials, showed a beneficial effect of n-3 PUFAs on the severity of NAFLD as expressed by laboratory parameters and imaging measurements. Despite available results provided encouraging data about the efficacy of n-3 PUFAs as a treatment of NAFLD in humans, well-designed randomized controlled trials of adequate size and duration, with histological endpoints, are needed to assess the long-term safety and efficacy of PUFA, as well as other therapies, for the treatment of NAFLD and non-alcoholic steatohepatitis patients. It is worthwhile to consider that n-3 PUFAs cannot be synthesized by the human body and must be derived from exogenous sources (fish oil, flaxseeds, olive

  19. Alcohol withdrawal

    MedlinePlus

    ... Seeing or feeling things that aren't there (hallucinations) Seizures Severe confusion ... alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens. Treatment may ...

  20. Alcoholism and Alcohol Abuse

    MedlinePlus

    ... This means that their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or ... brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the risk of ...