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Comprehensive review and amalgamation of findings from studies enabling a comparison of controlled drinking versus abstinence as treatment goals concludes that even among diagnosably dependent drinkers, neither has the advantage in promoting low-risk (non-)drinking.
HOT TOPIC 2021 HTM file
‘Dangerous data’: drinking after dependence
First cracked in 1960s London, the orthodoxy that abstinence is the only feasible treatment goal for ‘alcoholics’ seemed shattered in 1973 by evidence that even physically dependent patients could learn to drink in moderation. Controversy was fierce, reaching the US Congress, TV networks and the courts. Explore the history and contested research behind an issue facing every dependent drinker starting treatment.
MATRIX CELL 2021 HTM file
Alcohol Treatment Matrix cell D5: Organisational functioning; Safeguarding the community
Key studies on organisational influences on alcohol treatment where the main aim or a major outcome is to reduce crime or otherwise safeguard the community. In the context of a market which drives treatment organisations to expand, asks, “Is small beautiful?”, explores the implications of focusing treatment on the family rather than the patient, and finds signs that control responsibilities can undermine therapeutic quality.
MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell C2: Management/supervision; Generic and cross-cutting issues
Key studies on management and supervision across psychosocial and medical treatments of problem drinking. Highlights that “Manners Matter”, focuses on staff recruitment, queries the ubiquitous stages of change model, and details the fascinating history of the most controversial issue in alcohol treatment: whether to insist dependent drinkers try for abstinence. See the rest of row 2 of the matrix for more on features common to psychosocial and medical treatments.
MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell C4: Management/supervision; Psychosocial therapies
Seminal and key studies on management and supervision in psychosocial therapies. Focus is on evidence of the need for post-training ‘coaching’ and for letting therapists know how their clients are doing – especially when they are doing badly.
STUDY 1962 HTM file
The abstinent alcoholic
Classic description of the patient who has sustained abstinence after treatment but is still unhappy, unfulfilled and/or nervously hanging on – in other words, not really ‘recovered’. They formed the majority of patients seen at Connecticut’s alcohol clinics in the 1950s who were not drinking at follow-up.
Around the world, programmes which take a spiritual or overtly religious route to overcoming substance use problems are extremely common and in some countries dominant – but do they work any better than the alternatives? This review systematically sifted the evidence from the past 30 years.
Is it feasible (and desirable) to give regular doses of alcohol to hospital inpatients when supervised withdrawal or short-term abstinence from drinking is not a realistic goal?
REVIEW 2019 HTM file
Family-based prevention programmes for alcohol use in young people
Findings of this comprehensive review seem to almost entirely deflate what in the mid-2000s was a bubble of enthusiasm for parental programmes as a way to prevent or reduce drinking among teenagers – but despite this overall verdict, some interventions have had remarkable results.
With patchy evidence of the effectiveness of baclofen, and serious concerns about the medication’s safety, is it ‘premature’ for the muscle-relaxant to be prescribed as a treatment for alcohol use disorders?
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