‘Towards a comprehensive system for treating alcohol-related problems’ was the title of the fourth annual conference held by the Addiction Research Centre in Trinity College Dublin in September 2004. A panel of speakers addressed various aspects of alcohol treatment from both a national and an international perspective.

The first two speakers outlined the effectiveness, diversities and similarities of alcohol treatment systems internationally.

• Dr Thomas Babor, University of Connecticut, focused on the scientific evidence for strategies and interventions designed to prevent or minimise alcohol-related harm, including treatment services. He summarised the results of Project MATCH, the largest controlled treatment evaluation study ever conducted.1 This study looked at the effectiveness of matched medication-free therapy for individual clients. At the end of his presentation Dr Babor discussed the implications for alcohol policy of research on treatment methods.
   
• Dr Harold Klingemann, University of Applied Sciences, Bern, discussed the diversity and similarities across alcohol treatment systems. He firstly defined treatment and examined its concepts; this was followed by a description of the International Study of the Development of Alcohol Treatment Systems (ISDRUTS), which was carried out between 1984 and 1990 in 16 countries. He ended the presentation by focusing on the trends in alcohol treatment in various countries, which include: new financing schemes, increased monitoring, evidence-based practice and less focus on illicit drugs.

The second session focused on the developments and failures of Irish alcohol treatment systems.

• Mr Rolande Anderson, Irish College of General Practitioners, presented a paper entitled ‘Helping Patients with Alcohol Problems’. An in-depth look at the increase in alcohol consumption in Ireland and its societal costs was followed by an examination of the relationship between the severity of alcohol problems and the type of interventions needed. He identified opportunities for recognising problem alcohol use among attendees at general practice. Mr Anderson concluded his presentation by calling for an increase in the amount of research/resources presently allocated to alcohol-related problems in Ireland, particularly at primary care level.
   
• Dr Shane Butler, Addiction Research Centre, Trinity College, began his paper by reviewing alcohol treatment planning and service delivery in Ireland over the past 20 years. He continued by identifying the main factors that explain the failure to create an integrated, comprehensive treatment system at local and regional levels in this country. Finally, he argued that there is a need to challenge popular perceptions of and professional intransigence towards alcohol misuse in Ireland.

The final session of the day focused on alcohol policy and the prospects for change.

• Dr Betsy Thom, Middlesex University, provided an overview of trends in the development of alcohol treatment policy in England since 1950. She outlined ways in which treatment policy has changed and the factors that have prompted change or resulted in stagnation.
   
• In the final paper of the day, Barry Cullen, Addiction Research Centre, Trinity College, explored the need to re-orient the Irish alcohol treatment system towards a public health model. He argued that there is a need to develop more research into alcohol misuse; it is also necessary, he claimed, to acknowledge and learn from the failures in the current system and to listen to the demands for change from the public and from professionals working in the area. He concluded by outlining prospects for change, which include: the need for major investment, the need to consider an integrated drug and alcohol approach, and the need for substantial organisational change at all levels within health and social care systems.

1. For more detailed information on Project MATCH, see Babor T and Del Boca FK (2003) Treatment matching in alcoholism. Cambridge University Press.