Home > Guidelines for the treatment of alcohol problems.

Haber, Paul and Lintzeris, Nicholas and Proude, Elizabeth and Lopatko, Olga [Australian Government, Department of Health and Aging] . (2009) Guidelines for the treatment of alcohol problems. Sydney: Commonwealth of Australia. 267 p.

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Summary of recommendations vii
1. Introduction 1
• Purpose of the guidelines 1
• Structure of the guidelines 1
• Evidence-based health care 3
• Community and population approaches to alcohol problems 4
• A note on terminology 4

2. Prevalence of alcohol consumption and related harms in Australia 7
• Prevalence of alcohol use 7
• Alcohol-related harm 8

3. Screening, assessment and treatment planning 13
• Screening 13
• Comprehensive clinical assessment 21
• Treatment planning 32

4. Brief interventions 41
• Who to target for brief interventions 41
• How to deliver brief interventions 42
• Who can deliver brief interventions? 43
• Where should brief interventions be delivered? 43
• Limitations of brief intervention 45

5. Alcohol withdrawal management 49
• Alcohol withdrawal syndrome: Clinical presentation 49
• Assessment and treatment matching 51
• Supportive care 57
• Medications for managing alcohol withdrawal 61
• Treating severe withdrawal complications 68
• Wernicke–Korsakoff’s syndrome 76

6. Psychosocial interventions for alcohol use disorders 81
• Overview of psychosocial interventions 81
• When to use psychosocial interventions 82
• Choosing psychosocial interventions: a stepped care approach 82
• Motivational interviewing 85
• Cognitive behavioural interventions 86
• Relapse prevention strategies 89
• Residential rehabilitation programs 89

7. Pharmacotherapies for alcohol dependence 93
• Naltrexone 93
• Acamprosate 96
• Combined acamprosate and naltrexone 98
• Disulfiram 98
• Other medications 101
• Integration with psychosocial treatments 102
• Increasing medication adherence 102
• Selecting medications for individual patients 103

8. Self-help programs 107
• Alcoholics Anonymous 107
• SMART RecoveryR 110
• Self-help for families 111

9. Specific populations 115
• Adolescents and young people 115
• Pregnant and breastfeeding women 121
• Indigenous Australians and people from other cultures 130
• Older people 135
• Cognitively impaired patients 138

10. Comorbidities 145
• Physical comorbidity 145
• Co-occurring mental and alcohol-use disorders 147
• Polydrug use and dependence 153

11. Aftercare and long-term follow-up 161
• Aftercare 161
• Working with the persistent problem drinker 161

Appendixes 165
• Appendix 1 Screening and diagnostic instruments 167
• Appendix 2 Diagnostic criteria for alcohol use disorders 195
• Appendix 3 Withdrawal scales 197
• Appendix 4 Alcohol and drug interactions 202
• Appendix 5 Getting through alcohol withdrawal: A guide for patients and carers 205
• Appendix 6 A guide for people with alcohol-related problems 208
• Appendix 7 Disulfiram Agreement 213
• Appendix 8 Treatment guidelines for mental disorders 214
• Appendix 9 Standard drinks 215

Glossary 221
Acronyms 225
References 229


Item Type:Evidence resource
Publication Type:Guideline
Drug Type:Alcohol
Intervention Type:AOD disorder treatment method, AOD prevention, AOD disorder harm reduction, Screening, AOD disorder, AOD disorder drug therapy, Rehabilitation/Recovery, Alternative medical treatment, Education and training, Psychosocial treatment method
Source:Australian Government, Department of Health and Aging
Date:2009
Pages:267 p.
Publisher:Commonwealth of Australia
Place of Publication:Sydney
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:A Substance use, abuse, and dependence > Natural history of substance use > Recovery
B Substances > Alcohol
B Substances > Opioids (opiates) > Opioid product > Naltrexone
E Concepts in biomedical areas > Pregnancy
G Health and disease > Substance related disorder > Dual diagnosis (comorbidity)
G Health and disease > Substance use disorder > Alcohol use > Alcohol intoxication
G Health and disease > Substance use disorder > Alcohol use > Alcohol dependence
G Health and disease > Substance use disorder > Alcohol use > Alcohol withdrawal syndrome
HA Screening, identification, and diagnostic method > Medical screening and diagnostic method
HA Screening, identification, and diagnostic method > Psychosocial screening and diagnostic method
HJ Treatment method > General treatment method concepts
HJ Treatment method > Substance disorder treatment method
HJ Treatment method > Substance disorder treatment method > Substance replacement method (substitution)
HJ Treatment method > Substance disorder treatment method > Substance replacement method (substitution) > Disulfiram therapy
HJ Treatment method > Substance disorder treatment method > Substance disorder relapse prevention method
HJ Treatment method > Psychosocial treatment method
HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention
HJ Treatment method > Directive and nondirective therapy > Psychoanalytic therapy > Cognitive behavioural therapy (CBT)
HJ Treatment method > Psychosocial treatment method > Motivational interviewing
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for substance use
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines
T Demographic characteristics > Elderly / Older person
VA Geographic area > Australia and Oceania > Australia

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