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Home > Alcohol Matrix cell A3: Interventions - medical treatment.

Drug and Alcohol Findings. (2016) Alcohol Matrix cell A3: Interventions - medical treatment. London: Drug and Alcohol Findings and the Substance Misuse Skills Consortium. 5 p.

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URL: http://findings.org.uk/PHP/dl.php?file=Matrix/Alco...


The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-related problems). It maps the treatment universe and for each sub-territory (a cell) lists the most important UK-relevant research and guidance. Across the top, columns move from specific interventions through how their impacts are affected by the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. 

What is cell A3 about?

About the treatment of alcohol dependence in a medical context and/or involving medical care, typically by GPs or by alcohol treatment or psychiatric units in hospitals. Clinical staff are responsible for medications, so the centrality of these to an intervention distinguishes it most clearly as medical. Drugs (primarily benzodiazepines) help patients withdraw from alcohol more comfortably and safely, or (primarily in the UK acamprosate, but also naltrexone and disulfiram) are intended to sustain longer term abstinence or moderate drinking.

But drugs are never all there is to medical care. They help to forge a relatively intoxication-free space during which patients can lose the habit of regular drinking and be supported to find other ways to cope and construct lives incompatible with a return to heavy drinking. Drug-based treatments also include potentially therapeutic interactions with clinical and other staff, and ways to encourage patients to take medications. Sometimes this means enlisting family and others, deepening their involvement in the patient’s recovery. Without these factors there is a risk that any benefits of medication will be lost once the treatment ends.

Though usage has been increasing, in Britain treatment for alcohol dependence usually consists entirely of advice and support. Drugs are almost universally used to ease withdrawal in inpatient units, but in 2013/14 in England, of the 101,782 drinkers treated in non-residential community settings, just 16% were prescribed a medication. As we’ll see later in this bite, relegation of medications to a minority option accurately reflects their generally minor effects relative to the other influences which together constitute the ‘placebo effect’ seen in trials. For this ‘disease’, medications usually add little (but on average, do add a little) to the patient’s impetus to get better, the processes in their life which help them realise and sustain this ambition, and the impact of deciding to enter and get actively engaged in treatment, one manifestation of which is regularly taking medication.

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