Alcohol-withdrawal syndrome: treatment strategies
DOI:
https://doi.org/10.20882/adicciones.424Keywords:
Alcohol dependence, alcohol withdrawal syndrome, detoxification, abstinence-motivation, relapsepreventionAbstract
Background: Due to high morbidity as well as severe medical and psychosocial consequences, alcoholism is one of our society’s most serious health and social problems. Inpatient detoxification is probably the decisive phase in the whole treatment strategy. Method:We review the related literature and discuss the relevant dimensions of alcohol-withdrawal syndrome treatment strategies. Results: Our discussion is based on an incremental treatment program with specified characteristics at each stage. The stages include: diagnostic process, first measures after admission, medical and psychotherapeutic issues, treatment coordination, and finally, discharge and follow-up planning. We advocate appropriate measures at each stage (pharmacology, examination guide, motivation program, relapse prevention). After reviewing the most prevalent pharmaceutical treatments for alcohol withdrawal, we outline recommended treatments according to the degree of withdrawal, from mild symptoms to delirium tremens. Some drugs were effective, such as: clomethiazole, haloperidol, carbamazepine, tiapride, diazepam, clonidine, disulfiram, acamprosate and naltrexone. There were also effective psychotherapeutic approaches (group psychotherapy with confrontation techniques, defence-mechanism analysis, selfmanagement led by value reorientation and behaviour therapy). Conclusion: The treatment of alcohol-withdrawal syndrome entails a substantial medical component, but its success also depends upon a multidimensional and personalised treatment plan. The treatment must include an abstinence-motivation program and address relapse-prevention issues, beginning during the hospital stay and continuing as an outpatient strategyReferences
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